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 Topic: Controversial Research Funded by UK Newspaper

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kereth  



Joined: 08 Jun 2004
Posts: 19
Interests: classics, anthropology, gender and religion in the ancient world, religious and magical practices, archaeology, theory of ideas
Physical Location: Southeastern US

Posted: 31 Jul 2004, 8:32 pm    Post subject: Controversial Research Funded by UK Newspaper Reply with quote

Sex changes are not effective, say researchers

The Guardian has commissioned a study which asserts that high levels of dissatisfaction among transsexuals after "the surgery" demonstrates that surgical sex reassignment is ineffective. While the research may not be as unbiased as the Guardian strive to present it, it does raise some interesting points.

I'd like to hear some heated (or at least lukewarm) discussion on the methodology, preconceptions, and implications involved in this research here.
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leispiach  
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Posted: 26 Jan 2005, 2:19 pm    Post subject: Re: Controversial Research Funded by UK Newspaper Reply with quote

kereth wrote:
Sex changes are not effective, say researchers

The Guardian has commissioned a study which asserts that high levels of dissatisfaction among transsexuals after "the surgery" demonstrates that surgical sex reassignment is ineffective. While the research may not be as unbiased as the Guardian strive to present it, it does raise some interesting points.

I'd like to hear some heated (or at least lukewarm) discussion on the methodology, preconceptions, and implications involved in this research here.


And luckily, nothing came of it. I stopped reading The Guardian after Julie Bindal's ill informed attack on transsexual women (Gender Benders Beware). The Guardian is the only UK paper that has consistently published diatribe and the most vicous of attacks on transsexual women by feminists (and this comes from a feminist!). Not even the Daily Mail has plumbed these depths.

These "investigations" like all media research, are aimed at sensationalising, nothing more. It's about numbers, and getting those numbers to read the paper. The Guardian has one of the lowest circulations of a national in the UK.

The only disatisfaction I've heard from transsexual women, comes from the too high expectation of the aesthetic results from the surgery in the UK.
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kereth  



Joined: 08 Jun 2004
Posts: 19
Interests: classics, anthropology, gender and religion in the ancient world, religious and magical practices, archaeology, theory of ideas
Physical Location: Southeastern US

Posted: 26 Jan 2005, 3:49 pm    Post subject: Re: Controversial Research Funded by UK Newspaper Reply with quote

Fairness compels me to post this response from David Batty. I asked Mr. Batty some time ago for his permission to post this here and some other places where I had spoken less than complimentarily about his research, and his reply was vague but, it seems, affirmative. He may email me at kereth at gmail dot com if he wishes me to remove it. Please note that this was written back in September 04.

****
I'm the author of the articles on standards of transsexual care, which have recently been published in the Guardian and on its website.

The main article in Guardian Weekend was the result of 14 months of investigation, including more than 100 interviews with TS/TG men and women, activists, medics and other experts, as well as ploughing through dozens of research papers going back well over 50 years. I spent 2-8 hrs interviewing the main case studies - worryingly, several people told me I had asked them more about their lives than the psychiatrists who had assessed them.

My initial interest in the standards of care was prompted by the discovery of the complaints against Russell Reid. (Incidentally patients have been making complaints about him for years before Charing Cross stepped in.) Having read the case notes of many of his ex-patients, interviewed several of them in depth, and spoken to other clinicians involved, I felt this was a significant story. I broke the news of the GMC inquiry in January.

However, complaints against one expert clearly didn't represent the whole story. From speaking to transsexual lobby groups and patients it became clear that the level of mistrust between the TG/TS community and the medical profession had a significant impact on the quality of care. Also from speaking to a range of medical experts it soon became clear that there was a lack of concensus on treatment - and a poor evidence base behind their practice.

The Weekend feature sought to address those issues through several case studies where things had clearly gone wrong. I decided to make Marissa the central case study for a couple of reasons. Firstly because her story was so incredible - I knew it would attract widespread attention. But secondly because she accepts some responsibility for the traumas she suffered AND firmly believes she is transsexual and is proud of her identity. In other words, here was a case that showed poor medical treatment had potentially awful consequences for people who are transsexual as well as those who have been misdiagnosed.

The other case studies illustrated flaws with treatment (I have seen their case notes) and the attitudes and expectations of patients. (Note that for legal reasons certain aspects of their medical hsitory could not be disclosed.) On the one hand you have those who believed changing sex would solve all their problems, and at the other end of the spectrum Rachael Padman, for whom genital surgery was just another step and not the one which she felt created her. As several psychiatrists and transpeople said to me patients who are isolated, disfunctional, in bad relationships, etc will probably remain so after surgery without proper preparation, care and support.

Some in the transsexual community has done their best to discredit those who complain they have been misdiagnosed or improperly treated. The vast majority of those I spoke to who regretted surgery were not liars or chasing compensation. Many had suffered considerable trauma and confusion, some had been sexually abused in childhood, others suffered from severe mental illnesses. The degree to which most could have been held accountable for their poor medical care was slight IMO. Although I have come across cases where people seem to have had surgery on a whim - usually in Thailand where you don't need to fulfill criteria for surgery.

