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Apr 17 2012

The Null HypotheCis

“You’re right, Cliff. You can’t prove who you are. None of us can. If we try to prove we exist, we’re just suckers. And if we ask other people to tell us we’re real, we’ve lost everything.

Cliff… listen to me. All you can do- all any of us can do- is make a decision. You’ve got to say, from all the way down, ‘This is who I am. I’m Cliff Steele and I’m a human being’”

-Kate “Coagula” Godwin, Doom Patrol #74, by Rachel Pollack

When you spend enough time hanging around trans folk, and talking together, sharing, reminiscing, telling stories, kvetching about all the irritating things the grues do, articulating your experiences and listening to theirs and finding those pangs of recognition that assure you (at last!) that it isn’t / wasn’t something unique to your own little mismatched brain, you begin to recognize commonalities. Recurrent themes. Motifs. Certain stories that get retold again and again across our lives, varying the genres and settings and principal protagonists but not the arc.

Amongst these are the stories of denial. The methods we used for convincing ourselves we can’t possibly really be trans, we simply must be making a mistake. They echo the concepts that thread through cis society and are used as a means of invalidating us. “It’s probably just a kink, a sex thing”, “it’s just a phase… if I just settle down with a woman, maybe have some kids, and learn how to be a good man, it will go away”, “doesn’t everybody, on some level, sort of want to be the opposite sex?”, “I should just learn to live with being a feminine man”, “I just need to man-up, be more masculine, that will make it go away”, “maybe I’m just a self-hating gay man?”, “maybe I can just cross-dress on weekends? That will be good enough”, “It’s just my asberger’s”, “just my OCD”, “just my depression”, “just my lack of confidence”, “just my hatred of my identity”, “just…”.

And deepening this denial is the assumption that in order to accept the possibility of being trans, we have to prove it to ourselves. This, again, eerily echoes the external invalidations, demands and expectations placed upon us, as in the gatekeeping model. “But how do I know I’m trans? What if I’m wrong? What if I’m making a mistake? What if I regret it?”

These doubts typically persist well into the process of beginning transition, and usually don’t abate until the actual medical, physical processes (with their attendant joys, comfort and relief) have begun. We almost all are eventually approached by a young, new transitioner, who confides those doubts in us. And we’ve all heard it a million times before. Everyone, even the most confident, assured, outgoing and proud members of our community were at one time just as unsure, still struggling to work past the baggage of self-denial we’d carried along, and so meticulously constructed, for most of our lives.

What’s interesting, and where this again, for me, sheds a lot of light on the amazingly strange ways that belief and doubt operate in the human mind, on what beautifully irrational little things we are, and feels like an important touchstone for skeptics to explore, is that a lot of this irrational denial can itself be framed as the due, logical level of skepticism that such a drastic decision demands.

After all, surely if we’re going to risk so much, put so much at stake, in such a monumental “decision”, we should approach it carefully, and make sure to be certain, right? Shouldn’t we be looking for proof that we’re trans before gambling our whole lives on that being the case?

Well, maybe… if proof of being trans was even really something possible, beyond the simple proof of subjectively experiencing your identity and gender as such. But more importantly: we never ask ourselves for “proof” that we’re cis.

Cis is treated as the null hypothesis. It doesn’t require any evidence. It’s just the assumed given. All suspects are presumed cisgender until proven guilty of transsexuality in a court of painful self-exploration. But this isn’t a viable, logical, “skeptical” way to approach the situation. In fact it’s not a case of a hypothesis being weighed against a null hypothesis (like “there’s a flying teapot orbiting the Earth” vs. “there is no flying teapot orbiting the Earth”), it is simply two competing hypotheses. Two hypotheses that should be held to equal standards and their likelihood weighed against one another.

When the question is reframed as such, suddenly those self-denials, those ridiculous, painful, self-destructive demands we place on ourselves to come up with “proof” of being trans suddenly start looking a whole lot less valid and rational. When we replace the question “Am I sure I’m trans?” with the question “Based on the evidence that is available, and what my thoughts, behaviours, past and feelings suggest, what is more likely: that I’m trans or that I’m cis?” what was once an impossible, unresolvable question is replaced by one that’s answer is painfully obvious. Cis people may wonder about being the opposite sex, but they don’t obsessively dream of it. Cis people don’t constantly go over the question of transition, again and again, throughout their lives. Cis people don’t find themselves in this kind of crisis. Cis people don’t secretly spend every birthday wish on wanting to wake up magically transformed into the “opposite” sex, nor do they spend years developing increasingly precise variations of how they’d like this wish to be fulfilled. Cis people don’t spend all-nighters on the internet secretly researching transition, and secretly looking at who transitioned at what age, how much money they had, how much their features resemble their own, and try to figure out what their own results would be. Cis people don’t get enormously excited when really really terrible movies that just happen to include gender-bending themes, like “Switch” or “Dr. Jekyl And Mrs. Hyde”, randomly pop up on late night TV, and stay up just to watch them. Etc.

It makes sense to approach issues carefully, and remember to hesitate, doubt and question. But this only operates as constructive skepticism when the questions aren’t slanted towards biases, when the skepticism is equally distributed. To hold the idea of being trans to a highly critical standard, but to not hold the idea of being cis to any critical inquiry whatsoever, is not a rational skepticism, it is leaning into a particular perspective and conclusion you’re unfairly privileging, and attempting to rationalize a cultural bias (and psychological fear). To question one without questioning the other is no more an example of constructive, critical skepticism than is questioning the profit motives and bias of Big Pharma but taking it on faith that alt-med practitioners, naturopaths and homeopaths have nothing but good intentions. Or like trying to poke holes in the theory of evolution while simply leaving The Good Book as the assumed bedrock truth.

A good scientist doesn’t simply rigorously question one particular theory while leaving all other theories unchallenged. A good scientist weighs all the competiting hypotheses against one another on equal footing, equally demanding of evidence. At the very least, if she falsifies something, she knows to limit the conclusion to “this particular hypothesis is incorrect”, not suddenly assuming that a different hypothesis she happens to fancy must therefore be correct.

And you can’t falsify something as wholly subjectively defined as a gender identity anyway. And if you can’t falsify a claim, it’s a bit silly to demand it to be proven.

This treatment of cisgenderism as so thoroughly unmarked, so deeply embedded as the assumed default, the privileged “normal”, that is conceptually rendered the null hypothesis, the case that must only be disproven and never, ever is itself held as something that needs to be questioned, proven, something that one ought be “sure of”, that it ends up rendering cisnormativity a force so powerfully ingrained in our culture that it’s almost wholly inextricable. It fuels the attitudes that are taken towards deception and disclosure (“why didn’t you TELL ME you’re trans?” “Why didn’t you ask?” “Why would I ask?“), towards “passability” (“but you don’t look trans!”), towards our representation (Why are only explicitly trans characters ever considered trans characters? Is there anything really stopping us from imagining Princess Peach, Aloe & Lotus, Han Solo or Appolonia as transsexual?) our sexuality, our political and social and interpersonal responsibilities… so much hinges on the idea that unless you’re proven to be trans, you’re cis, and that’s that.

And of course the entire gatekeeping procedure is an extreme externalization of this entrenched cisnormativity, the assumption that cis is so incredibly “normal” that it’s the null hypothesis, that the burden of proof falls entirely on the hypothesis that the patient is trans, that she must meet a number of strict criteria before her claims to her gender identity will be accepted as true. At no point in the conventional gatekeeping model is the doctor ever expected to provide any evidence proving the contrary position, that the patient is really cis. And if a doctor or therapist suggests some possible theory for why a cis patient would become “duped” into believing himself transgender, again the burden of proof falls to the patient to falsify their assertion rather than for them to falsify her’s.

This whole idea that your subjective identity can’t be legitimate unless you’re somehow able to back it up with objective evidence is a pretty awful situation to be put in, especially when you’re inflicting it on yourself, given how any “proof” of being trans is entirely dependent on subjective experience. What proves that you’re trans is only to understand yourself as trans. When dealing with gatekeepers and family and the numerous external forces that would deny us our identities, it’s not such a crippling situation, because at least we know, and we are the proof, and beyond that it’s simply a matter of figuring out what they think would count as “proof” and what exactly they need to see or hear to believe you (if anything). But when imposing this situation on yourself, when the only possible actual certainty is in accepting and understanding yourself as trans, but you refuse to accept and understand yourself as such until you have that certainty… you’ve created an impossible situation for yourself.

