Monday, March 11, 2019

Jamie Shupe creates his own problems

“Shupe's experiences are not relevant to the challenges transgender people face or the professional demands of the clinicians who treat them.”
Monday, according to Jamie Shupe (at Heritage Foundation's blog no less): I Was America’s First ‘Nonbinary’ Person. It Was All a Sham. Last September I wrote about Jamie Shupe who was legally the first non-binary person in the United States. Shupe contacted me asking for a correction. I described Mr. Shupe as ex-non-binary. Mr. Shupe informed me that he is still non-binary but is no longer a transgender woman. Moreover, Shupe is intersex.

To be honest, I do not know if Shupe is now non-binary. I do know that his his transgender experiment came to an end. Sadly, due to the medical care he received, it was just that; an experiment.

A sham is a thing that is not what it is purported to be. That doesn't seem applicable. Shupe writes:
Now, I want to live again as the man that I am.

I’m one of the lucky ones. Despite participating in medical transgenderism for six years, my body is still intact. Most people who desist from transgender identities after gender changes can’t say the same.
I suppose that Shupe is referring to people who have gender-affirming surgery. But those are a small minority of transgender people (estimated at about one-third). More importantly (as you will see), Shupe would not have qualified for surgery. Requirements include:
  1. A comprehensive mental health evaluation. Surgery usually will not occur for at least two years after the initial evaluation.
  2. Clear and consistent documentation of gender dysphoria from thoroughly qualified clinicians. A referral for surgery usually must come from a qualified specialist.
  3. A “real life test,” usually a year or more living as their gender in everyday life — professionally and socially.
  4. Intensive pre-surgical counseling throughout the real life test.
This process results in a minuscule desistance rate. In a recent study of 47 male-to-female patients, 91% experienced an improvement of quality of life. All of the patients stated they would undergo the surgery again and did not regret it at all.

Shupe's story has a very different genesis:
After convincing myself that I was a woman during a severe mental health crisis, I visited a licensed nurse practitioner in early 2013 and asked for a hormone prescription. “If you don’t give me the drugs, I’ll buy them off the internet,” I threatened.

Although she’d never met me before, the nurse phoned in a prescription for 2 mg of oral estrogen and 200 mg of Spironolactone that very same day.

The nurse practitioner ignored that I have chronic post-traumatic stress disorder, having previously served in the military for almost 18 years. All of my doctors agree on that. Others believe that I have bipolar disorder and possibly borderline personality disorder.
We failed Mr. Shupe. If the story is true then he believed that a nurse practitioner would be qualified to diagnose and treat gender dysphoria. Only a highly trained specialist can diagnose the condition. A patient's self-diagnosis is insufficient and borders on irrelevancy. The nurse practitioner (presumably with the VA) also failed Mr. Shupe. He or she had a professional obligation to refer Shupe to a qualified psychiatrist.
Shupe blames mythical activists:
I should have been stopped, but out-of-control, transgender activism had made the nurse practitioner too scared to say no.
I do not believe that for a second. With any doubts, the nurse could have (and should have) referred Shupe to someone more qualified without suffering social opprobrium. Fear of a malpractice suit usually outweighs fears of disapproval by a minority group. At least it should.

I appreciate the fact that Shupe is taking some personal responsibility for the outcome. He used terrible judgment.

Shupe claims that he did obtain more professional care:
After I began consuming the cross-sex hormones, I started therapy at a gender clinic in Pittsburgh so that I could get people to sign off on the transgender surgeries I planned to have.

All I needed to do was switch over my hormone operating fuel and get my penis turned into a vagina. Then I’d be the same as any other woman. That’s the fantasy the transgender community sold me. It’s the lie I bought into and believed.

