The time is fast approaching when I'll need to decide what to do with the rest of my life. Graduation is less than two months away. You'd think I'd be chomping at the bit to get out there and wield my shiny, new masters degree, but I'm not. I can't really even tell you why.
It's not that I don't enjoy what I'm doing right now, school wise, that is. My practicum this year has been great. I really enjoy the people I work with and the environment they create to work in. It's not really that I'm struggling with the work. I've enjoyed working with the clients at the agency. I've got a lot of positive feedback from co-workers. If everyone is to be believed, I'm actually kinda good at it. Obviously, being a therapist can be draining. I have one client who consistently blows me away with horror stories from her childhood, and there are mornings I wish I could play hooky. Usually, though, once I get there I'm fine.
Is it about the money? Or rather the lack thereof? Maybe. A little. Still after three years of squeaking by on part-time income, almost any full-time income will be a welcome improvement. I'm not really sure that's it, though.
Part of it is going back to the proverbial "9 to 5." (Does anyone really only work 9 to 5 any more?) I've kept up the web development stuff to pay the bills. The $8/hr I get at my internship doesn't even cover child support. I recently decided to rent some office space, because honestly folks, working from home sucks. It's not about distractions as much as it is about it sucking the life out of you. I'm someone who has to get away from work. If I work at home, I can't. Ever...and motivation and focus go right down the toilet. But I digress.
The point is I'm actually enjoying having my own office space. The difference is night and day. Even though I'm putting in full to long days right now, I'm still making my own decisions. I get in when I want to get in and not because I am required to be somewhere at some given time. I leave when I want. No one is dictating to me how I should work (can you say "managed care?"). Even after graduation, I'm still two years of full-time work (4000 hours) away from anything close to that kind of freedom in the mental health world and I will always have some damn bureaucrat, whether government or corporate, looking over my shoulder telling me how I should be doing my job. I do know some therapists who only take cash. How many years after starting my own practice before I have that luxury?
There's also the little piece about flexibility and freedom. Even if I never actually take advantage of it, knowing that I can pack up my laptop and work from just about anywhere the mood strikes me—Starbucks, Barnes and Noble, the Bahamas—feels very nice. It wouldn't be nearly as easy to pack up clients. Do I really want to be tied to a practice?
There are just too many questions I don't have the answer to yet. Another part of the dilemma is there are several folk who will be disappointed if I bail on the therapist gig. I've never been good at disappointing people.
I just opened the fortune cookie I got with my lunch. "Your present plans are going to succeed if you stick to them."
I spent 8 painful hours at my new practicum site today going through employee training. Among the endless information stream I was
forced privileged to read, was DRA training. What, you might, ask is DRA training? Well, it's the act of Congress that gave Medicaid broader powers and greater funding to ferret out fraud. Fine. Whatever. I'm sure fraud exists. It's probably a good idea investigate and prosecute those defrauding the federal government taxpayers of their money. Though I must say that every time I get tangled in insurance red tape that is supposedly saving me money, I have to wonder how much money is being spent to sustain the bureaucratic system.
But what I found most interesting is what DRA stands for. It's the Deficit Reduction Act (of 2005). That has a much better ring that The Trimming Medicaid and Student Loan Subsidies Act doesn't it? Oddly enough, those were the only items on the table. Apparently the government isn't wasteful anywhere else. (co*ir*u*aq*gh) It's interesting that the White House fact sheet on the DRA doesn't mention boosting the budget for ensuring compliance and honesty. It makes no mention of how much fraud they believe exists. No mention of how much they anticipate recovering. I hope it's a lot. The budget for auditing heath care providers is 75 million. I guess the old axiom applies here: You've got to spend money to make money.
I've been reading Rewriting the Soul: Multiple personality and the sciences of memory. It was recommended to me by one of my professors. I picked it up more for the "sciences of memory" part than the "multiple personality" part. I confess I am a skeptic of multiple personalities (officially Dissociative Identity Disorder or DID now). It's been a very interesting read. His commentary on how we acquire knowledge in the social sciences was particularly intriguing.
