Are the people who are going after Michele Bachmann for her husband's ex-gay program self-righteous hypocrites? After all, most of the ex-gay movement's critics — from the American Psychological Association to the LGBT lobbying group the Human Rights Campaign — support therapy aimed at helping trans people change genders.
Let's say someone named John Deer from Dallas, Pa., decides that for health and sanity, s/he needs to live as Jane Doe. Therapists will check to see if John/Jane meets the criteria of gender identity disorder. If they decide she fits this diagnosis, they will back her as she addresses her deep, visceral discomfort with her male gender role. They will encourage Jane to adopt gender behaviors that feel "right" and, if appropriate, will counsel her through hormone therapy and sex reassignment surgery.
Yet substitute "sexual orientation" for "gender" in the above description, and most Americans — 69 percent, in one recent poll — will say, "That's crazy! Sexual orientation should be accepted." Therapists, while supporting individuals' right to manage their own lives, will refuse to help patients change sexual orientation, on the grounds of their Hippocratic oaths to "do no harm."
This argument — that America is guilty of a double standard in regard to the ex-gay movement — has recently been getting airplay. For example, on a recent segment of NPR's Morning Edition, ex-gay Rich Wyler criticized the APA for assuming his goals as a patient were illegitimate. (Full disclosure here: The author is partnered with Peterson Toscano, another interviewee on the aforementioned piece and a well-known critic of ex-gay programs).
The notion that ex-gays are "straight people trapped in a body with gay desires" has a certain superficial appeal. After all, who is the APA to decide that one kind of discomfort with self is more respectable than another? But this argument is based on a profound misunderstanding of gender and sexuality — and in perpetuating these misconceptions, the ex-gay movement continues a long tradition of peddling snake oil instead of real medicine.
To begin, let's look at the psychiatric concept of "gender identity disorder." The language from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (better known as DSM-IV) is long and complex, but its essence is:
1. A strong and persistent cross-gender identification — not merely a desire for any perceived cultural advantages of being the other sex.
2. This disturbance causes clinically significant distress.
Examples of cross-gender identification might be a child's repeated statements that s/he is the opposite sex, or his/her insistence on behaving like a member of the opposite sex (like trying to join the other sex's sports teams or using their bathrooms). Clinically significant distress, as a teenager or adult, may include suicidal feelings or inability to function at work.
The difference between the trans experience and the ex-gay one should already be coming into focus. While both involve distress, in one case I desire to change myself — change my deep feelings and inner being. In the other, I long to change my outer body so as to become myself: so as to allow the physical to reflect what is known within. To return to the John Deer example cited above, it isn't so much that John decides to be Jane. It's more that John finally accepts what he has always known.
Until recent decades, attempts to make trans people accept their socially assigned gender roles were as automatic as psychiatric interventions designed to try to "straighten out" gay people. The effectiveness rate for these "ex-trans" interventions was, if anything, even worse than the dismal rate for "ex-gay" therapies. Today, as the APA noted in a 2009 report, the evidence is overwhelming: Self-acceptance is infinitely healthier than "de-transing" or "de-gaying."
The gender identity disorder diagnosis is controversial in the trans community, because it implicitly characterizes the trans experience as an illness rather than recognizing that the primary source of the discomfort trans people experience results from societal ignorance. But the DSM-IV phrase — not merely a desire for the perceived cultural advantages — is a useful one in further illuminating the absurdity of the ex-gay movement's position.
Cultural advantages? Sure, I see the overwhelming privileges associated with leaving homosexuality behind. Rich Wyler named a few of them on Morning Edition: retaining conservative family, friends and church. Being able to get married and have a family, with government support. He could have added: no longer risking violence by holding hands at a bus stop.
But the advantages of being … trans?
A growing body of research illustrates that trans men and women face vicious and intense discrimination if their transgender status is known. As many as two-thirds of trans Americans live in poverty. Around a fifth have experienced homelessness; many report being denied apartments or houses as a result of being perceived as "freaks."
Violence against trans people is shocking and widespread. Just this April, a trans woman who tried to use the bathroom in a McDonald's in Baltimore was famously beaten until she went into seizures, while the employees looked on without reacting.
To transition to another gender in our world is an act of great courage and rebellion, which requires confronting friends, family, and the world with a truth of the heart. The individual who does so takes significant risks for the sake of joy and psychic wholeness.
I'm not saying that a few rare individuals in ex-gay programs, who try to change themselves to please their pastors, parents and Bible teachers, don't achieve peace when they try to live according to their personal interpretation of a 1,600-year-old book. But the vast majority of ex-gays are motivated by fear of punishment in this world or the next — not by brave integrity. The spiritual fruits of their quest for change tend to be terror, shame, numbness and self-hatred — a slow death of their true selves, which is to say of their souls.
In a free country, people have the right to self-destruct. But to equate all of this with the hard-won and life-giving freedom of trans people isn't just wrong-headed. It also takes extraordinary intellectual chutzpah.
Glen Retief is the author of The Jack Bank: A Memoir of a South African Childhood. He teaches creative nonfiction at Susquehanna University.