Maybe someday we’ll have brain scans that can analyze the parts of the brain that are “atypical” (or, as I’ve taken to saying, extraordinary) in gender variant individuals and thereby determine whether or not you have the neurological features that indicate a predisposition to transgenderism, the best it could do is determine a predisposition. Such a system could never ethically be used as a singular, definitive diagnostic tool, and given the subjectivity and self-determined nature of gender, there’d still be an abundance of “false positives” and “false negatives” (though even those concepts don’t make much sense). The responsibility for giving yourself permission to define yourself as a woman, a man, in-between, both, neither, or apart would still land on your shoulders. The same questions would linger. And we’d just come up with new ways to rationalize it away and maintain denial.

Truthfully, you’re always going to be able to find little “what ifs”. Little uncertainties. Little bits and pieces of yourself that MAYBE aren’t TOTALLY in line with the gender to which you’re transitioning (or wish to transition). Aspects of who you are that don’t fit into the archetypal, perfect, “true transsexual” narrative. Nobody fits that narrative perfectly. And yeah, maybe, philosophically speaking, a given trans woman might on some level “really be a dude” and a given trans man might in some way “really be a chick”. But you know, even if that IS true of yourself, and you aren’t “really trans” or aren’t “trans enough”… whatever parts of yourself, whatever fragments of you might “really” be cis or “really” your assigned sex, they really don’t mean a damn thing beyond what they mean for you. And frankly, if being “really” cis and “really” your assigned sex, playing along with who you “really” are,  isn’t doing a sufficient job of making you happy and well and at home in your body, then you should tell it to go fuck itself. Go ahead and give yourself permission to “be something you’re not”, proof or no proof, if that’s what’s going to give you a chance at some semblance of happiness, comfort and fulfillment in this life. That’s all we’ve got, after all. And no one gets to judge your identity and its sincerity and legitimacy but you.

When we start looking for approval of our feelings, and assurances that they’re real and that they count, beyond the subjective certainty and realness of experiencing those feelings, we’re lost. Well and truly lost, looking for a path we simply can’t find. And when you’ve made doing what you need to do in order to be happy conditional on that approval and assurance, we’ve resigned ourselves to unhappiness. A self, an identity, a gender… these aren’t really fixed, concrete facts in the world. These are means. Processes by which we understand ourselves and our relationship to things, and articulate and express them. You’re never going to get any certainty beyond the certainty you yourself assert, or any assurance beyond the sense of I am. This is who I am. This is what I am experiencing. This is what I want. This is what I need to do.

That’s all the evidence you’ll ever have, and all the evidence you’ll ever need.

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  1. 1
    Human

    Just wanted to thank you for an awesome blog post. I’m agender, and often i just think that maybe i’m just cis and have some weird delusions. Texts like this have helped me figuring things out and rooting the “null hypotheCis” from my own thinking.

  2. 2
    Miri

    When I first “heard” you mention this way of reframing the questions surrounding being trans (I can’t if it was in another post, or somewhere else), I thought it was wonderful. It’s really helpful, and as you said, is a much more rational way of thinking it through.

    I still experience weird nagging doubts, when I encounter something, some behaviour, or preference, or whatever, that seems prevalent in other women, either cis or trans, in real life, or online, on TV, or in movies, that I don’t share. I invariably ask myself, “am I sure about this, am I really trans?” And it’s an impossible question to answer. But if I consider the inverse, “am I cis” things become very different. I can quite easily conclude that I am not. The evidence is overwhelming. And I can almost as easily conclude that I’m not a man. And really, while I can’t prove that I’m a woman, I know that I’ve always, desperately, wanted to be one, so in the end, proving this hardly matters.

    Of course, the idea that being cis is as questionable as being trans is one that will be very hard to disseminate and have accepted. But I think that this is really an important piece in the puzzle of having trans people normalized in the public consciousness.

    1. 2.1
      Natalie Reed

      I first mentioned it in our secret FB no-grues club. That’s what gave me the idea for this post.

      1. Abbey

        This is good. I’ll try to bring it up at the next Monday group.

      2. Azure-

        Secret Facebook no-grues club? How do I get in? :o

        1. Alex Anonymus

          Digging the “grue” reference. I shall keep my torch handy just in case.

          And this is a wonderful article. I have had those doubts so many times and likely will have them some more before it’s all said and done.

    2. 2.2
      leni

      I still experience weird nagging doubts, when I encounter something, some behaviour, or preference, or whatever, that seems prevalent in other women, either cis or trans, in real life, or online, on TV, or in movies, that I don’t share.

      Your comment made me realize something about my own cis-ness: I do not know how to think of myself as female without connecting it to either my body or by other people’s recognition of it. I don’t, and probably can’t, think that “I feel like a female” because… I don’t know. I just can’t. Because I don’t know what it means to feel female without thinking about my female body or my “place” as a female in my culture. I don’t even know how to think about it outside of those contexts.

      And I’m not trying to make light of what must be a very difficult process, but it occurred to me that you are in a place to have some insight into this that I’m not sure cis women can even have. I’m sure there are cis women out there who are more perceptive about this than I am and maybe some of them figured it out, but I literally think I’m incapable of separating my inner womanness from my outer, if that makes sense.

      Maybe by engaging in that internal dialogue and constant questioning you have an opportunity to learn more about what it is to be a woman, at least for yourself but potentially all of us, than those of us who never question it.

      So, with regard to your other comment:

      Of course, the idea that being cis is as questionable as being trans is one that will be very hard to disseminate and have accepted.

      The very nature of cis-ness makes it very hard to question because, like me, I think most cis people just do not (and maybe can not) think of our genders as something separate from our bodies. Cultural issues and gender roles aside, there just isn’t that much to question. It’s sort of like “Body matches feeling? Check. Ok now what? Should we do some Mendel diagrams or something?”

      It’s not so much a null hypothesis as something that just doesn’t have much potential to really tell us anything we don’t already “know”. Often it is the exception that is the most enlightening. I think that’s just as true for trans people as it is for any other kind of person outside any norm. Maybe even more so.

      1. Natalie Reed

        One thing I’ve been thinking about lately as a possible hypothetical (and I cant remember if it was you who I posed this to lately?)… let’s say your brain is put in a robot body that isn’t explicitly gendered female. Given how people tend to view robots as male unless their deliberately designed as “femme-bots”, everyone starts calling you “he” and conceptualizing you as male. Would you feel the need to correct them? Would you still have a female identity? Would you still be a woman?

        1. WMDKitty -- Survivor

          That’s an interesting question — I would really have to sit down and think about it, though.

        2. Xanthë, Amy of my threads

          Yay, cyborgs! Unless we’re talking about Cybermen, where the transplanted brain had all emotions and sense of gender identity obliterated by some circuitry that was described as a “emotional inhibitor”, then a body that belongs to a woman who is still in possession of all of her mental faculties, is still a woman’s body. :-)

          And in case people were unaware, the Cyberman arc of series 2 of the new Doctor Who is totally awesome!

          1. Natalie Reed

            You know, now that I think of it… remember how rich, old, badguy who created the Cybus Cybermen specifically mentioned obliterating gender as part of his utopian vision? And he did… but it’s the emotional inhibitor that obliterates it, not the metal body. And yet we still call them CyberMEN, don’t we? Says something, doesn’t it? But yeah: parallel Jackie Tyler as a Cyberman was no longer a woman. But the second The Doctor and Mickey shut down the inhibitors…

          2. WMDKitty -- Survivor

            Speaking of the good Doctor, Daleks. Do Daleks have gender identities? All they are is brains in super-high-tech robotic pepper pots, but they were once living, breathing humanoid people.