[Binet's] measures of "intelligence" had to agree, generally, with preexisting judgments and then be adapted at the margins. Had he declared that many children who could not cope with French elementary education were intelligent, he would have been mocked. Had he said that the better students at the lycées where stupid, he would have been reviled. ... Binet's great innovation, the testing of intelligence, made sense only against a background of shared judgments about intelligence, and it had to agree with them by and large, and also to explain when it disagreed. Who shared the judgments? Those who matter, namely the educators, other civil servants, and Binet's peers in the middle classes of society.
...One result of calibration is that prior judgments became both sharpened and objectified. What were once discrimination made by suitably educated or trained individuals were turned into impartial, distant, nonsubjective measures of intelligence. Intelligence became and object, independent of any human opinions (my emphasis).
Now, I was aware that IQ tests are under fire for being culturally (white, middle class) biased, but it wasn't until I read those words that I understood the why and wherefore.
Many sociologists of science, and a few philosophers, have recently welcomed the idea that scientific knowledge is a social construction. They contend that science does not discover facts, but constructs them (Hacking, 1995).
Makes you stop and think doesn't it?
[Note: As with all sensitive topics, I've been sitting on this one so I can read it over a few times and make sure it sounds relatively sane. It's almost old news now and the APA has recently released this statement regarding the work group process and Dr. Zucker's experience. I'm posting this anyway, because I think it's still an important topic.]
Certain parts of the blogosphere have been buzzing about the APA's announcement of the DSM-V work groups and their members: specifically page 11 wherein Kenneth J. Zucker, PhD is named the chair of the Sexual and Gender Identity Disorders Work Group. I don't know how well known Zucker is to the population at large, but NPR's recent piece, "Two Families Grapple with Sons' Gender Preferences: Psychologists take radically different approaches in therapy" has certainly raised his public profile. There are quite a few folk upset that Zucker has been named the chair of a work group tasked with taking another look at gender identity disorder (GID). Some folk, count me among them, think GID needs to go. There is some justified concern that with someone who believes in treating GID chairing that committee, there will be little or not change to GID. Some even seem to fear there will be some backsliding.
There are a couple of things people seem to be missing in the discussion. First, one writer has suggested perhaps that the APA was not fully aware of Zucker's work. Charitable, but not bloody likely. You can be damn sure that the APA is fully aware of Zucker's work and theoretical framework. The fact that Zucker has been named the chair tells you two very important things. One, it tells you the state of establishment thought on GID. I doubt that numbers even exist, but I'd be stunned to learn there are more Ehrensaft's than Zucker's out there (see the NPR article). Get into the professional establishment and the ratio undoubtedly drops even more. Two, it tells you that whatever your disagreements with Zucker and his philosophy and approach to gender issues, he is most likely not the quack/hack some are making him out to be.
Second, people are also wondering how the APA, which dropped homosexuality as a mental disorder from the DSM-III in the 70s, could appoint someone with such "backward" notions about gender to chair a committee set to re-evaluate GID. Some have stated that Zucker and his work with children diagnosed with GID is about preventing homosexuality. Based on what little I know, I find that unlikely. Nothing I read in the NPR article suggests that is the case. Also, a local psychologist who is quite familiar with Zucker's work recently refuted an email claiming that Zucker is a supporter of the ex-gay movement. The hysteria that we are heading back to pathologizing homosexuality is unwarranted and unfounded. Gender expression and sexuality are completely different concepts and one has little or no bearing on the other. It is perfectly consistent, from a theoretical/professional point of view, to be fully accepting of homosexuality while believing in GID.
Third, we are talking about children here. We are not talking about adults. Scientific literature does suggest that gender identity is somewhat to very plastic in children. One text I read stated that gender identity is fixed by age seven. Zucker works with children under ten. If we can modify a child's gender identity to be more consistent with social expectations shouldn't we at least try? The answer to that question is unequivocally, "It depends." It depends on the child. It depends on the parents. It depends on what sort of philosophical/religious/moral stance any one of the parties involved takes. I think children who don't conform to society's gender expectations are in for a rough ride, no matter which path they take.
At the ages we are talking about, the parents exert an enormous influence on the lives of their children. Little girls aren't the only ones who like to stomp around in mom's high heel shoes. Does that mean little boys have a latent desire for the feminine or does it just mean that mom's shoes are colorful and make cool noise? What meaning do the parents assign to these behaviors? Some fathers will flip if they see their little boys wearing mom's shoes. Others won't flip until he puts on a dress. How many of you would feel okay if your child started wearing underwear of the opposite sex? The NPR story is as much about the respective parents' ability or lack thereof to accept their child's gender bending.
