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Transableism

Today I came across a blog article on Body Integrity Identity Disorder (BIID), in which the condition of wanting to be a deaf person (but living, contrary to this desire, as someone with hearing) is compared to the condition of being mis-sexed (Gender Identity Disorder, or GID). I have very clearly different feelings on this subject than the author does, and after having done some out-loud thinking on it, I’ve decided to write this blog entry to address those feelings.

The first of these issues is the coining of the term “transableism”, When I read this word for the first time today, knowing what the word ableism means, I was expecting to read a blog article about ableism within trans communities. Trans and gender-variant people aren’t immune from harbouring internalized prejudices just because we’ve reached out to friends, family, lovers, and/or professionals for help to deal with being gender-incongruous. I thought this topic would be of particular interest to me, because a lot of people within and outside of trans communities seem to think that ableism is just made-up, or that it’s the only remaining acceptable form of discrimination that does not warrant being challenged by anyone, disabled or not (which may or may not be disputed by people of other marginalized groups). I was surprised to learn that this word apparently means that a person is able-bodied but wants to socially and/or medically transition to being physically disabled (such as electively becoming deaf or paralyzed). I can’t speak to whether or not “transableism” applies to mental disability as well, but I can’t fathom why anyone would have a desire, for example, to develop habitually disordered thinking. I suppose if it were possible that “transableism” included a desire to develop a specific mental disability, it wouldn’t be written about exclusively as a form of BIID.

It seems to me that coining the term “transableism” reflects a fundamental misunderstanding of what the word ableism means, in addition to a very likely ignorance of the disability rights movement that has been ongoing for decades. For instance, as I understand it, when you build new buildings in Canada these days, you are required to make accommodations in your plans so that it is accessible to people who are not able-bodied (and this includes the washrooms). But this was not the case until fairly recently, and older buildings can still remain inaccessible to people who use a wheelchair or power scooter to get from point A to point B, or even people who are able to walk with the use of prostheses and/or canes. It also seems (though I am not certain about this) that new building plans are required to make accommodations for the legally blind, such as Braille indicators on elevators and washroom signs and fixtures, but older buildings can remain unaccommodating (thus, essentially saying “We don’t serve your kind here”). The requirements also apply, as far as I know, to building renovations in which the building code changes as a result, but not to renovations where an upgrade is not a factor. These limited systemic social changes have only taken place because of the disability rights movement, and we still have a long way to go.

In other words, we live in a society in which disability is still systemically marginalized, and as a result, people who live with disabilities are treated as icky, unworthy, unsightly, inconveniencing, and just generally lesser than people who are demonstrably able-bodied and able-minded. This is, in fact, a critical aspect of the dialogue about why Body Integrity Identity Disorder (BIID) and Gender Identity Disorder (GID) are even listed in the American Psychiatric Association’s Diagnostics and Statistics Manual year after year. Doctors just have the most impossible time believing, without a series of barriers and impediments collectively referred to as a process of gate-keeping, that a person can be genuinely mis-sexed or… mis-abled (to stipulate a word that, for this blog entry, may just.be more useful). And since the doctors write the books on it, the rest of society believes that they have authority on the subject, and therefore exhibit the belief that the self-report of anyone diagnosed with these conditions is neither objective nor valid (a form of ableism).

This brings me to my second issue with this subject. The direct comparison between GID and BIID suggests that being a post-operative transsexual is to live with a disability. This is accomplished by oversimplifying the condition of GID, and oversimplifying the transition process itself. While the author of the article stated that they “want” to become deaf, for the purpose of generating a more legitimate comparison between their experience and mine (as a person who is trans), I’m going to frame their experience in stronger terms. When someone argues “I was born in an able body and believe I should have been born in a disabled body” is comparable to “I was born in a mis-sexed body and believe I should have been born in a body with a different phenotypic sex (or lack thereof)”, they are arguing that having a sex change (or having one’s sexual organs nullified) is comparable to being rendered physically disabled. I find this offensive, and I know I’m not alone in my feelings on that. In fact, I find this revealing of how medical gate-keeping came to be established in the first place. If anything, I was more mentally and emotionally disabled prior to getting help to start testosterone injections (and to pursue a surgery to remove my reproductive organs), than I am today. Many people I knew before I started injecting testosterone can testify to that fact.