          3. Xanthë, Amy of my threads

            <Doctor Who geekiness>
            It’s in the Cybes’ ultimatum in the final episode of season 2, once they have invaded ‘our’ Earth: “Cybermen will remove sex and class and colour and creed. You will become identical. You will become like us.”
            Back in episode 6, both robo-Jackie and the Cyberman deactivated by Doctor and Mrs Moore can remember their names, but the one which has its emotional inhibitor knocked out wonders where her fiancé is, and remember she is to be married the next day.
            CyberMEN is a name that was coined in the dark ages of the 1960s of course, so the presence of MEN is indicative of it being assumed to generically stand for “human”. The Star Trek Borg are an obvious updating of the same idea.
            As for the Daleks, the show’s mythology has it that they are the eventual evolved form that the humanoid Kaleds would have reached after countless mutations from the radiation released in the nuclear wars that ravaged their planet, a process that was accelerated and warped by Davros – it seems he might have had little need for retaining gender along with qualities such as mercy and pity.
            Other interesting Doctor Who aliens: Sontarans are all clones of the original warrior who are hatched by the million, and aren’t gendered; the intelligent species of Alpha Centauri (featured in the Third Doctor’s stories on Peladon) are described by the Doctor as ‘hermaphodite hexapods’.
            </Doctor Who geekiness>

          4. Natalie Reed

            It certainly does disappoint me a tad that of the hundreds of alien species we’ve seen The Doctor encounter, the vast vast majority have been sexually dimorphic in a sense that is easily read as male/female.

            And it also intensely bothers me that the only explicitly transsexual character he’s encountered is Lady Cassandra, which is REALLY insulting in that she’s sort of supposed to represent the “perils of cosmetic surgery and vanity” and such. It ends up reading as “transition is just unnecessary and vain cosmetic surgery, and you all should totally learn to just accept yourselves!”. It kind of breaks my heart that Russell Davies would be Typical Privileged Cissexist Gay Man in his sole on-screen representation of us. And then there’s the former member of Torchwood that Jack off-handedly mentions, which does carry a slight implication of transition-as-”emotional problem”.

          5. WMDKitty -- Survivor

            Huh, hadn’t thought about that. But then again, how do they reproduce, if at all? Or are the Daleks effectively immortal?

          6. Natalie Reed

            They generally just reproduce by growning another dalek mutant from a chunk of dalek tissue taken from another dalek (or kaled… or, as in Bad Wolf / The Parting Of The Ways, kidnapped humans).

        3. hall-of-rage

          Have you ever seen the beginning of Caprica, prequel to the new Battlestar Galactica? (yes it’s related)

          1. Natalie Reed

            No. I’ve never seen BSG or Caprica at all. But I love joking about how Caprica’s alien world version of Vancouver’s skyline didn’t bother to edit the logo out of the Scotiabank Tower. Nice to know Scotiabank has off-world branches!

        4. leni

          …let’s say your brain is put in a robot body that isn’t explicitly gendered female. Given how people tend to view robots as male unless their deliberately designed as “femme-bots”, everyone starts calling you “he” and conceptualizing you as male. Would you feel the need to correct them? Would you still have a female identity? Would you still be a woman?

          Well yeah, because it would be me with all my experiences and memories intact, just magically transplanted into a new robot body. I would still be my female self, and probably even more pissed-offedly so. So point definitely taken.

          But I still don’t think I’d get it.

          1. Natalie Reed

            The point is that when you remove superficial things like the body and gender roles and all that from the equation, or consider them unimportant or non-deterministic, non-defining, gender identity is the aspect that persists and remains, that is who you ARE, even if everything else were to shift or be erased.

            A more scientificky way of looking at it is in terms of neurological body-map and proprioception. How the brain “expects” the physical body to be configured.

      2. alliecat

        I think the reason cis is thought of as a null hypothesis is at least partly *because* it’s unthinkable for the vast majority of cis people that they could be anything else – in the same way that for me now that I’ve mostly overcome the cisnormativity into which I was conditioned as a result of that, I can no longer imagine myself not being trans.

  3. 3
    Anders

    If you don’t know who you are, what makes you think someone else does?

    If the good people here were to draw up criteria for who gets access to the pharmacological and surgical means of transitioning, what would they include? Or is the very question of criteria a sign that I’m going wrong somewhere?

    1. 3.1
      Miri

      Not entirely wrong, just more asking for something unnecessary. It’s a bit silly to draw up a list of criteria for when those things should be provided, when there’s really only one that’s valid: because they want it.

      Think of this way. If I’m the only one who can say I’m trans, then if I say I am, under what rationale (other than where there is an actual, life-threatening reason) could be acceptable to deny me the treatment I require?

      No other criteria are necessary, or even desirable.

      1. Anders

        Doctors like to have symptoms and signs. Scientists even more so. :)

        Ok, let’s try a different tack. A therapist suspects that a person’s depression may be due to hir being a transsexual and denying it. What kind of questions should the therapist ask? What should ze be on the lookout for?

        1. hall_of_rage

          Natalie already gave a bunch of the most common evidence in this post. If a person is being honest with their therapist about their dreams and aspirations, it should be obvious enough most of the time, innit? If they’re not, presumably guessing wouldn’t do much good, but maybe somebody else has a better answer. I mean a better question would be, if you think your patient is trans, or if you think your friend is trans, what should you do?

          An even more relevant question to me: if your friend is trans, but putting off transitioning and you see them spiraling down, how can you help? I mean if you’re worried about their mental health, being pushy is presumably the worst thing to do?

        2. Miri

          I feel a bit funny, since you’ve asked this question twice, more or less, but meh…

          It’s difficult to answer this, because despite many common threads frequently existing in our personal narratives, every trans person’s experience is different. Even in the way their dysphoria manifests. And if this hypothetical person is in denial, it would be hard to get anything concrete out of them you could use.

          For example, if my psychologist I was seeing a year ago had posed any questions to me about whether I felt like my assigned gender or not, or whether I wanted to be a woman, or whatever, I would have vehemently denied it, all the while screaming “YES” inside…

          Really, I understand the difficulty this poses for scientists and medical practitioners. They are trained to look for objective evidence. The problem is there is nothing objective about this. It’s completely and utterly subjective. The only person who has the evidence, who can truly see it, is the trans person emself. Ey has to come to the conclusion about eir transness emself, or at least be able to admit that ey is in doubt over eir assigned gender (which would then allow psychotherapy to be employed to work through this and bring about a conclusion). The only evidence that’s going to ever be made available to medical practitioners or scientists is the trans person’s assertions of eir gender identity. There really is nothing else.

      2. alliecat

        I agree that the very question of diagnostic criteria beyond “does the person believe themselves to be trans?” is problematic, but I do think informed consent is important – “does the person understand all the potential outcomes and consequences of this particular treatment?”

    2. 3.2
      A. Person

      Anders, I would say you were on the wrong track. Given Internet pharmacies and other sources of DIY EEI, it’s too easy to bypass any criteria set by the medical community except those needed for surgical procedures. And historically, people forced themselves to comply with the criteria.

      It would be better if everyone backed off pressuring trans people to be certain or for proof. From what I’ve seen, the people who make decisions that they later regret almost always say they felt pressured into doing so.

      1. Anders

        You’re probably right. Apart from Secret Vault there are very few perks to being transsexual.

        Ok, I’ll try again – what are some of the common symptoms?

        Say I have a research question – e.g. does psychotherapy help patients to cope with dysphoria during HRT? I’d like to characterize the patients beforehand, so other people can see if my results can be generalized to other populations. Part of that is describing the symptoms the patients have. What questions should I ask if I want to catch the common symptoms?

        1. hall_of_rage

          Then hire someone like Natalie to help with your research.

          It’s a no-brainer, Anders: ask the specific questions when you are actually making an experiment; as a cis person without much experience in any trans community don’t expect to know what you are doing without consultation.

          1. hall-of-rage

            (Sorry, should’ve specified: a cis person *with* experience in trans communities should already know they need an assistant/consultant like Natalie, or anyone who is trans and knows something of others’ experiences.)