My biggest problem with GID is how culturally dependent it is. To me it seems the last vestiges of an outmoded way of thinking about male and female. I can pretty much guarantee that the discussion and the definition of GID would look quite different if society didn't have such rigidly defined pink and blue boxes; if society didn't insist that a human being can only stand in one and only one box; if society didn't apply enormous pressure for an individual to pick the box that has traditionally been associated with the anatomical bits between their legs. GID is more often diagnosed in boys than in girls. You'll have a very difficult time convincing me that's biological. I suspect it has more to do with gender bias in our society. Like Madonna said, "Girls can wear jeans and cut their hair short, wear shirts and boots 'cause it's okay to be a boy. But for a boy to look like a girl is degrading, 'cause you think that being a girl is degrading." Which gets your heart pounding more: your daughter in boxers, your daughter in briefs, or your boy in panties?
It would be interesting for NPR to do a follow up story in 10 years when Bradley and Jona are adolescents. Will Jona's popularity continue into adolescence when the rest of her peers start paying more attention to gender and sex? How well do you think it will go over if Jona insists she should be allowed in the girls' locker room? Still, even if Jona runs into some land mines while navigating adolescence, it seems to me the odds of successfully navigating adolescence increase dramatically with a firm and sound sense of self.
Where Zucker, in my opinion, ultimately falls short is in his conceptualization of the problem:
"Suppose you were a clinician and a 4-year-old black kid came into your office and said he wanted to be white. Would you go with that? ... I don't think we would," Zucker says.
If a four-year old boy came into your office insisting his penis was a vagina, I don't think anyone would go with that. He's got to come to terms with reality. The quesiton becomes, "What does it mean that you have a penis (or that your skin is black)?" Does having black skin mean you can only have a future in professional sports? Does having a penis mean you can't play with dolls? Perhaps Zucker didn't think his race analogy through, but he's basically validating racism by implying that there are behaviors assigned to people with white skin that people with black skin may not adopt. While that my still be an unfortunate reality, few would (openly) suggest there is some biological order that dictates such restrictions. For me the concept is not a whole lot different. Skin color or anatomical bits between the legs, either way whatever definitions and behaviors society has assigned to those anatomical realities need to be examined and, in most cases, eventually dismantled.
Brandon's tale is heart wrenching for anyone who has come from a place where they were taught to hate or fear some particular aspect of themselves. His mother's talk of his "addiction to pink" ticks me off in more ways than one. Still, I'm not convinced Zucker is the demon some are making him out to be. Indeed, I was recently pointed to this post by Alice Domurat Dreger
How do I know these are wrong? Well, I asked Zucker. Point blank. ... I asked Zucker: Do you think if a child ends up transitioning sex as an adolescent or adult, that’s a bad outcome? No way, he said. In fact, he pointed out that in that case--when a child grows up to be an adolescent who needs to change sex because that means s/he will be better off--Zucker helps arrange it to make sure it happens.
Wild allegations and hysteria are not the way to address this issue, certainly not with a scientific body like the APA. Get your facts straight...err...correct...and develop a well reasoned argument to support your case. Humanity is slow to change, but truth will eventually win out. We accept the world is not flat. We accept the earth is not the center of the universe. That may seem self evident now, but those are truths that were a long time gaining widespread acceptance.
Netflix has "Buck Rogers in the 25th Century" available for on demand viewing. I've been down all day with some nasty virus and had little better to do than lie in bed and watch Buck Rogers. Not that Gil Gerard in hard to watch, even with all the hokey martial arts and...unique...70s fashion.
It's been interesting to watch the show wrestle with race and gender. It would be interesting to be able to listen to recordings of the planning meetings to hear what people had said. There are so many...oddities. One the one had you have Colonel Wilma Deering. Female in a command position. Confident. Decisive. Not the traits commonly ascribed to women. Still, she's not above using her "feminine wiles" to distract a villain. Nor does she seem threatened or upset by Buck's implied womanizing, and actually has an implied colorful past of her own. Then there is Princess Ardala. The quintessential femme fatale. Sexy and dangerous. Except that she has the inability to control her lust for Rogers and in episode after episode is undone by it. In the last episode of season one the point is made that Ardala is not a real woman, just a spoiled girl. An interesting distinction.
