Dysphoria Euphoria

I’m a man of simple tastes: strong, black coffee; Highland single malt; bacon. I appreciate Alexander the Great’s solution to untangling the intricate knot of King Gordius of Phrygia: Slice it in two. I’d apply a similarly simple solution to the increasingly complex and entirely man-made problem of living in a world where social media giant Facebook provides a list of more than 50 “genders” from which to choose: For purposes of public policy and accommodation, go with the plumbing God – or god-like surgeons – have provided.
The latest kerfuffle arousing passions in the “gender fluid” movement is the case of Mack Beggs, female high school wrestling champ. Ms. Beggs’ rise to the top was made possible by forfeits and performance-enhancing testosterone. Some parents didn’t want their girls competing against a wrestler with a physique like a 1980’s East German female Olympian in three-fifths miniature. That oddly-proportioned and physically-dominating body was the result of testosterone, part of treatment helping this girl transition into manhood.
While she “identifies” as male, Ms. Beggs is biologically and chromosomally the same female she was at birth. While any other girl on testosterone would have been disqualified, the rules of the governing body for school sports in Texas declared that the state’s education code permits using banned drugs such as steroids if it “is prescribed by a medical practitioner for a valid medical purpose.”
The simple and elegant solution to this problem is to end the discriminatory separation of the sexes in all school sports. No more “separate but equal.” No more Title IX shenanigans. This approach would not only solve the Texas dilemma, it would accommodate those girls who want to play as girls on boy’s teams, and vice versa. Whether you’re a boy, a girl, an XX+testosterone, an XY+estrogen, or some other combination not yet medically possible, you would compete for a position on a single team. May the best athletes win.
This would leave some sports male-dominated, as anyone who has watched a WNBA game could attest. Some sports would enjoy a greater mix, and a few might have mostly estrogen-powered players. But all would compete on a playing field leveled by ability, not political fashion. I think Alexander the Great would approve, after he stopped laughing. This great military commander was tutored by Aristotle, an early empiricist who believed that peoples’ concepts and knowledge were based on perception. If a girl perceives she’s a boy…
Ultimately, we are going to have to deal with reality, a harsh realm for some. “Transgenderism” is a psychiatric condition called “gender dysphoria.” The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the gold standard for defining what ails us mentally, defines gender dysphoria as a perception and belief that the sufferer is a different sex, i.e., trapped in the wrong body. DSM-5 provides specific diagnostic criteria, including intense desires to have the sex features of the other gender, to transform into another gender, and for society to recognize them as another gender. The prevalence of gender dysphoria is quite small: 0.005-0.014% for adults born as males and 0.002-0.003% for females (American Psychiatric Publishing, 2013).
As with any mental illness, sufferers should be treated with respect and compassion. But respect should not include abandoning societal norms. The Dysphoria Express has been on that track for too long, and there’s trouble ahead. This train is now stopped at Gender Station, but will soon be on its way to darker places where accommodating everyone’s perception of self will engender social tyrannies incompatible with Western values.
One such darker place is not far down the track. In a 2014 study published in the American Journal of Applied Psychology, researchers examined the motivations and mental distresses behind gender dysphoria and “body integrity identity disorder.” Not yet part of DSM-5, BIID sufferers also believe they are trapped in the wrong body. Instead of the wrong sex, they believe they are disabled people forced to live in an able body. The study found the motivations behind both illnesses to be remarkably similar. Should the treatment be similar, too?
The happy ending for wrestler Mack Beggs was being allowed to compete and winning in a rigged game. The happy ending for BIID sufferers is mutilation. Their stories are rare, but they are real.
“Karl” believed he was really an amputee. After immersing his legs in dry ice for six hours, he drove himself to an emergency room (in a car already fitted with automatic hand controls). Surgeons had to remove both of his legs. “Chloe,” a Cambridge-educated research scientist, is “desperate to live the life of a wheelchair-bound person.” She reported making several attempts at injuring herself, but finally found a doctor overseas willing to cut her sciatic and femoral nerves. High cost is the only thing that prevented the surgery.
Dysphoria is dysphoria. Treating it by amputating body parts – sex organs or limbs – just because it’s possible is cruel. Surgeons may be outpacing psychiatrists now, but that does not change the fact that we are dealing with mental disorders. We will be a better society when we apply the right medicine to try to cure these patients.