Now, before this puts a twist in someone else’s boxer briefs, let me clarify that there is nothing wrong or bad about being mis-sexed, mis-abled, or disabled. To an extremely limited degree, I am mis-abled (I have persistent thoughts about removing the most distal segment of one of my fingers); and I am also both mis-sexed and disabled, and receive treatment for these concerns. None of these facts make me a bad person, and none of these facts have any bearing on my capacity to be a good person. But as much as I believe that being disabled or mis-sexed or mis-abled are simply not bad or wrong in any way, I also have to acknowledge the fact that I still live in a society which privileges the cisgendered, able-bodied, able-minded, and the fully integrated body image. As such, until this power dynamic is dismantled, being mis-sexed, mis-abled, or disabled can be understood as both a medical condition and a social condition that is associated with social oppression. That is, though there is nothing innately bad or wrong about living with any or all of these conditions, badness and wrongness are systemically projected onto that state of being.

After thinking about the first two reasons I identify the language and comparison in that blog article as problematic, I started to realize a third reason. As human beings, when we age, so do our organs. The older we get, we experience an inevitable and progressive loss of sight and hearing, mobility, flexibility, and function. Occasionally, we experience unfortunate accidents, assaults, or ailments that may cause any one of us to lose a body part, or the function of a body part. For instance, I’ve transcribed numerous letters describing the events or biological processes that led to partial or full, reversible or irreversible loss of sight in one or both eyes, while I worked for an ophthalmologist. Everything ranging from being accidentally struck on the eye with a plant frond while gardening, to having a botched cataract transplant surgery overseas, or being assaulted in such a way that one eye was permanently lost and a prosthetic had to be made, to autoimmune disease literally dissolving part of an eye in its socket repeatedly after multiple surgeries. My training in school simply did not prepare me for the possibility of typing these letters out day after day, and I am actually relieved in recent years that this particular temp job didn’t turn into a career, but I digress.

The point I’m trying to get at here is, loss of body parts and/or loss of functions of the body occasionally happen by virtue of inevitable, accidental, or involuntary aggressive processes. But nothing happens by accident or by virtue of progressive aging/disease processes that changes one’s phenotypic sex. And as much as one might argue that the single case of John and Lorena Bobbit represents an aggressive involuntary act that resulted in a sex change, I beg to differ. Not only was Mr. Bobbit’s appendage successfully reattached, a gender reassignment surgery is a lot more complex than simply hacking off everything that hangs (and therefore, is simply not comparable).I could not, for instance, get a job as a baggage handler at an airport, and successfully transition into the body I believe I should have been born in by removing my earplugs on the tarmac.

It seems to me, it’s fair to suggest that the comparison of transsexuality to “transableism” just isn’t an appropriate one. I’ll even further emphasize that the word “transableism” could be so easily misinterpreted as an intersection of completely different ideas that are only distantly parallel, that it doesn’t serve the conversation to continue using it.

12 thoughts on “Transableism

  1. One, BIID is not listed in the DSM, this is something we have been fighting for. It has recently been recommended to be included in the DSM-V by Dr Micheal First at columbia university. Because it is not listed we simply can not find ANY treatment, none, nada. Most of us do not like having BIID, but without the medical profession taking us seriously, we’re left with no options. Those of us who have sought therapy have often been mistreated with medications that have little to no effect or just plain misdiagnosed. Also, GID may be reclassified as gender dysphoria in the upcoming version of the DSM.

    Two, in no way do we say being a transexual and having a sex change is equivalent to being disabled. You seem to be having an emotional response to something you haven’t really researched. The point of the article you read on TA.org is that the course of the two disorders are quite similar. I can point you to actual research by professionals if you want, but you would need to pay to access it. Here is a brief article on the research of VS Ramachandran.

    http://healthland.time.com/2011/02/02/mind-reading-neuroscientist-v-s-ramachandran-on-unlearning-pain/

    The current research indicates that GID and BIID are both the results of the inability of the brain to properly integrate sensory information in the super parietal lobes. in the case of GID, the brain has developed with the wiring for the opposite sex. In the case of BIID, the brain is missing the wiring for the affected body parts. In both cases, the brain is intolerant to this. The sufferer feels trapped in the wrong body, life, etc. This usually begins at a very early age and intensifies in adulthood.