I'm not sure what to make of all the latex and bikini's. That could be, at least in part, due to my male point of view. I guess one could make the argument that a woman exposing her body is empowering and women don't have to be sexless to be powerful. I'll leave that up to the ladies to decide. My favorite gender-WTF, though, was when Twiki found a love interest. Those of you old enough to remember the show will remember Twiki's signature beedee beedee beedee. His love interest's signature sound? Booty booty booty.
Race is equally muddled. Diversity is carefully calculated. Five captives in a cell and one is black, one is Latin, one is Asian, one is white and one is aging. Wouldn't it be nice if the world were equally divided into fifths? Um...wait. No Arabs? Despite obvious attempts at diversity, the arch enemies, the Draconians, have a decidedly Asian feel to their uniforms, reminiscent of samurai. Though they did switch the original Kane from the pilot, who also looked to be of Asian descent, for someone with a more Latin feel. There was another episode where the bad guy's lair looked like it came right out of a Chinese painting. Oh, and this is the best one: Buck gets to play body guard to Miss Cosmos. How do beauty contests work in the 25th century? Genetics. Miss Cosmos is the "almost perfect genetic ideal of a female human." Miss Cosmos is also couldn't be more Scandinavian. Platinum blond hair. Blue eyes. Pale skin. That's the human genetic ideal, huh?
Still, for all it's awkwardness, I did enjoy watching the show. Not every TV series from my childhood can stand up to my memory of it. "Dukes of Hazzard"? I remember watching that show religiously and enjoying it immensely, but I tired of watching it after just a few episodes. Even the hunky John Schneider couldn't keep me coming back for more. Next to bear scrutiny: "Battlestar Galactica".
I think one of my biggest pet peeves about the field of addiction treatment is this idea that we can scare people away from their addiction. It doesn't work. For one thing, people desperate for their next hit aren't thinking, "Do I take this hit and risk [insert dire prognostication here]?" Research has even demonstrated that scare tactics don't work. That doesn't stop people from trying to go that route. Today I visited a residential treatment center for drug addicts, and it happened again. Someone had found some flier that told about all the bad things smoking pot can do to you. Benefits for smoking pot: none. That's bullshit. Of course there are benefits from smoking pot or people. wouldn't. do it. Get real. Sure there are health risks as well, but there are health risks associated with drinking alcohol, too...and hamburgers and french fries and steak and butter...you get the idea. You can't deter people that way.
A while back I sat through a video shown to some teenagers about the evils of marijuana. It was all about horrific cases of cancer that supposedly resulted from marijuana use. Right in the middle of the video one of the folk being interviewed said, "This isn't about trying to scare you." What the hell? What do you call it then? Why interview some guy who lost his lower jaw, and eventually his life, to cancer? Why the graphic images of surgery to remove diseased bone? You can get oral cancer from any smoking or tobacco habit, not just pot, and for every person who might have such dire consequences there are 100 or even 1000 who don't. Do you think the kids were fooled by that disclaimer? I don't.
Perhaps the one thing that has annoyed me the most was a poster hanging in the same room where we watched the video. I don't remember the exact text now, but it basically said, "My mom drank herself into the grave, but Budweiser and Coors didn't come to her funeral." WTF? Great example of not taking responsibility for your own behavior. This is really what we want to teach teens? How to shift blame? The thing is: someone from the treatment team hung that poster up. I just don't get it.
Yes, I'm reading The Golden Compass. I needed to some light reading in part to fill the times on an airplane I can't use my laptop and in part to break up all the high-falootin' reading I've been doing lately. One can only read so much scholarly literature before one's brain goes to mush.
In an approach pioneered by Cleary, Humphreys, Kendrick, and Wesman (1975), a regression model is applied in which a test or indicator variable serves as the predictor variable, and the score on some important “gold standard” serves as the variable to be predicted. In this model, an indicator can be considered fair or unbiased for both groups only if the regression lines are the same for the groups in question. Regression lines can differ in both the slope of the line and its intercept value. Different slopes suggest that the indicator is differentially useful across levels of the indicator for the groups, whereas different intercepts suggest that the indicator is systematically over- or underpredicting the gold standard for some group.
