Fact Checking Alice Dreger
A fact check to the fact checker
(See also: A message to the linguistically challenged)
20 May 2008
Response to: http://alicedreger.com/informed_dissent.html
(Italics are quotes from Alice Dreger's blog)
Well, I see Alice Dreger is up to her usual: distorting the facts and creating a smokescreen so that those with power who are not being held accountable for their unethical behavior appear to be justified in further victimizing marginalized communities. As usual, she is telling us what to do and being deceptive as she talks down to us – vintage Dreger – while deflecting the attention away from those who are harming people and making it look like those harmed are the real problem.
I’ve been watching the same sort of thing happen over the debate regarding Zucker and the DSM. Lots of errors about basic facts.
She should know about errors about basic facts. Her recent article in defense of J. Michael Bailey was full of errors. Click here
Some of these errors have been noted in an open letter from Marshall Forstein, M.D., of Harvard Medical School. Forstein pointed out that in his letter that, contrary to claims made in petitions and frantic emails, “sexual orientation is NOT even an issue for the DSM committee to consider.”
Once again. This appears accurate but it is not factually correct to accuse those of us who are discussing SEXUAL ORIENTATION as having our facts wrong. We are discussing sexual orientation, and she understands why because she wrote an article about this same topic herself defending J. Michael Bailey, because the people named to the DSM committee are discussing homosexuality. That is the issue and it is deceptive to put this on her blog and mischaracterize why we are discussing sexual orientation. The problem is not with the intersex or trans community. It is with Blanchard, Zucker, and Dreger. They have been writing papers and elaborating theories which conflate sexual orientation with transsexuality. So, let’s be accurate and check our facts, Alice Dreger. We are talking about this because they, the proposed members of the DSM committee write many articles about homosexuality and see it as one of only two causes of transsexuality.
And the DSM “is a guide to diagnosis and NOT to treatment.”
Once again, we know that. It is inaccurate to act as if we do not. The fact that one or two people might not know that is not necessarily the case for most of us. Why didn’t Dreger write to the people who don’t know this if she really wants to help out instead of making all of us look like uniformed troublemakers? Well, she has an agenda – to protect Zucker, Blanchard and Bailey. That’s why.
The tone of Forstein’s letter reminded me of my own tone as I lectured my well-meaning neighbors on my porch yesterday. Basically: “Geez, people! You don’t have the most basic facts right! How do you expect to gain and keep allies if you can’t get the facts straight?!”
Once again, she paints all of us with one stroke (pretending that she is addressing her neighbors but this is not written to her neighbors, is it?). This is outright propaganda. Many of us are quite informed, articulate people capable of exposing the facts. She would be well advised to get informed and stop generalizing about a whole community.
The errors Forstein chronicled are important, but arguably not as important as the erroneous claims that Zucker does “conversion therapy,” i.e., that he tries to change children’s sexual orientation from gay to straight, and that he thinks a patient turning out to be transsexual represents a “bad outcome.”
Fact check. I thought that Alice Dreger had read J. Michael Bailey’s book. In his “Queen” book, Bailey wrote:
“….Zucker believes that most boys who play with girls’ things often enough to earn a diagnosis of GID would become girls if they could. Failure to intervene increases the chances of transsexualism in adulthood, which Zucker considers a bad outcome.” (Page 31 in book)
“Zucker thinks that an important goal of treatment is to help the children accept their birth sex and to avoid becoming transsexual. His experience has convinced him that if a boy with GID becomes an adolescent with GID, the chances that he will become an adult with GID and seek a sex change are much higher. And he thinks the kind of therapy he practices helps reduce this risk” (Page 30 in book)
“…Zucker’s therapy seems kinder and more consistent, and thus more likely to be effective. Zucker believes that it is, although he is the first to ackowledge that no scientific studies currently support the effectiveness of what he does.” (Page 34 in book).
Now. One final fact check. Here is why Zucker and Blanchard are talking about homosexuality. Let’s get that fact straight. And therefore we who are opposed to their being part of the DSM committee are discussing this same topic because:
The DSM is concerned with diagnoses, not treatments per se. We know that, Alice Dreger. However, that is why people that are ideologically motivated with very little, if any, empirical data to support their theories (and Bailey himself admitted that) should not be placed in charge of the definitions or diagnoses. Here is the problem. Drucker will have input into the DIAGNOSES, not the treatments but the treatments are not the issue for Zucker and many of these people that have been influenced by him. In my opinion, they want NO TREATMENTS. I am convinced that the motivation is to tie the hands of those who would desire to provide treatments and they might be able to do that by controlling the definitions, i.e. the diagnoses. In other words, if the members of this committee, some of which I know have been influenced by the views of Zucker which are that gender identity, as opposed to gender role, is extremely malleable, even more malleable than sexual orientation, then reassignment may eventually become almost impossible, if not outright impossible in the years to come.