        2. A. Person

          The common symptom is that the patient reports an incongruence between their gender identity and assigned gender. ;)

          Trying to objectively measure gender dysphoria seems like a futile effort because you are trying to make comparisons between subjective experiences. Is a person who feels discomfort with their body only when they look in a mirror or a photograph of themself but frequently dreams about being of the other sex more or less dysphoric than someone in the opposite situation? Is someone with a high frequency of gender dysphoric thought more or less dysphoric than someone who reports high alienation with their body?

          How uncomfortable does a trans woman have to be with having a penis to qualify for SRS? Is mild discomfort enough? Does it have to feel totally alien? How do you objectively measure and quantify alienation from a body part anyway? Do you have to attempt auto-castration or is just thinking about it enough? How frequently? How do you get such data without relying on subjective reports? How does that fit with trans women who are comfortable with having a penis but still experience gender dysphoria? Do you end up agreeing with the TS separatists that these women are not really women because they don’t opt for SRS?

          If you find an objective measure, how do you prevent the spectrum that it identifies from becoming a hierarchy? Is a single linear measure good enough, or do you require multiple measures to locate a person in a gender identity phase space? How do you determine the region in that phase space that qualifies for medical assistance? What happens to a person who is located on the boundary of that region? How do you determine the error bars? How do you apply the error bars to people who fall along that boundary?

          Why is it necessary to treat trans issues like a disorder anyway?

          As for your research question, the way I would handle it is by examining the set of people that report an incongruence and opt for medical treatment, and periodically collect self-reported measures of their comfort. If the distribution at the end suggests that my population contained distinct sub-populations, then I would go looking at what determines those sub-populations. I wouldn’t be surprised that if what determined those sub-populations have more to do with broader social conditions. But I’m a bit concerned by the idea of trying to apply the results of a study of treatment effectiveness from one sub-population to another for anything more than hypothesis formulation. If I was concerned about the effectiveness of psychotherapy during treatment for a general population that exhibits symptom X, then I would go and select a broad range of people with symptom X, and not try to infer from a more specific population.

          1. Anders

            Why is it necessary to treat trans issues like a disorder anyway?

            Because it is. A disorder is a condition that in itself (i.e., apart from societal expectations) causes clinically significant suffering or impairment in daily life. So, homosexuality is not a disorder because in the absence of homophobia there would be no problems associated with it. But if all transphobes were converted into transphiles tomorrow, people would still need to transition. And until they’ve begun down that road, they would experience clinically significant suffering.

          2. Natalie Reed

            Yeah, I actually agree with this, and will write a post on it (someday).

            Though really, it’s not that being trans is a disorder. It’s that gender dysphoria (often wholly mitigated through transition) is.

          3. Anders

            I agree, that is a much much better way to describe it.

            It’s also worth remembering that much of the social safety net as well as insurance companies may demand an actual diagnosis. We had that problem with our patients. They were tested for a number of diagnoses, none of which fit very well. And so they were written off as lazy.

          4. A. Person

            I admit to rhetorical over-reach with that particular question.

            My unstated point was that there is a history of pathologizing behavior associated with trans women, and that it hasn’t been healthy or productive for either the medical community or trans women. The repeated query for symptoms annoyed me, because it felt like it missed the point of this particular post and harkened back to that sort of thinking.

            As for the social safety net, I would like to point out that while a diagnosis of GID may be useful in countries with more enlightened healthcare systems, it can be counter-productive in the US. Most US insurance companies refuse trans healthcare related costs when given trans related billing codes. All nontherapy-related treatment is considered experimental. If they can pin any future healthcare problems to trans related treatments, they will deny coverage for that as well.

            I’m sorry if I’m coming across ranty today. The costs of transition, both monetary and social, is a significant source of unnecessary stress in my life.

          5. Anders

            You were right to protest, it was I who was over the line. Again. *sigh*

            In an ideal world trans people would be intimately involved with the process of identifying Gender Dysphoric Disorder. Not the only ones, but certainly with great influence on the final product. And we need a diverse group of trans people as well, from all over the world and with all kinds of background. Hopefully, that would stop the pathologizing instinct and put the focus on what actually bothers trans people.

            But this is not the ideal world, unfortunately. I don’t know if GID is better than nothing – that’s not my area of expertise.

    3. 3.3
      Anders

      Yeah, I realized that I was too pushy and too oafish on the way home. I’m sorry for that. Is this what is called Othering – treating trans people like some exotic alien race to quanity and measure? I suppose I’m working through all the wrong ways to ask questions (and yes, I read Natalie’s post on how to ask questions; apparently I’m a slow learner).

      Once again, I’m sorry and I’ll try not to do it again.

  4. 4
    Michael

    Tangentially related to “proving who you are”, did you see that about 25,000 transgender people in the US may be effectively disenfanchised by the new rules requiring voters to provide personal ID in order to vote?

    http://www.thenation.com/blog/167402/how-gender-identity-may-determine-right-vote-2012

    1. 4.1
      Anders

      It was brought up in another thread, but yeah.. is that even legal under the Constitution? To disenfranchise an entire group of people?

      1. Kevin, Youhao Huo Mao

        “We have to protect against Voter Frauuud!!!”

        But, all reporting on voter fraud has either said it’s really minor or that it costs more money to put these measures in place.

        “Voter Frauuuud!! Dead people voting for Democrats!!!”

        It just doesn’t happen.

        “Voter Fraaaaaauuuuuuud!!!”

        *sigh*

      2. kagerato

        Sadly, the answer to that question depends on which court you ask. Barriers to voting have been ruled both legal and illegal before in different jurisdictions, or when the exact details differed in what were ultimately trivial ways.

        In my opinion, the entire issue has been turned on its head. In the context of voting, it is not the responsibility of the individual to prove they are who they say they are. Rather, it is the responsibility of the state to demonstrate the evidence that they are not who they claim. When that is infeasible, let them vote already.

        The entire activity of restricting voting rights based upon things that amount to an indirect poll tax is extraordinarily dubious. Considering the evidence and lack of counter evidence, this whole scheme is essentially a ploy to discourage and disadvantage voters who are more likely on average to vote Democratic or oppose Republican candidates. What they’d really like to do is restrict the vote only to rich white men, as it used to be, but that kind of advocacy was largely forced underground by public pressure.

        1. northstargirl

          The push for voter ID laws reminds me a *lot* of the opposition two decades or so ago to the “motor-voter bill” (that would allow you to register to vote while you were applying for a driver’s license). Many of the arguments against “motor-voter” carried a subtext of “if we make it that easy to register, it will help the Democrats, so we’re against it.”

          The older I get, the more I see the same old corn brought out to be roasted again, and again, and again.

    2. 4.2
      troll

      I would assumed that the people who pushed those laws through probably never considered for the slightest moment what the impact on trans people would be. I would also assume that had those same people considered said impact, they would have seen it as a feature rather than a bug.

    3. 4.3
      Natalie Reed

      Yep, I saw it. Don’t worry. I SEE AND KNOW ALL … …(trans-related major news items).

  5. 5
    yiab

    I’m curious, in this post you seem to be using “cis” to refer to a specific identity rather than simply “not trans”, which appears in contradiction to your earlier post about its etymology. Am I just missing something?

    1. 5.1
      Miri

      “Cis” does mean “not trans” in one sense, but in another, more accurate, sense it means the opposite of “trans”, in the same way that “right” could be interpreted as meaning “not left”, when it’s more accurate to see it as having it own meaning, one that stands in opposition to the other.

      Seen in this light, “cis” is just as much an identity as “trans” is. Keep in mind that “trans” is not in origin a self applied label. It was created by cis people to define and describe us, to make the “other”. It is an identity we adopt to take ownership of a term that was not created with our interests in mind. “Cis” is an invisible identity, much the same as “straight” was not so long ago. But it’s still an identity all the same.

      1. hall-of-rage

        I do find that such a useful analogy. That is,

        cis:trans :: right-handed:left-handed.

        The analogy doesn’t hold up for medical stuff, just social; but fortunately for me my schoolteachers did *not* tie my left hand to a chair while I learned to write.