    And I don’t personally like the terms transabled, wannabe, pretender, or just about any of the other terms that have been invented to describe us. Not a single one really describes what it’s like living with BIID. Not all of us want to be physically disabled, but to us it seems like that might be the only option to end our discomfort. The technology simply does not exist to fix our brains.

    “I was more mentally and emotionally disabled prior to getting help to start testosterone injections” – I was mentally and emotionally disabled prior to my starting to use a wheelchair… it freed me from a life of intense torment.

    • First, I’d just like to say that you seem to have an equally emotional response to my writing as you think I’ve had to yours. In no way am I suggesting that someone would want to have either BIID or GID. That’s just a ridiculous thing to say, considering the time, thought, and effort I put into my response.

      And secondly, your argument comes down to this: “The specific terminology that describes my identity isn’t in the DSM, and my intent is magical, therefore your entire argument about how ableism informs aspects of this conversation is invalid.” But your intent isn’t magical, and when specific terminology isn’t in the DSM, that doesn’t make what either of us have to say less valid. You’re just not going to convince anyone who doesn’t already agree with you, because it’s a bloody terrible argument. And ultimately, that number of allies is always going to be a marked minority, because arguing/lecturing like you have in your response here, isn’t going to win more for you.

      Of course, if that doesn’t matter to you, I’m wasting my time even trying to get that across. In that case, you’re wasting your time blogging, too.

      There are, in fact, a lot of body dysmorphia/dysphoria/integrity disorders described in the DSM. Some simply fall under the category of “not otherwise specified” (this is a subcategory in virtually every category of the DSM and ICD-10, as well as non-psychiatric medical conditions listed in the ICD-10). Your experience isn’t unknown to the medical profession, to body modification communities, or to disability rights activism communities, so you don’t need to try to validate it by making inappropriate claims about someone else’s (especially at the expense of their taking the deepest personal offence from this measure).

      But ultimately, I know from how you’ve chosen to respond that I’m not going to get through to you. This comment (and honestly, the entire journal entry, now that I’m aware of what a conversation this isn’t) is here for people who will keep an open mind about it. It might do both of us a favour too, or at least I would hope it might. Because that matters to me.

  2. I’m simply trying to correct misinformation. I’m not sure how bringing science and research into this discussion involves magic. I don’t recall saying anything about unicorns…. but the functioning of the brain is magical in it’s own way. “Any sufficiently advanced technology is indistinguishable from magic.” – Arthur C. Clarke

    “This is, in fact, a critical aspect of the dialogue about why Body Integrity Identity Disorder (BIID) and Gender Identity Disorder (GID) are even listed in the American Psychiatric Association’s Diagnostics and Statistics Manual year after year.”

    This is a false statement. Now you claim BIID falls under not otherwise specified. I would agree with this statement.

    “When someone argues “I was born in an able body and believe I should have been born in a disabled body” is comparable to “I was born in a mis-sexed body and believe I should have been born in a body with a different phenotypic sex (or lack thereof)”, they are arguing that having a sex change (or having one’s sexual organs nullified) is comparable to being rendered physically disabled.”

    Arguing that because BIID and GIID are similar and BIID is a debilitating disorder, GID must also be a debilitating disorder is a logical fallacy. Saying A is like B and B is like C, therefore A is like C does not make it true. No one has ever made that claim that GID is debilitating, only that the two disorders show a great deal of similarity.

    My argument is based on peer reviewed research. Not sure how else I can go about convincing people besides pointing them to actual experts like VS Ramachandran and Michael First.

    I’m not even sure what your argument is besides not liking that a comparison was made between GID and BIID and that’s why I’m saying your having an emotional response to something. You obviously put a lot of time and thought into it. I’m sorry if I offended you and perhaps I’m misreading your argument.

    And yes, I do have an emotional reaction to things like this. I’ve invested tons and tons of my own time and money looking for a cause, helping researchers, and hoping some day someone will find a medication or therapy that actually works.

    • The “intent isn’t magical” aspect of my response comes from your “but I didn’t mean to argue that transsexuality is comparable to a disability.” You may not mean it, but the manner in which you constructed the parallel you see between the two tells readers that, in fact, you do mean that. The same way that using an ableist word as a pejorative tells people, whether you mean it or not, that disabled persons are lesser. Or the same way that telling a racist joke, whether you mean to diminish the political impact of racism or not, tells people that you think it’s treated far too seriously. And the punchline (or the pejorative, or the argument) is only considered effective in the first place because of shared assumptions about the social value of the marginalized group for whom continued respect is considered expendable.