I picked this up not so much because of the impending movie release as a blurb in this month's issue of Out. It mentions the existence of two gay angel characters in the second book. Naturally my interest was piqued. I'm curious as to how that is presented in the book. I'll let you know when I get there.
Second book? Yes, it's a trilogy, a fact missing from all the marketing hype. Is the movie only the first book or all three? I don't know. I sure hope it's only the first. You try and munge a whole series into one movie and you are asking for a flop. Just ask Disney (The Black Cauldron) and 20th Century Fox (The Seeker: The Dark is Rising).
If the movie powers that be have a brain between them (which is often open to debate) they have produced the first book and are waiting to see how much money the first movie makes before committing to the other two. If the movie is as entertaining as the book, they should do well.
Went and saw N*W*C a few weeks back. Posts like this one tend to sit for a while so I can make sure I'm saying what I want to say. Still feeling a little trepidatious about this one, but it's time to put a fork in it and call it done.
After the show I participated in a discussion group at a local coffee shop where I was one of three white people at a table of 9. I was, however, the only white person who was talking. I go to these things because I want to try and broaden my understanding of the human experience, but I usually end up walking away feeling like an ass. Not because of anything stupid or insensitive that I have said. I'm smarter and more aware than that. I walk away feeling like an ass because, regardless of my personal beliefs or my personal politics, I am white (and middle class male, to boot), and that automatically makes me one of them, one of the oppressors. I suppose I internalize those kind of messages way too easily, but that's a topic for another day.
Apparently N*W*C is quite controversial. Groups on campus really had their panties in a knot about the show. There were several power guest speakers that came in to "deconstruct" the play even before the curtain went up. From what I've been able to gather, people are upset because it takes too soft a stance on racial inequality. They spend a lot of time poking fun at stereotypes and I guess folk think that will give the masses permission to join in. I suppose I can see some rich, clueless white kid taking it the wrong way, but I find it hard to believe people would walk out of the show thinking it's okay to call a black man a n*gger. I thought it was pretty clear that is still not okay.
Some were uncomfortable or offended by how often n*gger, wetb*ck and ch*nk were said during the show, mostly (if I understood correctly) because of the comic context in which they were used. I really don't get that. Have you ever seen Chris Rock live? He drops the n-word all the time. "But he's black. That's different." Well, they each kept to the slur that fit the color of their skin. You didn't hear the Latino using n*gger, nor did the black man use ch*nk. So what's the big deal? Is it the venue? If the show were at a private theater and not a university campus would that be different? Think about comedy in general. If you pay attention, it's all about stereotypes. When the Asian fellow says, "Oh! And Asian people do know how to drive! We're just cautious" we all laugh because we know exactly what he's talking about. Because of the comic context I'm not sure it reinforces stereotypes nearly as well as getting stuck behind a car going 45 in a 55, finally being able to pass, and glancing over to find it piloted by an Asian person.
The more I think about it the more it sounded like the message was "we are more alike than we are different and we need to get past these rigid, ridiculous definitions of race." Not sure what the problem with that message is. Just because we aren't there yet doesn't mean we can't dream. And if no one dreams...well, how is it supposed to happen then?
There was a segment where each of the three--a black man, a Latino, and an Asian--took turns talking about the things in other stereotypes they wished they could be. For example, Asian men are often viewed as asexual. Hence, the Asian fellow talked about how he wanted to be seen as a mysterious, sex machine with the guaranteed ability to drive his woman to distraction in the bedroom. ("Big penis" was a running joke throughout the show: black = have, Asian = have not, but more on that in a minute.) That seemed to be one of the sticking points with the discussion group (which was primarily Asian for whatever reason). It seemed they didn't like the idea that not all stereotypes are bad and that some people might actually want to be seen that way.