The theory that Blanchard et al. are expounding has two key elements which will have enormous impact on redefining transsexuality in such a way that
1) it is NOT really a GENDER identity disorder at all and
2) with ONLY TWO categories possible for all people with "gender confusion" which appears to be the word that is becoming more and more common.
Now, if GID is not about gender but SEX, and there are only two diagnoses, one of which is based on HOMOSEXUALITY, what treatments can be ethically justified by therapists if homosexuality is NOT also reintroduced as a TREATABLE disorder? If you include autogynephilia, then you have to include homosexuality because the theory that Blanchard and others are propagating posits that there must also be "trans" people motivated by homosexual orientation (and ONLY those two categories). This erases intersex and trans experience and the essential definitions that we often use to give meaning to our own sense of being – our own definitions of ourselves and if we are not allowed to define ourselves within the system to the best of our ability, then I don't see anyway to improve our well-being within that system – only further marginalization and stigma.
If Zucker is treating homosexuality in childhood and he admits that these boys grow up to be homosexuals and according to Bailey he is treating them in the hopes of preventing transsexuality, then why not treat homosexuality in adulthood to prevent transsexuality? That is why we are discussing this issue.
Professionals? It is time to act – PROFESSIONALLY
Writing to a whole community instead of addressing the people whose behavior Alice Dreger and others associated with her are denouncing is not professional. When I write about Dreger, for example, I don't generalize and characterize her behavior, writings and ideology as characteristic of the whole intersex community. Why does she include me and thousands of others who have nothing to do with the non-factual allegations she is writing about?
This is political spin. This is part of the ongoing assault against the intersex and trans communities. I and hundreds of others in the IS and Trans communities have NEVER written anything similar to this deceptive blog entry by Alice Dreger.
The documentation about Alice Dreger that I have published is based on verifiable sources, not generalizations, not innuendo, not rumors, which is more characteristic of her writings lately.
I have not claimed anything to be true about these people that I cannot back up with reliable sources. It would be advisable that she and other "experts" defending Zucker and Blanchard make the same effort when speaking about us in generalized terms. Don't include me in those generalizations without informed opinions that are reality-based, not agenda-driven spin. It is very offensive to include my work in these generalizations about the trans and intersex communities.
I would never write a blog that gave the impression that all mental health professionals were acting the same way as Zucker, Dreger and Blanchard are because I know otherwise.
What advice like this does is discredit all the well researched articles that many of us in the trans and intersex communities have written about this topic.
It is time that some of the professionals act responsibly (notably those in charge of the APA and those who are enabling Zucker and Blanchard) and inform themselves and stop giving advice until they do know the facts. It is time to demand accountability of those who provide care and who speak as ethicists about our care. The professionals in this debate have much more responsibility. Part of being a professional is that one takes the time to inform oneself of the facts. Many of us have. These factual articles are published. Read them.
A message to the linguistically challenged
I usually don't talk about my professional background. However, at times, when others who have degrees want to give advice, it is important that we who are intersex and/or trans, also speak with professional clarity and expect the same professional respect that non-trans/non-intersex professionals give to their peers. This is something that many of us have faced and those who are not intersex and/or trans often have no idea how they come across and they often have no idea how we often are devalued and deemed unworthy of any professional respect despite our own degrees and accomplishments. This is offensive and needs to stop.
I am a linguist with a degree in linguistics from the Université de Monptellier, France. As a linguist, I am concerned that Marshall Forstein, M.D., of Harvard Medical School pointed out in his e-mail that, contrary to claims made in petitions and frantic emails, "sexual orientation is NOT even an issue for the DSM committee to consider." What about the words "homosexuality" or "sexual orientation" does Dr. Forstein not understand? The people named to the board in question (Blanchard and Zucker) have used the word "homosexuality" repeatedly in referring to transsexuality. They are going to have input into the definitions concerning GID. Has Dr. Forstein taken the time to read what Blanchard and Zucker have written about homosexuality as part of the differential diagnosis for "GID"? If one reads their articles, it is plausible to conclude that Blanchard and Zucker would most likely try to introduce homosexuality into the DSM as part of the taxonomy for transsexuality because it is not based on GENDER at all, it is based on SEXUAL ORIENTATION.
This is what is disturbing to many people who read the rants of uninformed experts such as Dreger and it makes many of us very wary of their ability to discuss this topic with intelligence in order to make informed decisions considering the matter at hand: Zucker and Blanchard having control of the definitions of gender variance in the DSM, since they are on record as not really accepting gender as a valid construct for defining transsexuality.