  6. 6
    Stentor

    Great post. The “am I really …” question seems to assume there’s some set of ticky-boxes on our souls that we can be judged against. But there’s no soul, and no ticky-boxes. Do you want to transition? Then you’re trans. Do you not want to transition? Then you’re cis. Wanting or not wanting to transition are just want trans and cis mean. Those can be tough questions (or at least they were when I wrestled with them), but I found it more helpful to think in terms of what way of living would make me happy, not in terms of what would be congruent with some preexisting ontological fact about myself.

  7. 7
    Kevin, Youhao Huo Mao

    A few months ago I struggled with the whole “am I trans” or “am I genderqueer” issue. It was a huge struggle because of the whole “losing family, losing friends, losing job” aspect of coming out. Decided I was trans, and am happier for it. Now, after probably 15 years of pretending it was not an issue, I’m right about to go to a gender therapist – just as soon as I move.

    1. 7.1
      WMDKitty -- Survivor

      Best of luck with, well, the whole process.

  8. 8
    hall_of_rage

    HAHAHA the irony: I did exactly this where the null hypothesis was “straight”, and I didn’t even /want/ to be straight, but didn’t consider why that was. I’m not actually trying to say this is a big deal compared to being trans, e.g. there isn’t a “point of no return” for sexual orientation. But even so I only accepted myself as queer once I realized it was okay to have it be subjective and unproven. I love what you said on Sunday about not being in Kansas anymore. Thank you, Natalie.

  9. 9
    troll

    I’m rather surprised that you don’t think a brain scan or some other test could ever be definitive. Transgenderism (and cisgenderism as well) must have a physical cause, simply because everything must. Humanity’s ability to test for that sort of thing is currently pretty limited, but I see no reason why it must remain so in perpetuity.

    1. 9.1
      Miri

      It’s problematic because it’s possible that there could be more than one cause. So, hypothetically, a brain scan might be positive for a bout 30% (to make up a random number) of patients, say, but return negatives for the rest. And yet, the rest report the same feelings as those with positive scans. What would this mean? We’d be in the same place as now, except, there would be a great temptation in the medical profession to resume denial of treatment to some trans people because they failed to be properly diagnosed. And, it is possible to say that if there are multiple causes, that the possibility exists that effective tests may not be found for all of them.

    2. 9.2
      kagerato

      No, not everything has a cause, and not every cause that exists is observable, either. Where is the cause in the radioactive decay of an isotope? What is the cause of the Pauli exclusion principle which creates the electromagnetic force?

      Thinking that there is causal meaning in all things is a common mistake. It leans on determinism and implies agency and interaction in everything. Yet the genuine null hypothesis is that there is no cause until proven otherwise. In the absence of evidence, assume nothing.

    3. 9.3
      Anders

      If we find some brain sign – e.g., the size of certain subthalamic nucleus – there may still be so large overlap between cis and trans people that it’s clinically worthless. Tiny differences which can be noticed in a large material are interesting, but not particularly valuable for diagnosis.

  10. 10
    Brin Convenient

    “Cis people don’t get enormously excited when really really terrible movies that just happen to include gender-bending themes, like “Switch” or “Dr. Jekyl And Mrs. Hyde”, randomly pop up on late night TV, and stay up just to watch them. Etc.”

    And, Boom. Just when I start to think that maybe my experience is an outlier, that maybe I’m not, in fact, trans enough, that I’m somehow inauthentically calling myself trans, that maybe I’m too cis to be included in the trans nrrative (a result of identifying bigender is that my gender identity lines up with my sexual assignment sometimes), you say something that resonates through me like standing under a church bell.

    I remember seeing ads for Switch when it first came out, and being completely captivated by the idea that someone else thought of this idea, too. Watching Just One of the Guys and Little Sister and Ladybugs and all of those movies and wondering if it was really so easy, if I could “get away with it,” too. After all, even when they got caught, nothing bad really happened to them (except that cisheteronormativity was re-established).
    Those movies directly led me to transformation erotica, too. I just wanted to live in a world where that kind of switch, through magic or science, was not only possible, but easy. In fact, I couldn’t watch “It’s a Boy/Girl Thing” for just that reason. Not that it was a particularly well-written or well-produced film, but I’ve watched a lot of shitty movies. No, I discovered it right when I was solidifying my own boy/girl identity and the “magic” and ease of the switch, not to mention the fact that it was UNWELCOME to both parties was too much to bear. I don’t think I missed too much, btw.

    On the other hand, I enjoyed Zerophilia, again, not for its quality, but because it was actually thought-provoking, in its own way, despite the occasional juvenile joke. Perhaps a bit wish-fulfilly, too.

    Now to go back and read the rest of the post. I was just arrested by that passage.

  11. 11
    Emily

    Excellent post. I’ll be quoting, with citation, your notion of the ‘null hypotheCis’ at a future date.

    As long as transsexualism — or let me just say those who seek full transition — remain such a marginal entity (there just aren’t many of us), then the internal miasma (and external obstacles) will still make “Am I trans?” a very perplexing and difficult question. Also, we can’t get away from the metaphysical fact that gender is just one of those enforced identifiers that connect to the most fundamental levels of our ontological claim to self-awareness. It takes a massive amount of inner work and outer articulation to go against the grain of the empirical: who I look to be is not who I am.

    Having said that, I think awareness creates a more receptive dynamic. Trans kids are coming out earlier. That’s a fact. And there are better resources to offer them the proper support (medical and psychotherapeutic). There *will* be people at all ages who say, “I think I might like life better [as opposite sex].” And perhaps they have a degree of trans* inclination; I am not dismissing there gender dysphoria out of hand. But not everyone is suited to transition. It is, and will be for the long future, an extremely disruptive process that, while ultimately rewarding for those who have no other option, is not ideally pursued by everyone.

    Hence the self-interrogation. I spent a very long time, like many trans* people, engaged in all kinds of convoluted arguments, and patterns of distraction, to convince myself (1) that I wasn’t trans and then (2) OK, maybe I’m kinda trans, but I won’t transition. This is where an expert gender therapist is worth her weight in a platinum dragon’s horde of treasure. Accepting one is a transsexual, while apparently automatic for a new vocal generation, is still largely an intensive process of self-examination, in which our brains are our best friends and worst enemy at the same go. It doesn’t help either that our transitions are often greeted with (1) disbelief: what? you don’t LOOK trans? You were all into MMA and working out?; (2) indifference: well, whatever floats your boat, dude; (3) repudiation: DON’T do this. No one will hire you. You’ll become an alien to society.

    Our internali ability to deny the obvious is incredible, especially if we do not have access to the educational resources to help us *identify* exactly WHAT is going on. My own predicament is that, because of sociocultural factors (and religious baggage), I was unable to ARTICULATE that I had a recognized neuroendocronological condition, with a specific form of treatment, that required help. I didn’t even know what ‘transsexualism’ was until a very late age. Flipping through the DSM-III at age 16 didn’t help. I had a portfolio of my own erroneous explanations: I’m a crossdresser, just like the clothes (a little, on the weekends, actually I don’t like them, give them away); I was a woman in a past life and her ‘spirit’ continues to exist in me; I have a strong ‘feminine side’; I’m just an effeminate Gothy androgynous New Romantic Art person; etc. etc.

    So I’ve always felt that being trans, for me, was more like a puzzle than a ‘knowing’. It was like a labyrinth in which my goal was never, ever to reach the centre. Figuring out that my cross-gender identification was more than a habit, inclination, daydream, hobby, fetish, phase, and/or illness meant having to stop thinking about signs and start thinking about sources. My feeling that I was really a girl had little to do with the phenomenon associated with it (liking dresses, wanting to be called ‘Emily’, imagining myself with a girl’s body) and more to do with the most terrifying underlying ontological fact: it was about my very selfhood. Not the signs of the selfhood. The source of the selfhood. The ‘me’ itself.

    At this point of internal honesty, accepting that my cross-gender inclinations weren’t cross-gender at all — since I was really female — and that the actual fakery was what I was doing every day , , , this meant that I had solved a difficult sort of mental puzzle. But realising the puzzle was never a puzzle except that I made it so meant I had to come up with a new argument, or a new scientific theory. The result of the process is a theory about myself that explains not only experiences, feelings, dreams — but an acceptance of ‘WHO’ those phenomena are arising from.