Only one therapist tried to stop me from crawling into this smoking rabbit hole. When she did, I not only fired her, I filed a formal complaint against her. “She’s a gatekeeper,” the trans community said.
That clinic would have served as a referral but would not suffice for a mental health evaluation (see above). As for fantasies and the amorphous transgender community, he cannot call it a lie without having gone through the lengthy process and then the surgery. Surgery does help transgender women feel more feminine. Shupe has no way of evaluating the net gain or loss. Again, I do not know what “the trans community” means or who those people are.
Some medium-rare, refried horse manure:
Professional stigmatisms against “conversion therapy” had made it impossible for the therapist to question my motives for wanting to change my sex.
Questioning motives and state of mind is obligatory and it is not conversion therapy. Conversion therapy would be an attempt to change Shupe's gender.
The “Diagnostic and Statistical Manual of Mental Disorders” (Fifth Edition) says one of the traits of gender dysphoria is believing that you possess the stereotypical feelings of the opposite sex. I felt that about myself, but yet no therapist discussed it with me.
For the record, here is what the DSM says:
  1. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration, as manifested by at least six of the following (one of which must be Criterion A1):
    1. A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned gender).
    2. A strong dislike of one’s sexual anatomy.
    3. A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender.
  2. The condition is associated with clinically significant distress or impairment in social … or other important areas of functioning.
A professional assesses these conditions situationally. He or she, for example, is not going to ask if someone if he has a strong desire to be a certain gender. The therapist asks other questions (beyond my understanding) to arrive at a conclusion about the degree of certainty.
Dr. Ray Blanchard has an unpopular theory that explains why someone like me may have been drawn to transgenderism. He claims there are two types of transgender women: homosexuals that are attracted to men, and men who are attracted to the thought or image of themselves as females.
Ray Blanchard is no crackpot. He is a highly respected sexologist and Shupe's description is reasonably accurate. Blanchard's opinion in this regard has been dismissed as lacking in empirical evidence. Blanchard, by the way, believes in public funding for gender-affirming surgery. He believes that the surgery improves quality of life.
More sophistry:
The medical community is so afraid of the trans community that they’re now afraid to give someone Blanchard’s diagnosis. Trans men are winning in medicine, and they’ve won the battle for language.
The medical community is a scientific community. Suggesting that they are motivated by fear is just nonsense. Blanchard's theory, by the way, is not a diagnosis. Again, Blanchard is a proponent of gender-affirming surgery.
Despite having taken or been injected with every hormone and antiandrogen concoction in the VA’s medical arsenal, I didn’t look anything like a female. People on the street agreed. Their harsh stares reflected the reality behind my fraudulent existence as a woman. Biological sex is immutable.
Shupe is describing a very real problem for transgender women who transition in middle age or later. They would be much more feminine had they done so earlier in life. No one disagrees that biological sex is immutable. Shupe's age should have required more intensive counseling before he was prescribed hormones. The fact that he was relying on the VA's care is telling.

The VA has some fabulous doctors in many fields. Gender dysphoria, however, might not be one of those areas.
Don't blame us for your pathology:
LGBT organizations helping me to screw up my life had become a common theme. During my prior sex change to female, the New York-based Transgender Legal Defense & Education Fund had gotten my name legally changed. I didn’t like being named after the uncle who’d molested me. Instead of getting me therapy for that, they got me a new name.
I honestly believe that Shupe is the victim of some terrible medical care. The LGBT community has no way of knowing that.
In January 2019, unable to advance the fraud for another single day, I reclaimed my male birth sex. The weight of the lie on my conscience was heavier than the value of the fame I’d gained from participating in this elaborate swindle.
What he seems to be saying is that he traded fame for sanity. The record says otherwise. Shupe was treated according to his testimony which varied at times. I do not think that he knowingly perpetrated a swindle or a sham. The more realistic explanation is that he wasn't properly diagnosed and essentially believed his own bullshit.

If you read this polemic in full, Shupe is very honest about his many mental health challenges. The problem is that he is a terrible diagnostician. If one accepts his narrative at face value he was able to persuade doctors to accept his varied self-diagnoses. That would be a legitimate problem concerning professional responsibilities. The fact that Shupe is intersex adds another variable that is extremely rare.

In the final analysis, Shupe's experiences are not relevant to the challenges transgender people face or the professional demands of the clinicians who treat them. Using these same experiences to devalue forms of gender affirmative care would be nonsensical and irresponsible.

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