Quotes from Blanchard:
"In my terminology, which follows the individual's chromosomal sex, these groups are homosexual and heterosexual transsexuals, respectively." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav DOI 10.1007/s10508-008-9328-y)
We have the rudimentary terms used in this proposed taxonomy in the short sentence above: "chromosomal sex", "homosexual", and "heterosexual".
"There are two distinct types of cross-gender identity. The feminine gender identity that develops in homosexual males is different from the feminine gender identity that develops in heterosexual males. In other words, homosexual and heterosexual men cannot ''catch'' the same gender identity disorder in the way that homosexual and heterosexual men can both ''catch'' the identical strain of influenza virus. Each class of men is susceptible to its own type of gender identity disorder and only its own type of gender identity disorder." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav DOI 10.1007/s10508-008-9328-y)
"Homosexual and heterosexual men"? Very revealing use of the term "men" here. So there we see how Blanchard is referring to M to F transsexuals. In this case, he is referring to them as "men" and he uses the word "men" several times in that short paragraph.
If we read further in this same article, it is clear why Blanchard would refer to M to F transsexuals as "men":
"I have not seen any new research studies that present compelling evidence for a third, distinct type of male-to-female transsexualism. It is quite difficult, however, to achieve complete certainty in taxonomic work. I made this point in a lecture on the parallels between gender identity disorder (GID) and body integrity identity disorder (BIID), a condition characterized by the feeling that one's proper phenotype is that of an amputee, together with the desire for surgery to achieve this. Most, but not all, persons with BIID report some history of erotic arousal in association with thoughts of being an amputee (apotemnophilia). ." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav DOI 10.1007/s10508-008-9328-y)
What are the parallels between GID and BIID? As a linguist reading this rather short article, the semantic field that Blanchard has ascribed to the term GID is very problematic because he is using the term GID in a way which is inconsistent with the DSM itself.
The current edition of the Diagnostic and Statistical Manual of Mental Disorders has five criteria that must be met before a diagnosis of gender identity disorder (302.85) can be given:
- There must be evidence of a strong and persistent cross-gender identification.
- This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
- There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex.
- The individual must not have a concurrent physical intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia).
- There must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning.
There is no mention of sexual orientation as a factor for diagnosing GID.
There is no mention of body image problems and desire for castration, etc. That is covered in another part of the manual: GIDNOS.
The emphasis is on IDENTIFICATION and inappropriateness of GENDER ROLE. Blanchard is not talking about GID at all as it is currently defined in the DSM. He is talking about something unrelated to this diagnosis.
He is talking about homosexuality, sexual paraphilias, body integrity issues and that is clear if one takes the time to read his work. I would not say that his findings are all wrong. I would simply point out that he is not talking about GID and that is clear from all discursive analyses I have made of his texts.
So, I would hope that professionals in the field of psychiatry would take the time to examine how Blanchard is using language, how he is using the terms which would have a great impact on future revisions of the DSM.
Now, who is the one talking about homosexuality? Blanchard himself. And he calls the people he is talking about HOMOSEXUAL MEN.
As a linguist, I am not going to take Dr. Forstein's advice because it is based on ignorance. Dr. Forstein and Dreger would be better advised to scrutinize Blanchard's use of language and terms before giving advice to those of us in the intersex/trans community because we are speaking about "sexual orientation" and homosexuality. I would suggest that this advice is better directed to Zucker and Blanchard.
Curtis E. Hinkle
Founder, OII
Call to action from Kristen Worely.
This is a call to action from Kristen Worley, an Olympian athlete from Ontario, who is working very diligently to expose the corruption of the CAMH. To read about Kristen Worley's stellar performances and her work on behalf of the Intersex and trans community:
Kristen calls me regularly to update me on what is going on in the Province of Ontario and she describes what the CAMH is doing as a form of child abuse. I agree. She has encouraged me to ask the members of this group and all other interested parties to write to the proper authorities in Ontario and the CPA to explain how Zucker and Blanchard are affecting people outside Canada. This is important because the CAMH, and therefore Zucker and Blanchard, are being financed by the Ontario Provincial government.
The CPA will be proposing a position on gender variance in mid-June and the Provincial government will be publishing a report soon which will expose the corruption of mental health care services in Ontario.