    And once I had a theory that I was pretty sure is right, it’s hard not to act on it.

    As Natalie said, there are just things cis people do NOT do. Several days of several hundred messages a day in a private trans* only/grue free FB group has reminded me of that.

    Yesterday, I went to put in my order for Archie 636, the gender switch issue. It’s five months away! The comic shop owner asked, “What’s so special about 636?” I explained, with intense excitement. ARCHIE BECOMES A GIRL! I can only imagine the rush reading that at 13 would have been for me. Cis-comic-shop-guy just stared at me indifferently, perhaps with a bit of sympathy for my interest — “Oh yeah?” he says half-heartedly.

    CIs people just, well, don’t think about that stuff. Incessantly. Obsessively. Self-destructively. Redemptively.

    1. 11.1
      Kevin, Youhao Huo Mao

      I would +1 this were there an option.

    2. 11.2
      northstargirl

      Yes. Any time I doubted, I thought back to my childhood and so many things I did that signaled I didn’t want to be a boy, some of which were pretty bold. I also thought of how those moments dated from my earliest memories, and how no matter what I tried to do, they always came back. In moments of doubt, that’s what convinced me it ran too deep, that it was futile to run from it, and that’s what helped me commit to the best thing I ever did for myself.

  12. 12
    HappiestSadist, Repellent Little Martyr

    So this is going to get bookmarked for when people around me need some explanations, because damn, Natalie, you do it well.

    For this post alone, I would happily make you the baked goods of your choosing.

    1. 12.1
      Lucy

      I’ll add a “me too”…Natalie explains so many things so well that the people around me are going to spend ages reading it all :-) That’s probably a good thing though.

      Natalie: do you have to write so coherently and with such understanding?…it does show the rest of us up sometimes! ;-) But seriously, keep at it…I’ve learned so much and feel at home here, even though I only lurk most of the time.

  13. 13
    Brin Convenient

    Read the rest of the post. Mind. Blown. How did I never see things this way?. Damn, Natalie, you just kill me with brains.

  14. 14
    Evan

    Natalie,
    I’ve been loving your blog, but I’ve got to make a slight quibble:

    When you assert that the cis shouldn’t be treated as “null hypothesis”, you’re right, but it doesn’t *quite* follow that it should be given equal weight with trans.

    The scientific way to approach this is bayesian; and there are three relevant pieces of information: 1: how common are the two hypothesis (cis and trans) in the population? (I picked the high end from wikipedia, with MTF at 1:500). So *absent any other information*, cis is 500 times more likely than trans.

    But the rest of the discussion you made then plugs in wonderfully, because the next part of bayesian analysis is to ask “given this new data I have, how much should I revise those base rates?” And this is where you should ask yourself 2: “how likely am I to obsessively dream about being the opposite sex, to constantly consider transition, etc, if I’m trans?” (answer: very likely) and 3: “how about if I’m cis?” (answer: very unlikely)

    All of that isn’t even to touch the difficulty of falsifying a subjective identification, as you importantly point out.

  15. 15
    genuinely curious

    hey! love your blog- it’s my first real foray into Trans issues- I agree with 90% of what you say but regarding the assumptions other people make about other people I can’t help but throw in my two pennies.

    Assumptions we make about people (when not based on flagrant phobias or bigotry) are usually made on probability-

    Like Han Solo- I don’t know very much about- but if we say (hypothetically) that we know that 10% of all men are trans- then would it be fair to assume that we can be 90% certain that Han is cis (in absence of all other information)?

    of course this really is a pointless exercise- why do we care about what *other* people are? Does Darth Vader’s force choke only work on cis men?

    if we *do* care how certain can we be of the proportion of cis/trans people (i.e. we can’t).

    Yeah okay now I’ve written that down and thought about it I guess that answers my question.

    In the case of talking to doctors or suchlike, the fact you’re on front of them *already* should be enough to seriously call cissness into question, let alone any other criterion they ask.

    Has Natalie done a post on Gatekeeping? It’s not a concept I’m too familiar with and it looks kinda related to this? :)

    1. 15.1
      genuinely curious

      okay I guess Evan just ninja’d me, freaky

  16. 16
    Leo

    Being trans is rare. The highest estimate I’ve found (Olyslager & Conway, extrapolation) is 1 in 500. That means that a Perfect Skeptical Inquirer should be about 500 times more suspicious of evidence they’re trans than of evidence they’re cis. (If you object to my use of “suspicious” to denote low priors, or complain that I should be using log odds, shut up, you know what I mean.) Now, detransition is rare (5%? I can’t find good data.), so once you’re pretty sure you want to transition, you should be skeptical of evidence you’re cis.

    I also want to pitch a hissy fit as your scare quotes around “really”. Feelings are not magical and out of the realm of objective evidence! Feelings are real things in the real world! They are slippery and easy to influence, but they are regular evidence, to be observed and analyzed like anything else. Likewise, I’m surprised that you say we’ll never have a perfect test for transsexuality. Surely whatever it is that makes us the gender we are has to be in our brain. Why wouldn’t we be able to isolate it, and say “This is womanhood, this is manhood, this is neutroishood, this is boihood” the same way we say “This is vision, this is short-to-long-term memory conversion, this is depression” of brain structures and chemical concentrations? It’s more complicated, but why should it be impossible to make?

    And now Apollonia is trans in my headcanon. Her father was hostile at first but grew more accepting as she started socializing with women, passing, and attracting straight men, and when Michael got interested in her her whole family was impressed and relieved by her success in a culture where women are valued for their ability to attract a husband, and disclosing helped her and Michael grow close even through their courtship was short, and I’m running off to write fanfiction.

    1. 16.1
      Natalie Reed

      Wow… which Appolonia are you thinking? I had Purple Rain in mind.

      Feelings are real things in the real world (in our brains) but only ever have any phenomelogical substance in terms of how they’re experienced. What if the exact same chemical processes are experienced by one brain as mild longing while they are experienced as wistful happy nostalgia by another? We all have more or less the same “stuff” but we still have intensely personal, subjective experiences. That subjectivity is the ONLY way in which any of those real, chemical process become feelings at all. Electrically stimulate euphoria in a mostly-brain-dead patient. Did you just produce euphoria, or did you produce only electric signals? Clone the chunk of brain where gender, body-mapping and proprioception are based, but nothing else. Does THAT chunk of tissue have a gender identity?

      As mentioned elsewhere, we don’t just look at raw probabilities. A good scientist / skeptic adopts a Bayesian model. We MODIFY those probabilities in accordance with available evidence. Maybe for a completely random subject the chances are 1:500, but what about a PARTICULAR subject who is going through feelings and experiences x, y and z that point strongly to being trans? Suddenly the probabilities start looking MUCH different.

      1. genuinely curious

        I guess the reason this brain stuff is mostly so hard to nail down as objective is that the brain is a malleable nonstandard fractral construct.

        I doubt that anyone will be able to put up exact ‘blueprints’ of the brain one day and say “this is the part responsible for liking hemingway”.

        I’d lean to one side and say that technically (pedantically) feelings are objective and can be measured- but because every brain is different to begin with and in a constant state of flux throughout the owner’s lifetime that you can’t ever really compare brain A to brain B in a useful way-

        So yeah, brains are inherently objectively subjective.

        I think

      2. Anders

        But the experiences are very easy to measure. We construct so-called Likert scales – “rate your pain on a scale from 1 to 10″ or anchored Likert scales where some of the numbers have descriptions attached to them. My entire research project was based on this. Like so (Rödholm 2003):

        Increased emotional instability
        Concerns increased sensitivity to emotional atmospheres, such as conversations about close relatives, personal problems, the high festivals, or at the movies or theatre. The evaluation should be based on the intensity and the effect on daily life.

        0 No increase in emotional sensitivity
        1
        2 Increased emotional sensitivity for instance in connection with conversations about personal problems, tragic episodes in movies or at the theatre. Concerning the latter examples, this is an expression of habitual personality.
        3
        4 Frequent embarrassing or annoying emotional sensitivity. Sometimes even in connection with comparative neutral topics. Can lead to avoidance of certain situations.
        5
        6 Disabling emotional sensitive. Daily family life affected. Difficulties in managing a life outside of home.