      Whether or not BIID is a specific listed term, or is described under the mini-umbrella “not otherwise specified”, is just not something I (or most people) would bother nit-picking over. Especially in order to dismiss the validity of what is otherwise said. The same way gender dysphoria isn’t a specifically listed term, but is described in any case. This just isn’t enough to try and throw someone’s entire argument out the window over. Body modification communities, disability rights activism communities, and psychologists/psychiatrists are well aware that there are people who live with these experiences. That is not to suggest that they all uniformly agree (or even that all members of a specific localized community agree), because they don’t. Just like the way not all women hold to the same politics. Sometimes, people are just ignorant, and sometimes you can try until you’re purple in the face to better inform them, and they’ll wait until the very last minute to reveal to you that you’re just lecturing someone who will never believe you even if you offer them a particularly persuasive insight.

      Additionally, using a relevant analogy is not the same as creating a logical syllogism. Peer-reviewed or not doesn’t make it more or less accurate. You are arguing that mismatched functionality of specific parts of the body, such as the left leg, is to “transableism” what mismatched reproductive organs and secondary sex characteristics are to transsexuality. That’s simply not A is B and B is C therefore A is C. Or however delicately you would otherwise prefer to specify the terms of that syllogism. It’s not a syllogism, because it’s argument by analogy.

      My argument is that the comparison is inappropriate. First, that the term “transabled” is grossly misleading and reflective of a failure to understand what the word ableism evokes. Secondly, that it raises all the unchecked notions of ableism that you are already trying to depart from, at the expense of re-introducing it into a conversation about transsexuality. That also makes it particularly unfair to both causes, because it incites close-minded, ableist rebuttals of our genuine lived experiences. And thirdly, that it’s just a terrible and misguided analogy fraught with problems.

      • I agree with you that it’s unfair to both causes, but that does not change what the neuroscience theory behind the disorders. I’m simply arguing from the position that agrees with my own experiences and makes sense to me. I’m not saying any other theories are less valid, only that I they don’t match with my own experiences.

        The issue of BIID not being included in the DSM is very important to us. Right now we’re in a medical limbo and we have to fight to be recognized. It’s limiting our ability to find treatment options, especially non-invasive ones, like use of assistive devices. One of the proposed diagnostic criteria is:

        “The preoccupation with the desire (including time spent pretending to be disabled) significantly interferes with productivity, with leisure activities, or with social functioning (e.g., person is unwilling to have a close relationship because it would make it difficult to pretend)”

        I live most of my life in a wheelchair, it’s the only thing that helps me function normally. My legs feel disconnected from the rest of my body and I suffer from involuntary muscle movements (myoclonus). Somethings really, really wired wrong in my brain and it’s been that way as long I can remember. My psychotherapist is very supportive of this decision, as is my GP. It’s significantly reduced the intensity of the disorder and from my perspective, it’s not harming me or anyone else. I’m disabled and it’s not a joke to me.

        My biggest problem is that I can’t find any support services. I’m doing my best to deal with this disorder in a healthy, open, honest way. I want to be healthy and active. I want to play sports. But because of discrimination and lack of recognition of this disorder, I’m basically being told I’m all on my own in dealing with this. That sucks.

        I disagree that many therapists are familiar with disorders like BIID. I’ve been seeing therapists since I was in college and not a single one had any clue about BIID. I’ve been seriously misdiagnosed in the past. My current therapist has a PhD and more than twenty-five years of experience and had no knowledge of BIID prior to my first visit. It’s only in the last few years that the medical community has taken any notice of us. We’re secretive people, we realize the medical community has little to offer us and will likely experience discrimination if we come forward. Prior to the internet, it wouldn’t have been possible to do any significant research.

        If your argument is about semantics and the connotations of the term ableism and being mis-associated with the term transabled, I have no quarrel with you. Like I said, I dislike the term and don’t use it. I dislike many of the terms used to describe us. Particularly, wannabe… I don’t want BIID and I don’t like being disabled. They are derogatory words intended to perpetuate stereotypes. I’m all for not perpetuating ideas that promote discrimination in any form.