The topic of passing came up since I, being gay, am "other" but can fake it if I want to. Thus my experience coming to terms with my sexuality can't compare with the experience of someone of color realizing the the color of their skin means something, and not something nice. We both had to come to terms with our position in society, but unlike me, a person of color can't usually pretend to be white. I didn't bring it up at the table and maybe I should have, but, honestly, I'm not sure that's an asset. Having to decide every single time if it is worth it to out yourself to some random sales clerk who assumes the flowers you're buying are for your wife gets old. Tiresome even. Most of the time I don't bother. I suppose I could camp it up like a friend of mine whose outrageous behavior is at least in part telling the world, "Don't you dare assume I'm straight." I could don glittery silk shirts and and rhinestone Elton John glasses. But none of those things is really me and would feel phony and affected. Sometimes I do wish I didn't have the choice to make and would prefer the stares and jeers of the uncouth.
Of course then you'd have the flip side of that coin. One of the young ladies at the table who is of Korean descent told the story of an experience in the hospital where a nurse entered the room and started making conversation based on all kinds of (incorrect) assumptions about her likes and dislikes just because she is Asian. Again, I probably should have asked if she corrected/educated the nurse and if she didn't then why not? Would it have been worse if the nurse had assumed she was white?
Right on the heels of that discussion came ex/non-Mormons. Some have likened their adjustment to living in a predominantly Mormon society to the oppression people of color feel. Several of the folk at the table take offense at that. They felt it devalues their experience. I could wade into treacherous territory here, but I'll just say I'm not sure how I feel about that. I don't feel its any more appropriate for me to assume the young lady at the table who self-identified as LDS is a repressed, homo-hating, pill-popping Mormon than it is for me to assume someone has grilled puppy for Sunday dinner because he is Korean. Is the distress a person of color feels worse than the distress of a white person in a minority? I don't know. Don't suppose I ever will.
Oh, getting back to "big penis." The ladies tired of the joke pretty quick. I didn't think it was excessive, but then, I'm a man. One lady said she wanted six people on stage three men and three women and that would give a more accurate picture. Accurate picture of what? Sorry, but that is the male experience. Having six people on stage would give a view of male/female interaction in the context of race, but if it were three women on stage it would give a completely different view. I'd be willing to bet they'd have been talking about boobs or Aunt Flo or something like that. The men in the audience would have tired of menstruation jokes just as quickly as women tired of penis jokes. Is one better than the other? I don't think so. Just different. The male experience is different from the female experience is different from the male-female experience.
Does all this have a point? I don't know. Probably not. Just ruminating on the experience.
One of my assignments for my practice class is to keep a journal of things that come up for me during the semester. I haven't been very good about it and I'm trying to catch up.
In my policy class, we have been discussing Bush's New Freedom Commission on Mental Health. From the opening letter:
On April 29, 2002, you [Mr. President] announced the creation of the New Freedom Commission on Mental Health, and declared, “Our country must make a commitment. Americans with mental illness deserve our understanding and they deserve excellent care.” You charged the Commission to study the mental health service delivery system, and to make recommendations that would enable adults with serious mental illnesses and children with serious emotional disturbance to live, work, learn, and participate fully in their communities.
Generally, the recommendations are a good start toward better policy and don't pull too many punches about the current state of mental health care. However, I find that I have real issues with the premise on which the commissions findings are based: "After a year of study, and after reviewing research and testimony, the Commission finds that recovery from mental illness is now a real possibility." It seemed that I was the only one in class who took issue with the use of the word recovery.
How exactly does one reduce or remove stigma from mental illness if official policy states that recovery is possible? What exactly constitutes recovery? My instructor suggested the definition of recovery is being able "to live, work, learn, and participate fully in their communities." Really? That's an interesting definition. Do you think if you talked to someone with diabetes who has their symptoms under control with insulin shots and dietary restrictions if they had recovered from diabetes they would say, "Oh, yes." Do you think if you asked someone with schizophrenia who has learned to manage their disorder with medication and counseling if they feel they have recovered their answer would be yes? Of course not. They would both tell you they have learned to manage their illness. Recovery is when you can stop taking pills and you don't have to worry about symptoms returning, like, oh, gonorrhea. Ten days of antibiotics and you're good to go. Otherwise, if the cessation of pill popping precipitates a return to a prior dysfunctional state, it's not recovery. It's managing your illness. Redefining recovery to mean "symptom management" doesn't do anyone any favors. It only muddies the waters and complicates and already complicated issue.
