The meaning of gender

In “Transsexualism: Clinical guide to gender identity disorder” (Current Psychiatry, February 2007), the author states, “Persons with GID transgress the traditional binary gender system.” This statement implies that gender is a social convention. If gender is just a social convention, isn’t the term “disorder” pejorative to those seeking to actualize the fluidness of sexual differentiation? Don’t persons with GID transgress their own “unambiguous genotype and phenotype,” which actually is a diagnostic criterion? Could the considerable psychiatric comorbidity reflect more than social discrimination, but also this rare, complex, subjective disorientation towards one’s body?

Underlying the treatment of GID are several tenuous philosophical assumptions, including the notion one can “reassign” through phenotypic alterations the genetic reality of gender. There also is an implied dualism in which the person is the conscious subject of experience, while the human body is sub-personal, a possession devoid of inherent meaning with only instrumental value. This position reduces masculinity and femininity to psychological phenomena.¹

Clinicians should be wary of colluding with patient pathology by cooperating in mutilation of a healthy human body, a violation of our ethical duty to preserve bodily integrity.

Thomas K. Nelson, MD
Assistant professor of psychiatry
Mayo Clinic College of Medicine

In “Transsexualism: Clinical guide to gender identity disorder” (Current Psychiatry, February 2007), the author states, “Persons with GID transgress the traditional binary gender system.” This statement implies that gender is a social convention. If gender is just a social convention, isn’t the term “disorder” pejorative to those seeking to actualize the fluidness of sexual differentiation? Don’t persons with GID transgress their own “unambiguous genotype and phenotype,” which actually is a diagnostic criterion? Could the considerable psychiatric comorbidity reflect more than social discrimination, but also this rare, complex, subjective disorientation towards one’s body?

Underlying the treatment of GID are several tenuous philosophical assumptions, including the notion one can “reassign” through phenotypic alterations the genetic reality of gender. There also is an implied dualism in which the person is the conscious subject of experience, while the human body is sub-personal, a possession devoid of inherent meaning with only instrumental value. This position reduces masculinity and femininity to psychological phenomena.¹

Clinicians should be wary of colluding with patient pathology by cooperating in mutilation of a healthy human body, a violation of our ethical duty to preserve bodily integrity.

Thomas K. Nelson, MD
Assistant professor of psychiatry
Mayo Clinic College of Medicine

In “Transsexualism: Clinical guide to gender identity disorder” (Current Psychiatry, February 2007), the author states, “Persons with GID transgress the traditional binary gender system.” This statement implies that gender is a social convention. If gender is just a social convention, isn’t the term “disorder” pejorative to those seeking to actualize the fluidness of sexual differentiation? Don’t persons with GID transgress their own “unambiguous genotype and phenotype,” which actually is a diagnostic criterion? Could the considerable psychiatric comorbidity reflect more than social discrimination, but also this rare, complex, subjective disorientation towards one’s body?

Underlying the treatment of GID are several tenuous philosophical assumptions, including the notion one can “reassign” through phenotypic alterations the genetic reality of gender. There also is an implied dualism in which the person is the conscious subject of experience, while the human body is sub-personal, a possession devoid of inherent meaning with only instrumental value. This position reduces masculinity and femininity to psychological phenomena.¹

Clinicians should be wary of colluding with patient pathology by cooperating in mutilation of a healthy human body, a violation of our ethical duty to preserve bodily integrity.

Thomas K. Nelson, MD
Assistant professor of psychiatry
Mayo Clinic College of Medicine