        - Are you more sensitive now compared with before operation*?
        - Do you cry more easily?
        - In what situations?
        - Is it harder to control laughter as well?

        * these questions were part of a study on stroke patients who had undergone surgical treatment.

        You have to be careful about what kind of statistics to use but apart from that its very easy to measure emotions.

        1. Natalie Reed

          And on these sorts of scales it ultimately always boils down to the subjective experience of the subject, who makes the rating.

          1. Anders

            Or sometimes the physician’s interpretation of what the patient tells him. (In order to validate a self-rating scale we must compare the results gotten from the two).

            Absolutely. But that’s not a problem, that’s just the nature of the beast. And it’s nothing new in medicine – physicians want symptoms and signs… well, symptoms are the patient’s subjective experience and signs are objective methods like blood pressure and weight. Sometimes only one gives useful information, sometimes both do. In the case of transsexualism, there is no lab test and I’ll go out on a limb and say that there never will be.

          2. Anders

            I guess I just wanted to point out that ‘subjective’ does not mean ‘impossible to measure’. Many people make that mistake.

          3. A. Person

            Sorry, Anders, for how much I’ve been quibbling with you today.

            Just because you can measure something, doesn’t mean that your measure is good. How do you calibrate measurement of subjective experience? Assume common experiences and use those as a baseline?

            I ask because when I see those type of charts, I’m almost always never certain how to answer, and for some reason, people are uncomfortable with ranges.

          4. Anders

            No need to apologize – I love to pontificate on this subject… :)

            The question of validity (do we measure what we want to measure?) is at the center of constructing a scale. Typically we calculate some form of agreement between the scale and what is called a ‘gold standard’. The problem becomes what to use as a gold standard. There are many ways to go

            A. You can try to find some sign that you think is physiologically significant for some. For example, blood sugar for diabetes. We don’t know of any such sign for trans people.

            B. You can say that the doctor is correct and use hir assessment as the gold standard. This is necessary in many psychiatric disorders where the patient denies that there’s anything wrong with hir. But that’s not the case for trans people.

            C. You can use some scale for disability – if your measurements agree well with some scale for disability (for instance the Glasgow Outcome Scale) then you can say that the scale is probably valid.

            D. The fourth option is to simply say that the scale is the golden standard and everything else has to be judged against the scale. But if you do this then you must be extra careful and humble when constructing the scale, and you must ask the patients if the scale describes their symptoms well. In a sense you are treating the patients’ stories as the gold standard. And that’s the way I’d choose if I was to construct a scale for Gender Dysphoric Disorder.

      3. Leo

        I was thinking of Apollonia in The Godfather.

        Do you have any data on how many people who think they might be trans end up transitioning and being happy about it? I can’t even find anything more than vague estimates on people who have already started transitioning. I suppose that by the time you notice you’re miserable trying to live as cis it gets pretty likely you’re trans, but where’s the tip-off point?

    2. 16.2
      Xanthë, Amy of my threads

      That means that a Perfect Skeptical Inquirer should be about 500 times more suspicious of evidence they’re trans than of evidence they’re cis.

      Except, as Evan pointed out, that if you look at the Bayesian analysis, then the presence of trans related fantasies and ideation begin to dramatically favour the consequent probability of being trans not cis.

      For example, would you be troubled by dreams or feelings that your birth gender was wrong, if you were cis? Would you be obsessed by exhaustively researching transgenderism if you were cis? Would you be going to the trouble of seeking psychological and medical opinions if you were cis? The presence of such things usually favour the consequent probability of transness being likely, despite the prior probability being so low. We don’t observe 99% of the population going off to the doctors with vague wondering whether they’re really cis; so the “500 times” suspicion really isn’t warranted, when the people who think they’re trans or are questioning have essentially self-selected/self-designated.

      1. Xanthë, Amy of my threads

        ^^ … which is more or less what Natalie’s comment pointed a number of hours earlier, and which I somehow managed to skip over when I got to this part of the comment thread the first time. :roll:

        1. hall-of-rage

          Well, I love seeing more comments showing people who understand conditional probability. :)

    3. 16.3
      ischemgeek

      You’re begging the question by assuming that cis people have transgender fantasies and obsessions and therefore if someone who may or may not be trans has these fantasies and/or obsessions, that has no bearing on the likelihood that they’re trans (because you’re using general population statistics for your putative Trans Questioner, and why would someone question if they’re trans unless they have fantasies about being the gender opposite their assigned one?).

      That’s like saying someone has to assume there’s a 90% likelihood of them being straight because estimates peg about 10% of the population as homosexual. But why would someone question their straightness unless they were having non-straight fantasies? The presence of non-straight fantasies on their own vastly increase the chance that the person in question isn’t straight.

      Using me as an example, I call myself bisexual even though I’ve never had a relationship with another woman and I’m currently in a hetero relationship. Why? Because straight women don’t fantasize about other women to the extent I do. Women are about as attractive to me as men. Ergo, bisexual. To assume that there’s a 90% chance I’m really straight is foolish: I know I’m bi just like I know I’m right-handed.

      Actually, on the same topic, would you say that a Perfect Skeptical Inquirer should assume there’s a 90% chance of their being right handed even if they find it easier to do everything requiring fine motor control with their left hand? That’s pretty much your argument in a nutshell.

  17. 17
    Abbey

    What I have said for years is this: Don’t be any *thing*, just *be*.

  18. 18
    cami

    Fuck yeah. This piece really helps. It’s the first thing that I’ve read or heard in forever that actually makes me feel good about being a trans girl. Seriously. I cried a little just now, but it was a good kind of crying. Not the fuck I hate my life kind of crying that I usually do but instead it was the I know what I’m doing is the right thing for me kind of crying.
    Natalie, I think that your on the right track with this whole developing a new framework thing. Today’s piece is an awesome start.

  19. 19
    ischemgeek

    I don’t deal with gender-identity stuff, but I imagine how you know you’re trans is the same way I know I’m bi: Straight women don’t find other women hot. And they don’t have fantasies about their former best friends, even years after losing contact. And they don’t actively avoid that one particular female teller at the supermarket because they’re afraid that they’ll turn all red (when you’re as pasty as me, you can turn really red, by the way) and start stammering because they’ve got a crush.

    Yeah, I’ve never had a lesbian relationship (my first relationship ever came at 21, and it’s still going – long story, suffice to say I had a lot of baggage to get over before I could do the dating thing), but I know how I feel. And I know a straight woman wouldn’t feel like this.

    Only for you, it’s worse because 1) gender affects much more of your daily life than sexual orientation, and 2) it’s generally accepted in most of my country, at least (Canada) that, oppressing, beating and killing people who are attracted to the same sex is Not Cool. Not so for people who are transgender.

  20. 20
    WilloNyx

    First I want to say that I am not sure I am even going to submit this comment. If I do I am sorry if I make assumptions that are unwarranted or cisnormative that may or may not offend people. It isn’t my intention but I am not sure what all word may come out. I need to feel this comment as it goes.

    Second I want to say this is an enormously beautiful piece of writing. I am thankful for having had the opportunity to read it.

    Third, this post makes me want cry with a shitton of confusion. I want to understand more than I will ever hope to understand. I don’t just want to understand because of the exoctic nature of trans. I want to understand where I fall on a spectrum of humanity. Every day now I wake up and I question what it means to be a girl. What it means to be a boy. What it means to feel like a gender. I can almost imagine what it feels like to not feel/to feel like the gender you are assigned because I have seen dysphoria/euphoia , felt dysphoria/euphoria in a number of ways outside gender. I have only ever seen dysphoria/euphoria in relation to gender. I have never felt it. I don’t have any clue as to what gender feels like and I want to. I want to because I struggle with feeling human most of the time. Sometimes I feel kind of human but not really. I go through every day and these beings walk around with some common sense of certainty about who and what they are and I have never had that sense in my head. I learned a long time ago that people are just really good liars and that full certainty is never actually there but I don’t really have any sense of certainty in my head. None of it feels real to me much of the time.