Someone in class said they were offering hope. I'm sorry, but what good is hope if it's a false hope? Do you think a client who has bi-polar tendencies is going to be just a tad disappointed when he learns that your definition of recovery includes taking pills daily for the rest of his life that may also make him feel lethargic and interfere with little things like his libido? By stating that recovery is possible you're still saying it is not okay to have a mental illness. How many of you balk when the person you're dating reveals they're on psychotropics? Why? They're recovered, right?
Policy makers and insurance companies are so enamored of the medical model of disease for mental health. They want it predictable and measurable. Like the medical world has all the answers for it's own domain of problems. The ultimate goal is to find a pill for all that ails you. None of that costly long term therapy. "Do you find yourself boiling your paramour's pet rabbits? Do you spend hours hiding in the bushes near the home of your latest obsession? Have you ever come completely unglued and beat your child with the forbidden wire hanger that found its way into your child's closet? Then ask your doctor about antifatalmominase, our new anti-borderline pill. Side effects include nausea, vomiting, anal leakage, migraines and high blood pressure. If you find yourself having hallucinations contact your doctor immediately as this may indicate a rare but serious side effect that could lead to a murderous, psychotic episode."
This semester my practice class is focusing on issues related to children and adolescents. We've spent a little time talking about sexuality and gender. It is interesting to me that we as a society are slowly getting to a place where the sex of the person you sleep with is less an issue, but woe unto the individual who doesn't conform to gender stereotypes.
The APA dropped homosexuality from the DSM (Diagnostic and Statistical Manual) back in the 70s, but Gender Identity Disorder is still on the books. Congress is set to pass an ENDA that includes sexual orientation in the list of protected classes, but Congress still can't stomach the idea of someone who is transgender or transsexual and gender identity has been removed from the version that will go to the floor of the House for a vote.
These days I tend to believe all prejudice toward women, homosexuals and other sexual minorities is rooted in the rigid definition of gender roles. I'm sure it is my place in a sexual minority that colors my thinking, but I don't quite understand why gender bending is so threatening to society. If someone born male would rather dress as or be a female why do you care? What possible threat does that pose to you as an individual? Doomsday predictions about the disintegration of society don't carry much weight with me. There is absolutely no proof for such dire prognostications. They rely heavily on mountains of dubious assumptions based on dogmatic declarations and have little real evidence to back them up.
It seems to me that Gender Identity Disorder is a social construct. It's very existence is based on the existing definitions of masculine and feminine. Were the definitions different, so would be the definition of the disorder. The fact is our society can't handle a continuum of gender identity. Men who are not athletic, aggressive and well muscled are disdained in our society. Just ask any shy, skinny, awkward fifteen-year old. Such men obtain some reprieve when they marry and demonstrate their ability to impregnate a woman, the ultimate marker of manhood that trumps all others. Women who are muscular, athletic and aggressive are met with equal disdain, again until they demonstrate their ability to birth a child, the ultimate marker of femininity. In our brave new world of more latitude when it comes to sexuality, society is grudgingly giving ground on the impregnation front. It's increasingly okay if an individual has no desire to impregnate or be impregnated, but by God that person had better toe the line on other gender identifiers.
The other aspect of Gender Identity Disorder that leaves me wondering is the taboo doesn't work equally for both sexes. Females are allowed to venture into male territory, but males are absolutely forbidden to venture into female territory. I am reminded of the words from "What It Feels Like For A Girl" by Madonna: "Girls can wear jeans, cut their hair short wear shirts and boots, 'cause it's okay to be a boy, but for a boy to look like a girl is degrading because you think that being a girl is degrading." Biology suggests that both sexes are equally vital for the survival of the species. Both serve necessary functions. Whence the unequal attitudes about gender roles?
I gave a short presentation on sexuality a few weeks ago and did my best to present facts since I have one or two biases when it comes to sexuality. Yesterday C gave her presentation on gender and C made no bones about her biases and laid them out there for everyone. I find the contrast interesting and am forced to wonder what, if anything, it says about me and my comfort level with my "other" status. I guess I'm just used to minds slamming shut when the subject comes up. I did (deliberately) present some statistics and recommendations regarding masturbation, sexual play in children, and gender identity that I'm pretty sure made some in the class uncomfortable. The point, I guess, is I was hoping they would have to deal with facts and not be able to dismiss them as rubbish from the radical homosexual.