        • A lot of the same sentiments could be expressed in terms of dissociative identity disorder–of which I am a survivor. But there’s no “hard-wiring” explanation, and thus, this promotes ignorance. I suspect that it is equally possible, that the same argument could be made within the profession of psychology/psychiatry, about your experience.

          Hard-wiring or not, it’s not a professional’s job to minimize your experience or attempt to persuade you that your disability is imaginary or invalid. And it’s shitty that professionals do this anyways–in your case and in mine. And like you, prior to the internet, I wouldn’t have been able to research one of my own conditions which is arguably the most significant contributor to my disabled existence. But I’ve recently fallen upon good fortune, and finally found a psychotherapist who seems to agree that my experience is valid, and wants to help me to understand how it impacts my daily life and relationships, so that I can some day realize what my potential is, and pursue fulfilling it independently.

          I’d suggest that you think long and hard about subscribing to a single paradigm of thought about your experience. Especially in the case of the hard-wiring argument, which is the same principle that drives sexist ideology, which in turn undermines women’s social and political power on a daily basis. And many forms of ableism, which psychological/psychiatric professionals are by no means immune to, simply because their job is to empower their patients.

        • I mean, hell. Even “hard-wiring” is disputed, and rightly so, considering how often it’s been used as a moral/ethical principle to discriminate against certain groups of people throughout history. And it’s since been proven that the brain is highly capable of re-wiring itself.

  3. By the way, I do appreciate that you accept and acknowledge that BIID is an actual condition. You are more open minded than most people in the disability community.

    I do actually agree with you on many points like that there is nothing wrong with living with these kinds of disorders and that we are not bad people because of it. And that we face a ton of societal issues because of it and that really, really sucks. So thank you for that.

    I’m actually intrigued by the fact you have thoughts about removing one of your fingers… that’s the rarest form of BIID. The most common is amputation of the left leg. Perhaps that’s just because statistically, we can’t make any real conclusions. It could just be that people desiring the removal of a finger aren’t distressed enough to seek treatment so they don’t factor into the current demographics.

    • I feel empathy to your cause, but I still struggle with my own feelings concerning the validity of “transableism” or being mis-abled in ways that differ from the persistent belief that one has an extra body part that doesn’t belong to them. I’m familiar with occurrences like what is called “glove anaesthesia” (which is anatomically impossible and thus, treated as a somatic disorder, or “it’s all in your head”), which isn’t the same as persistently reporting dysphoria because of the presence of a hand that shouldn’t be there (which I’m also familiar with, and which has previously been demonstrated to have no bearing at all on the soundness of an individual mind).

      This is perhaps in part due to the fact that I’ve simply never encountered people saying things like “I think I should be blind in one eye” or “I wish I was deaf” or “I don’t desire to have one or both legs amputated or put in a permanent cast, but I think I should be in a wheelchair”. But I have encountered discussions where an individual expressed a desire to have one or both legs put in a cast for a finite period of time that other people felt was unreasonable and fraught with serious risks. And I don’t believe that the reasoned and rational response is “Dude, you’re fucking nuts” because this is called ableism. And again, I have encountered multiple physicians reporting (either through television interviews or written reports that were used in papers or dictated in my psychology classes) about patients they treated who self-amputated, and who were found to be of sound mind. Aaaaand, I’ve encountered many more discussions of individuals in the body modification community who have amputated parts of fingers (such as I have the persistent thought of doing or having done to one particular finger)) or entire fingers, either by themselves or with help.

      If a thousand people drank from the well of ignorance, it wouldn’t make anything any of them had to say more true, simply because 999 other people were ready to back them up. And so, I don’t take the relatively small number of people who exhibit awareness of these experiences, as an indicator of its validity. I take it as an indicator of a more prevalent ignorance.

  4. Not engaging in the lengthy discussion, but wanting to address the issues with the word “transableism”.

    I can see how you might have thought it was about ableism in the trans community. However, the word I coined was “transabled” – nothing at all to do with ableism. Ableism was not a word used much at all back when I came up with the word transabled anyway.

    Interestingly enough, “transableism” was first published in the literature by a disability rights activist.

    It is not a perfect word, far from it. It doesn’t represent the experience of having BIID. But it’s better than the other words that have been used to describe what we have, and it’s a lot lesss medicalised than BIID. Until/unless someone comes up with better, I’ll keep on using it.

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