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The difference between sex reassignment and conversion therapy

April 29, 2016

Sex reassignment is the process of turning a male body into a female one or vice versa, and conversion therapy is the process of attempting to change a gay brain into a straight brain. There are two wings of people who think of the two as being much the same process: people who are pro-gay but anti-trans; and people who believe in the efficacy of conversion therapy, and think that if sex reassignment ought to be allowed, conversion therapy ought to be as well.

Between the two, I think I would get on better at parties with the latter person. It’s misguided but almost sweet to suggest that if gay people want to be straight, they should be allowed to do so on the NHS – provided of course, that this form of expression is not simply disguising a belief that gay people should make themselves straight, as opposed to thinking that they should simply be allowed to if they want to.

The error here is in the understanding of transgenderism. A trans person does not “want to be a woman” or “want to be a man”. A trans person feels that they are a man, when they are actually female, or they are a woman, when they are actually male. The significance of this is that, if the transman simply wants-to-be a man, then the (albeit fairly rare) feminist argument that trans people are bowing to cultural pressures in regards to our notions of man and woman would hold water.

Personally, I believe that it does not, because as a transman I do not perceive that transgenderism actually has anything to do with societal perception of gender. I have discussed this more thoroughly elsewhere, but in a nutshell I think that “gender identity” is a misnomer, as gender is culturally determined – gender is the question of whether we wear dresses or like cars, and all this finicky, arbitrary stuff. Sex identity, on the other hand, is deep-rooted and fixed. This is the thing that determines if a person feels the need to have a sex change.

Sexual orientation is also fixed. This we tend to agree more readily as a society; we’re all used to the argument that being gay is something you’re born with. Therefore, wanting to be straight is an exercise in futility. You cannot wish away the gay. When someone wants to be straight, they are responding to social pressure that says that they are likely to be less happy as a gay person; a perception that can be formed by influences from society main, lovers and ex-lovers, peers, family members, religious institutions, subcultures and other small collections of people whom one might mix with routinely.

In order for conversion therapy to compare to sex reassignment, one would have to be able to feel that one is straight, but for some reason be unable to act in a heterosexual way, and instead act in a homosexual way. That sounds bizarre to me. There is only one scenario where I think that’s remotely possible; when someone has suffered sexual abuse and trauma from a member of the opposite sex, develops an aversion to them, and seeks needed human companionship from a relationship with the same sex, which becomes sexual because of the rather restrictive terms in which we perceive the word “relationship”, leading to indirect sexual pressure. Such a person would be better off in platonic partnerships than agreeing to sex they are not particularly interested in. The other alternative to that scenario is people whose abuse from a member of the same sex inclines them to seek destructive relationships with the same sex.

For both sets of people, homosexuality is not itself the problem; the problem is trauma, and a conversion specialist is most certainly not the appropriate medical authority. What they need is someone who specialises in working through sexual abuse trauma. Offering people the chance to get-rid-of-the-gay is a distraction; the gay was a replacement for something else lost that would ideally not have been lost in the first place. If you remove the gay, what does the gay-shaped hole get filled with? My off-the-wall guess is loneliness and isolation.

It is a fact that homosexuality and transgenderism are both elements of the mind, or brain, if you care to make the distinction. The difference between conversion therapy and sex reassignment is simple, then; sex reassignment is the redistribution of body fat, plus a few nips and tucks, into a more feminine or masculine form, in order to remove dissonance between brain and body. Conversion therapy is, to quote Wallace and Gromit, “a bit of harmless brain alternation.” Obviously, if you can avoid faffing about inside people’s brains, you should. In the case of both homosexuality and transgenderism, it causes as many problems as it solves.

In conclusion then, the reason why you should avoid conversion therapy is the same reason as why you should support sex reassignment, over and above any kind of intervention into gender dysphoria; to change the brain is to change the identity, to the extent where someone may not recognise themselves. For anyone who is unhappy with their homosexuality, I would urge them to understand it is probably their treatment in society, or inconvenience caused by social systems, that is causing that upset. After all, current society is still residually heterosexist even in its most bohemian circles.

I seem to recall that when I thought I was a gay female, as opposed to a transman, even though that identity didn’t feel quite right, I never wanted to be a straight woman. That would have been no improvement at all. I remember thinking then, being critically minded: the difficulties of identifying as gay are other people’s fault. It is a sentiment echoed by every gay person I know, who feel neutrally or positively about their gayness, even if they are dissatisfied in other ways with their lives. Compare this to transsexual people, who despite what society does, continue to be unhappy – until they alter their bodies, whereupon they feel better. This suggests that for trans people, the problem is physical and not social.

For those who promote the choice of conversion therapy, understand that your advocacy for it has the side effect of supporting the notion that when someone is unhappy with their homosexuality, it is the homosexuality itself that is to blame. This perpetuates the concept in straight and gay circles alike, which leads more gay people to become self-hating, and blame the gayness when they should be blaming the heterosexism and homophobia. Those in favour of conversion therapy are saying: “Well, of course you feel unhappy as a homosexual. Who wouldn’t be?”

In actual fact, this is faulty thinking. There is no more reason to be unhappy because of homosexuality than there is to be unhappy because you have curly hair; in an ideal world, you might think your life would have been easier if you had straight hair, because then you wouldn’t have to keep straightening it, which makes your life more inconvenient than your straight-haired friends. But you realise that if people responded better to curly hair, you probably wouldn’t feel compelled to keep straightening it all the time; moreover, you recognise that your curly-haired problems are different but not necessarily greater than the problems of your straight-haired friends.

To translate that back into terms of sexuality, your straight friends are not necessarily better off than you for being straight; they might have disabilities, neurological conditions, lack of confidence, mental health problems, commitment issues, terminal fussiness, trauma, or they may be far away from our classical beauty ideals, else the specific beauty ideals of their preferred / pre-determined subgroup. All of these can inconvenience your social-sexual life greatly, to the extent that many gay people have better lives in that respect than many straight people — provided they live in a society that is comfortable with homosexuality.

Whenever we analyse a person’s ability to choose how to deal with the hand biology has dealt them, the most important question is not always “What do they want?” but rather “What works?” We could have debates round and around about whether people should get what they want. The answer to conversion therapy and sex reassignment is relatively simple; the evidence suggests that sex reassignment works as a means of making people happier and healthier – but conversion therapy does not. It would be wrong to compare homosexuality to a medical condition like gender dysphoria that often requires medical intervention, since there is no medical intervention for homosexuality. Reasonably, you could infer from this that homosexuality is not a condition.

Or if it is, one which is still most effectively treated by tolerance in society. The same could be said of other conditions, such as Asperger’s syndrome, which members of that community generally agree should not be medicated or treated in any way; it is a “condition” only in technicality, and it serves little purpose to treat it as anything other than a natural consequence of human genetic variability. Those who are absolutely wedded to the idea of homosexuality being a condition would do better to think of it in these terms. The only other alternative is a slow medicalisation of all minor differences, to the extent that suddenly everyone is “ill” with something. It’s hard to see that such a shift would be an improvement of society.

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