    So when I say that I have no clue if I am cis or not it really is because I just don’t know what it feels like to be a gender. I don’t know what it feels like to be disphoric or euphoric about your gender. I can get excited about my tits, my ability to have multiple orgasms, but likewise I can get excited about watching my (imaginary) penis grow and standing while peeing. I could even get excited about having both and it doesn’t make me to sad to imagine having none of these. To me if I try to imagine my brain in a male sexed body, I just imagine that I wouldn’t experience any dysphoria by doing so. It isn’t because I am bi gender or anything I don’t think, I think I just lack something in my brain that tells me things ought to be a certain way. I think maybe its because I lack the ability to identify strongly with any group.

    But on that same token, I feel so much empathy for everyone. I can so totally get people’s motivations for everything. I can predict many of them. I can relate to situations in so many ways. Perhaps that is because I don’t strongly identify with anything. Perhaps having a strong identification makes us blind. I don’t know. I just know that gender has me so fucking confused because I feel like I am missing a piece that everyone else cis or trans gets.

    I am sorry to ramble on and on. The truth is, I am probably cis but if my gender identity relied on what gender I feel like I am, I would have to say none of the above, maybe all of the above. They all kind of make total sense to me but absolute nonsense at the same time.

    Sorry again if my rambling entered into territory where I offend someone. This whole thing just makes me sad today.

  21. 21
    Melody

    Extremely insightful as always, Natalie. The idea of internalized bias regarding the questions of “Am I trans?” “Am I cis?” never occured to me.

    It wouldn’t have occurred to me at the time either, as those weren’t the questions I asked myself. Rather, I asked myself “Am I a man?” “Am I a woman?” “Am I neither?” “Am I both?” “Am I something else?”
    I had 25 years of experience with the first one, which never felt right, though it did feel easy before the other questions even occurred to me as possibilities. The third one was a much better match for a few months, until I allowed myself to explore the second – an exploration that whilst difficult in almost every way, felt so obviously unambiguously right that I had no need to question anymore.

    Circumstances forced me back to the default I’ve been assigned at birth for the first 8 months or so while I was pursuing transition / jumping through hoops to get it started, and that’s when intense dysphoria first presented in me. In contrast, mild dysphoria for me was just a sense that something is wrong, and I don’t know what, and that led to my exploration in the first place.

    Bias did have a tremendous effect earlier, by way of not even recognizing those questions as possible… for 25 years.

    That’s a limited portion of my narrative; a narrative I often worry about sharing in trans-spaces, for fear of being invalidated (and not only by the HBSers) because it’s so different to the normative one. The fact it’s different to the normative one didn’t dissuade me from accepting it as valid/legitimate/et cetera, but it does dissuade me from sharing it at most places.
    I’ve read enough of your writings and the comments to them now to feel a moderate expectation of safety in that regard here.

  22. 22
    Cara

    I still someday want to write an essay arguing that the strong assumption that one is cis is an example of harmful status quo bias.

    Personally speaking, I fairly rapidly went from considering the possibility that I was trans to concluding that I was something not-cis-male, I just wasn’t sure what. I made a best guess (gender-variant woman), years before starting transition, that has turned out to be right. I’m still not sure how rational all my hesitation and doubting about transition was: it has real, extremely high social and financial costs.

  23. 23
    sphex

    When we start looking for approval of our feelings, and assurances that they’re real and that they count, beyond the subjective certainty and realness of experiencing those feelings, we’re lost. Well and truly lost, looking for a path we simply can’t find. And when you’ve made doing what you need to do in order to be happy conditional on that approval and assurance, we’ve resigned ourselves to unhappiness. A self, an identity, a gender… these aren’t really fixed, concrete facts in the world. These are means. Processes by which we understand ourselves and our relationship to things, and articulate and express them. You’re never going to get any certainty beyond the certainty you yourself assert, or any assurance beyond the sense of I am. This is who I am. This is what I am experiencing. This is what I want. This is what I need to do.

    That’s all the evidence you’ll ever have, and all the evidence you’ll ever need.”

    This gave me chills. Wow. I’m going to print this out and frame it. What an amazing analysis of what it means to be human.

  24. 24
    Kendra

    This article got linked to by someone over on Reddit’s Ask a Transgender.

    I just wanted to say as a male who’s questioning myself, this is helping me a lot.

    Thank you very much.

    (Calling myself) Kendra

  25. 25
    SG

    I am a (probably) cis man, and I actually do often wonder if I am really cis. I sometimes think that the only reason I am not trans is that my subconscious sex is either agender or gender-flexible. I honestly think I’d be as physically comfortable in a female body as in my male body, and I’ve thought about this a lot. My gendered interactions with society are another story, as there are culturally-constructed things about being male that really bother me and culturally-constructed things about being female that I think would also really bother me.

    In any event, if I am trans the only way I’d ever transition is if it was a choice between living in continual psychological pain (or not living at all), and transitioning, because I think being a trans women would make many of my life goals completely unachievable.

  26. 26
    Caleidescense

    Thank You, Natalie! Your dissection of the argument of transsexuality with respect to falsification resolved a long standing problem with my dealing with my gender variance. This is a very significant moment.

    All the best

  27. 27
    JA

    After reading that section on what cis people don’t do, I’m not only now 100% sure that I’m trans, but I’m beginning to suspect that I might be Natalie Reed.

    Was “Dr. Jekyll, Mrs. Hyde” that bad?* I never had the courage to rent it when I saw it on the shelf as I was working there at the time, and the last thing I needed was co-workers giving me funny looks.

    *I can’t believe I’m asking that question given the title…

  28. 28
    Androgenie

    I decided that I had given up on caring what society thinks of me long before I realized that I might be transgender. I purposely broke stereotypes and dressed androgynously. I even started making my own T-shirts because I didn’t want to be labeled by anyone but myself. The only “stereotypical” label I accept is “Geek”.

    All of this made it so much easier, once I decided I might be transgender, to affirm to myself that I wasn’t cis when I found the right word(s) for what I am. I am androgynous (bigendered, genderqueer etc.) and society can suck it.

  1. 29
    Breaking down, proving it | Babylon Is For Vampires

    [...] Speaking of Reddit, I_am_krista posted the link to this great article: [...]

  2. 30
    Truth | Kira Moore's Closet

    [...] Which in turn led me to this: http://freethoughtblogs.com/nataliereed/2012/04/17/the-null-hypothecis [...]

  3. 31
    Is Gender Identity Disorder A Disorder? | Sincerely, Natalie Reed

    [...] And honestly, due to the fact that things like gender dysphoria, gender identity and transgenderism can ONLY be asserted or “proven” subjectively, and therefore ONLY be diagnosed through interpreting a patient’s subjective experience and [...]

  4. 32
    “Cheerleading” And The Dangerous Irresponsibility Of Jennifer Finney Boylan | Sincerely, Natalie Reed

    [...] trouble, to be secure in their knowledge of what they need for themselves, to not endlessly pursue an elusive and impossible “proof” or “certainty”, to understand that doubt is a natural part of that process, to know they can negotiate the process [...]

  5. 33
    The Null Hypothecis « ERIC'S CAFE

    [...] The Null Hypothecis [...]

  6. 34
  7. 35
  8. 36
    How Do I Know If I’m Trans? » Sincerely, Natalie Reed

    [...] contrast to the majority of thingies lurking in my archives, I’m still fairly proud of) called The Null HypotheCis. Basically, internalized cisnormativity leads us to assume that we need to PROVE that we’re trans [...]

  9. 37
  10. 38
  11. 39
    Gender Identity A dream - Empty Closets - A safe online community for gay, lesbian, bisexual, transgender people coming out

    [...] post by Zinnia Jones.) Also, it seems wrong from a skeptical point of view to view cis as the "null hypothesis" — that which needs to be conclusively disproven before a hypothesis of trans* or nonbinary [...]

  12. 40
    Beyond the Binary: Question Four | a gentleman and a scholar

    [...] or “not trans enough” is cisnormativity in action (recommended reading: Natalie Reed’s The Null HypotheCis). But when it comes to identitarian terms, the individual in question has the final say – whether [...]

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