Medical Tuesday Blog
The Continuing Epidemic of Trans
After a dark history in which transgender kids were routinely ignored . . . or persecuted, a new protocol of social and physical transition has emerged. For teens that experience persistent gender dysphoria, this protocol can provide profound relief from suffering. For some kids, however, gender dysphoria is temporary. And the effects of transitioning can be permanent.
The Atlantic recently had this headline for a cover story and provided the story of the girl who was 12 when first interviewed, and then followed her through adolescence. They detailed the struggles she went through. She was at the point of demanding bilateral mastectomies and hormone therapy. The parents were highly educated and spent a great deal of time with their daughter. As the girl progressed through middle school, she found other girls who felt the way she did. As she became more gossipy with her classmates, she began to see herself in other girls. She began to feel at home in her body.
The parents now feel that if they had heeded the information they found online, their daughter would have started a physical transition and regretted it later. Their daughter is a generally happy teenager whose mental-health issues have improved markedly.
The Kansas University Medical School used the Menninger Foundation’s psychiatrists and psychoanalysts as their psychiatry faculty. Having spent a senior rotation there in Topeka Kansas, I recognized this was a very Freudian institution. The Menninger & Leaf textbook we used outlined the five stages of personality development—the oral, anal, sexual, latency and the maturation of sexual development. The oral phase is from birth to about 18 months when the erogenous zone is the mouth leading to oral eating. The anal phase is from 18 months to three years when the erogenous zones are the bladder and bowels and when toilet training takes place. The Phallic Stage is from age 3 to 6 years when the erogenous zones are the genitals. Freud called the fourth phase from age 6 to 12 the latency stage during which the libido is inactive. Boys and girls have similar interests and capabilities including math and sports. Sexual identity stage begins to develop at age thirteen or puberty through adolescence and full sexual maturity. The gender differentiations are best described by Louann Brizendine, MD, a psychoanalyst, in her books, The Female Brain and The Male Brain. By using fMRI, she is able to map brain activity during various physical, emotional, and other thought processes. She found that the sexual center in the male brain was four times larger than in the female brain. Males may be stimulated to sexual activity within seconds while females may take hours or even days. This may totally reverse today’s emphasis on which gender is doing the sexual harassment.
Not everyone goes through the stages without a sexual identity crises which may include what Freud termed Phallic Envy in girls and homoerotic phases in boys. In today’s epidemic of transgender hype, the “Trans female” would be the former which should be resolved during adolescence. If not, perhaps today Freud would call his Penis or Phallic Envy stage manifested in the Trans Girl situation. Before the surgery capabilities we’ve had recently along with hormone treatment, the final result more likely than not would be the Lesbian of today. In boys, it would be the second or homoerotic phase which also would be resolved during adolescence. If not resolved, the homoerotic phases, more likely than not, would be today’s manifestation of the male homosexual condition, which is today’s Gay male.
The current political iteration has gone through Queer, Lesbian, Gay, bisexual and now includes Transgender. San Francisco still has places called Queer’s Beer and Succor’s Liquors. When all the letters have been used, as in LGBTQ, recent editorials have suggested giving up all these various names and return to just the first term—Queer. This may have nothing to do with anatomy, physiology or psychology but only with political goals.
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