The inclusion of the ARIF research was relatively last minute (commissioned two weeks before deadline). This was a literature review which confirmed what psychiatrists had already admitted - that the evidence base for the treatment of gender identity disorders is very poor. Most doctors and some TS people would like to see long-term proactive studies set up. However, some TS people - particularly some activists - are opposed to this due to their negative views (some no doubt justified) of the medical profession. However, there is now great pressure on transgender psychiatrists to develop evidence based practice and, hopefully, the new UK standards of care will provide the impetus for medics and the TS community to collaborate.

I dispute the accusations of transphobia. I'm not going to be held responsible for the views of Julie Bindel - who is a freelancer - or anyone else. A search of the Guardian archive will show that the paper is pro rather than anti-transsexual. I do not dispute that transsexualism exists, but as an investigative healthcare reporter I think that assessing serious problems in its treatment is quite valid. Some people have said, oh but what if this was a feature about gay people, etc. Firstly, as Ganesh points out, the difference is that transsexuals undergo irreversible medical treatment - treatment which perhaps has the most profound impact on a person's identity possible.

Secondly, I am gay and mixed race, and I try to take care to ensure that my own work is not prejudiced. (I studied gender, sexuality and race at university and these are issues I have regualrly explored as a journalist.) The focus of the piece was why the system was failing therefore the majority of the case studies were 'negative'. (I do also draw a distinction between MTF and FTM transsexuals.) But Padman was included to show that there are successful - very successful outcomes - and most of the commentators stressed that with the proper care and support the majority of people faired well. I also commissioned comment pieces from Press for Change in advance of the Weekend feature's publication. There's also a separate article on Padman on the Guardian website.

However, some trans activists whom I interviewed in the course of this research seemed to assume that I would unquestioningly promote their line - I did not and never would. I wanted to strike a balance of views - even if some of those came from people whom I personally considered offensive. Although I didn't come across any bigoted psychiatrists there were some whom I would not have felt happy to be seen by given their stereotypical view of gender roles and identity.

This is by no means the end of my investigation. As well as the UK standards of care, there is the inquiry into Russell Reid yet to come - and at least one court case. In the meantime I am also looking at the treatment of children with gender indentity disorders.
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leispiach  
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Posted: 26 Jan 2005, 4:56 pm    Post subject: Re: Controversial Research Funded by UK Newspaper Reply with quote

[quote="kereth"]Fairness compels me to post this response from David Batty. I asked Mr. Batty some time ago for his permission to post this here and some other places where I had spoken less than complimentarily about his research, and his reply was vague but, it seems, affirmative. He may email me at kereth at gmail dot com if he wishes me to remove it. Please note that this was written back in September 04.

****
I'm the author of the articles on standards of transsexual care, which have recently been published in the Guardian and on its website. /quote]

(Snipped to accommodate.)

He knows best, of course, being a professional. Being of mixed race and gay does not automatically mean he will understand transsexual peoples oppression or ideals, feelings or wounds. I can't speak for these transsexual people either, but I can empathise with their social struggles.

The way trans people are "dealt" with by researchers is less than equitable in my honest opinion, and their experiences are reduced to mere adjuncts of societal curiosity. part of the reason why so many lie to so-called clinicians and disappear from the study radar after surgery is because quite simply, they don't like being poked and prodded (psychologically) by people with no experince of what they have to go through.

This is why so many have told me they treat researchers with suspicion and quite often, unconsciously, tell researchers what they think they want to hear.

Batty's mention, and the way he mentions, Russell Reid's case is significant. The wording indicates that he feels Dr Reid was in the wrong, although he has been exonerated by the GMC and the RCPysch, with hundreds of happy trans people supporting him, and none supporting the Charing Cross team it so it appears. Perhaps that is why Batty's research is so skewed? One expert can be very different from another. Russell Reid, having met the man, I feel is a superb example of compassion and empathy. The two other psychiatrists I have met, involved in the gender business (and it is a business, a very lucartive one for psychiatrists) did not engender the same level of warmth when i met them. Quite the opposite in fact. It should also be rememebred that the requirement to see a psychological professional, is because it is deemed suitabel to find oter routes to personal fulfillment rather than hormones and surgery. So a barrier has been set up immediately there.

Another point that should be noted is the pathologic transvestite. I have only ever met one myself, but they can, due to the extremely subjective way in which psychology works, "slip through the net". Many do indeed go on to have genital reconstruction surgery (let's forget the less than accurate sex change surgery shall we?), and most likely regret it afterwards.

I am suspicious of people promoting a balanced view of anything, we all have our beliefs and biases, and none of us can truly be called objective. Within the psychological field, this is even more the case, as you are dealing with unknowns. Your only source of information is what is in the other persons head, hardly the basis for rigorous scientific resarch. Add to that your own views, and things become even more unclear.