Please write to all the following people and mention that you are writing in response to Kristen Worley's request to help not only Canadians but others around the world who are directly affected by Zucker, Blanchard and the CAMH:
Address the e-mail or letter to:
Honorable George Smitherman
gsmitherman.mpp.co@liberal.ola.org
and send cc's to the Executive director of the CPA, the APA, and the Provincial leaders below and media below:
kcohen@cpa.ca,
alderson@ucalgary.ca,
apa@psych.org,
carolynrobinowitz@usa.net,
leader@ontariopc.net,
leader@on.ndp.ca,
dmcguinty.mpp.co@liberal.ola.org,
jmorris@cp.com,
amcilroy@globeandmail.com,
rmacgregor@globeandmail.com,
rstursberg@cbc.ca,
douellette@on.ndp.ca
Kind regards,
Curtis E. Hinkle
Founder, OII
Here is the letter that Robbi Cohn sent to the APA
The DSM-V will be the "Bible", so to speak, for consulting therapists and other authorities. As was the DSM-IV. It would be unthinkable to utilize the renegade and unaccepted theories of two participants on the Sex and Gender Identity work group which had substantially less support from peers than any law of averages might mandate. Drs. Zucker and Blanchard are eminently neither capable nor suitable as chair and contributor, respectively. Dr. Zucker is a proponent of reparative therapy, a process the APA has NOT endorsed. Additionally, he is of the school that gender is malleable and a matter of choice. Yes, it does have the ability to manifest in virtually infinite variation, but, no, it is not maleable in the sense that I can go out to construct my gender identity anyway I so choose. It just is, waiting for me to discover it and actualize it. It is essentially part of Jung's path to individuation!
Dr. Blanchard is a proponent of the theory that most trans women are autogynephilic fetishists. While there is a kernel of truth, the conclusions that the Doctor has drawn not only have no basis in fact, and seem to be counter-intituive, but are also contradicted by the evidence. Most trans women lose any sense of autogynephila after they stop repressing and stop living in denial. He has not only made the mistake of conflating gender identity with sexual orientation, but has established some sense of causation which is not born out by the facts.
It is essential that the APA give transgender individuals the same degree of acceptance it gave to gay and lesbian individuals when homosexuality was removed from the then DSM-II in 1973.
I would be more than happy to engage in discourse in this regard. In fact, I called APA national and was shifted from one respondent to another, with the promise of a call back. No call yet
robbi_cohn108 AT yahoo.com
I look forward to your response.
Very truly yours,
robbi cohn
Upcoming Projects
I. OII is collaborating with an informant, to investigate information this informant alleges to have about J. Michael Bailey possibly asking Paul Vasey to have Alice Dreger write the 60 + page "defense" in the Archives of Sexual Behavior of Bailey's work in The Man Who Would Be Queen, and also Dreger's claim, that 3 transwomen specifically sought to "ruin" Bailey's career. We take these allegations seriously because
- Dreger's article is severely flawed on many counts,
- Of the success of our internal campaign to have some professionals in the field change their mind about submitting their criticisms of Dreger's article (due to it being published in "Zucker's journal"),
- from other information we have received, it is clear that Bailey did not provoke 3 transwomen with his junk science. What he did was undermine most of the transsexual population.
- It has further become known to OII, that the ramifications of Bailey's book have the potential to inflict great harm on the intersex population.
II. OII will post an article soon called Intersexed Polled Goats and Intersexed Scapegoats, demonstrating how intersexed persons are abused, misused, and misinterpreted by professionals in their attempt at using data obtained from transsexuals and transsexuality, to understand intersex people and intersex research, and OII will explain why such research and methodologies are conceptually flawed from the start. (Example, PT Cohen-Kettenis published an article in "Zucker's journal" in August 2005 on 17 Beta HSD3 deficiency and 5ARD2 deficiency and came to the conclusion, that if prenatal androgens are a major contributor to gender identity development, that "all, or nearly all, affected individuals, even when raised as girls, would develop a male gender identity and make a gender role switch later in life". Arch. Sexual Behav. 2005, 34: 399-410.) Although her "comprehensive literature search" article mentioned that severity of mutation was not correlated with gender identity, as noted by Wilson, Horm. and Behav. 2001,40:358-366, she "conveniently" left out of her 12 page discourse, discussion of Wilson's contention in that same publication, that "Such inconsistency might be the result of variability in the completeness of compensation via alternate pathways". Conclusions about gender identity, as described in most of this issue of Archives of Sexual Behavior exploring intersex, as well as in much of Zucker's writings (including improper understanding of brain neural degeneration which leads to his hasty conclusions of the implications of his notorious penile ablatio case and others for gender identity theory), will be explored and brought to the attention of others, as well as to why cross-pollination of transsexuality with intersex research is conceptually unsound and damages both communities. OII would make the same arguments if researchers were studying Complete Androgen Insensitivity Syndrome in order to more fully explain masculinization in people with XX chromosomes.
III. OII will be publishing soon, on how the NICHD committee on psychosexual development and their intersex focus, headed by Sheri Berenbaum, of Pennsylvania State University, misapplies and abuses the use of animal models to study, in accordance with their mission statement, the psychosexual development of persons with so-called DSD's, and why a journey into a very special place, will show how a very interesting type of animal, invalidates the way they and others invent and use the term DSD.