The healthcare system has systematically failed trans people, lesbians and gays, black people, Asian people and a myriad of other so-called minorties. Only trans people are the subject of such intense scrutiny, a legacy of the moralistic culture we have developed from I suspect.

As a system survivor myself, I feel the incursions of professionals and researchers all too keenly, when I see them being used to study others lives. It should be noted that not all people will respond the same way to the same question, and not all people will tell the truth, either deliberately or due to ther factors. I've come cross the "satisfy the questioner" attitude before, several times. But I recognise this, as I was once a guinea pig to. I suspect Batty was not. This is where I picked up my own "radical transgender attitude".

I don't believe for a second he does feel he is transphobic either, transphobia is a subconscious and invisible prejudice, as is heterosexism. It still doesn't mean that he isn't though. Not facing up to indoctrinated prejudices is a major problem for academics. As is essentialism. I've been, at different times, transphobic, homophobic etc. it's part of life. When we start using our more negative beliefs tio influence the lives of others however, that is when it is time to take stock and re-examine our own attitudes. This is something I rarely find in academia.

I must seem quite negative about it all, but investigations affect people in different ways, and it is rare indeed for those doing the investigations, to understand this. Blanket accpetance and a desire to fulfill ones wishes are too strong a motive to accomplish the necessary equanimity that dealing with trans people in particular requires. I also find the scholarly need to validate the results quite amusing. Say who what and where, sure, but the unnecessary rhetoric that reseacrhers display is quite innapropriate I feel.

I will mention Russell Reid in closing one more time. He can only go on what he is told by his clients. He wants to facillitate a better standard of life for all. The Charing Cross team however, seem to want to control a "problem". Anecdotally, I have heard nothing but complaints about the treatment that trans people recieve at the clinic there. Trans people are not deviants, nor are they mentally ill, and should be treated as human beings first and foremost, and allowed to put their case and make their own decisions about treatment. Dr Reid allows this, Charing Cross do not. If Dr Reid is guilty of anything, it is caring too much.

I am in no doubt that Batty's investigation was skewed by innate prejudices, that he has never confronted. And I still refuse to read the Guardian. None of this has been written from a professional viewpoint, it has been written as a human being, whose friends, some of whom are trans, have been mistreated by the system. It's about time the professionals got off their high-horses and started realising that they cannot be right all the time, and that they suffer from the same prejudices and desires as the rest of the human race.
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GuardDB  



Joined: 11 Feb 2005
Posts: 1


Posted: 11 Feb 2005, 7:41 am    Post subject: Reply with quote

leispiach you've sought to refute my work by lazily accusing me of transphobia. I won't bother trying to persuade you otherwise as you've clearly closed your mind to anything other being the case.

However, I wish to point out a misconception that has arisen about Russell Reid. He has NOT been cleared by the GMC. A professional misconduct investigation - now known as fitness to practice hearing - is due to start in May/June (2005). Let's just wait and see what that unearths.

Does the dearth of scientific research on the long-term success of SRS not trouble you? Why has no gender clinic in the UK - or anywhere else for that matter - bothered to find out how well its patients do in the longrun? If the TS/TG community is so fed up of articles which raise concern about this then I suggest they push for such independent research to be carried out. (The Royal College of Psychiatrists' review of the HBIGDA guidelines provides an excellent opportunity for the community to get involved in this.) If you are so convinced that post-transition problems are extremely rare then you've nothing to lose.
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Kimberley  



Joined: 24 Oct 2005
Posts: 2

Physical Location: Scotland U.K

Posted: 24 Oct 2005, 5:10 pm    Post subject: Reply with quote

I agree with the original post from the newspaper. It hit the nail right on the head.

I have been a patient at the Claybrook centre Charing Cross GIC for over 4 years and have yet to recieve any help, support or treatment. There seems to be far too much time spent on psychiatrists than technical ability to actually treat patients or understand their needs. The two Psychiatrists I saw at the clinic had little insight as what a gender change is and very little perception of what it consists of. More technical help and less psychiatry would be far more helpful.
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Kimberley  



Joined: 24 Oct 2005
Posts: 2

Physical Location: Scotland U.K

Posted: 24 Oct 2005, 5:24 pm    Post subject: Reply with quote

A sex change is NOT genital surgery and should not be treated as if it were. Many Transsexuals have genital surgery and still look completely male. Clinics should be completely re-structured to the physical needs to actually change a person physically rather than rushing them in for genital surgery which is not a visable physical female characteristic in the same way female fat re-dustribution would be.

Hormones rarely work unless the person is pre pubity and more research should be made into the physical differences between male and females. Rarely is a sex change actually a reality. Many transsexuals are a product of disilusion and misinformation from gender clinics who do not make it clear what can and can't be achieved depending on a persons physical appearance. A gender change is a gender change and the end goal should be someone who intergrates successfully into society. This rarely happens and the person is refered to as a transsexual or deviant and is not taken seriously.
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