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Letter to HBIGDA (1993)

Letter to HBIGDA (1993)

©1993, 2013 by Dallas Denny

This letter was prepared for submission to the HBIGDA Newsletter, but because of the untimely death of Roger E. Peo, the editor, it was never mailed. It may be freely distributed and reprinted, provided author information remains intact.




Broadway Theater Marquees Near HBIGDA 1993

“A Lot of Professionals are Crackpots”

“Alienation Produces Eccentrics or Revolutionaries”

“Raise Boys and Girls the Same”

—Jenny Holzer Truisms on Broadway Threatres, One Block from HBIGDA 1993 NYC symposium


27 November, 1993

Roger E. Peo, Ph.D.

Editor, HBIGDA Newsletter

P.O. Box 3445

Poughkeepsie, NY 12603


To the Editor:

I had the privilege of attending the XIIIth International Symposium on Gender Dysphoria in New York last weekend. I was impressed both by the number of participants and by the quality of the presentations. However, I would like to share my observations about the conference (I attended Saturday and Sunday’s sessions), and the newsletter seems like the most appropriate place to do it.

First, I would like to note that it is clear that a paradigm shift is taking place (Kuhn, 1962). As the gears of science slowly grind, as data slowly accumulate, long-held notions of persons with gender dysphoria as globally impaired seem to be giving way to the idea that aside from having gender dysphoria and the problems directly associated with it, most of these individuals are much like everyone else. It was frustrating, however, to hear paper after paper full of ANOVA’s with fractional point differentials between groups slowly chipping away at the old notions, while at the same time by my estimation between one-third and one-fourth of the audience was comprised of persons who had undergone or were undergoing sex reassignment. Most of these persons were physicians or Ph.D.s or held master’s degrees, and have been productive and creative in their personal lives and in dealing with their gender dysphoria. The presence of so many such people in the audience made many of the proceedings seem somewhat absurd.

I was pleased and proud to see science running its slow and laborious course, but my goodness! Can we not trust our senses and instincts to tell us we’ve been running up a blind alley? Is it really necessary to follow the river the long way around when we can save a hundred miles by portaging the canoe a few hundred yards? Would our energies not be better applied striking off on new paths rather than giving yet another battery of projective tests to yet another group of persons with transsexualism? Would we not be better scientists if at least some of our papers dealt with the positive aspects of transsexualism and the remarkable achievements of so many persons with transsexualism rather than continually asking ourselves how damaged they are?

So long as our literature deals almost exclusively with those in distress, it can be nothing more than, as I have called it elsewhere, “a collection of papers by clinicians explaining to other clinicians how to deal with such troublesome people.” (Denny, 1993). I am convinced that the peculiar relationship between persons requesting sex reassignment and those who are placed in the position of gatekeepers result in both false presentations by the clients and false expectations by the caregivers (see Bolin, 1988, or Denny, 1992 for fuller expositions). This translates into a literature so far removed from reality that much of it cannot be taken seriously. So long as health care professionals serve a gatekeeper function, self-reports and test scores by their transsexual clients will be suspect, and we must control for it. If we do not, not only will our work eventually come to naught, but future generations will use our work as an example of how not to do science.

Persons with gender dysphoria spend most of their lives outside the treatment setting, but this is not reflected in the literature. We must dare to venture out of our offices and observe persons with gender dysphoria “in the wild.” We know almost nothing about these people, and excessive speculations about etiology and psychodynamics cannot take the place of simple observational studies.

One way of broadening our horizons is to continually keep in mind that the agitated individual who is in an office because he or she has finally made the tumultuous decision to seek help is in all likelihood very different from those individuals who are not sitting in that hot seat. We should take seriously the small but persuasive literature written by anthropologists and sociologists who have examined persons with transsexualism outside the clinical setting. Reading this literature puts the clinically-based work in its proper perspective, and paying attention to it can start us off in the right direction with future lines of research. Holly Devor’s (Devor, 1993) presentation at the conference revealed some very interesting things about female-to-male transsexualism, and yet much of the audience seemed disinterested. Will we follow her lead now, or will we ploddingly work our way around to her position after ten more bi-annual conferences reporting twenty more years of ANOVAS?

We must also learn to pay attention to those with transsexualism. It is only logical that persons with gender dysphoria, who have been maligned in the literature for daring to read it (cf Money & Primrose, 1968) would ultimately master it. We are still debating the level of psychopathology of persons who will soon be contributing to that same literature. I suspect they will bring a depth of understanding that will revolutionize the literature. Sunday morning’s presentation by Barbara Warren, Rachel Pollack, and Yvonne Ritter of the Gender Identity Project (Warren, et al., 1993) was insightful and powerful, and was a clear message to attendees about current thinking in the transgender community. Why do we undervalue such contributions?

My point is not that we should abandon current lines of research. Much excellent work has been and continues to be done. Certainly, we need to improve assessment and treatment techniques. But it is tragic that so many potentially productive lines of research remain unexplored because our clinical blinders allow us to see only what is directly in front of us. If the ultimate goal of the literature written by clinicians is to improve treatment, surely more broad-based research will hasten that goal. At this time, the HBIGDA Standards of Care require the individual to want surgical sex reassignment in order to receive hormonal sex reassignment. There are no provisions for hormonal therapy for those who do not desire surgery, and yet many of the persons with gender dysphoria with whom I come into contact do not want or are at best ambivalent about surgery. Why have we not been listening to these people? Why do our standards propel them towards the very surgery for which we serve as gatekeepers?

My second point has to do with transphobia. Transphobia is a term invented by persons with transsexualism to describe the prejudice and discrimination which they frequently face. We all acknowledge the problems transsexual persons face in society, but it is time that we acknowledge the attitudes within HBIGDA ranks as well. Take the matter of language. During the conference, I heard persons referred to as “gender dysphorics.” I heard groups of transsexual persons compared to a “normal” control group. I heard persons with gender dysphoria called “deviates.”

Take also the issue of common respect. I did not attend the surgery session on Friday, but I was told that one surgeon used masculine pronouns while describing the individual on whom he was performing a vaginoplasty procedure. A physician friend of mine, widely respected and transgendered, reported to me that some of the conference attendees would not make eye contact or speak to her on the elevators. Or course, most HBIGDA members would not be guilty of such overtly discriminative behavior, but if you don’t think that this sort of disrespect eventually percolates into the literature, you’re not reading it with the same eyes I am.

Let me make it clear that I respect the work which has been done and the dedication of those who have done it. I know at least a hundred clinicians, and I find them, whether they are psychologists, surgeons, or psychiatrists, to be warm, personable, caring, and sympathetic to the needs of persons with gender dysphoria. My issues are with the general direction in which we seem to be going, the unconscious attitudes which we continue to project into the literature, and the overall atmosphere at the conference. I think it is time that we moved our collective consciousness in new and more productive directions, rather than waiting twenty more years until we are forced by the data to do it.

On Sunday, Ritter et al. reported that the Gender Identity Project in New York City uses the term transsexual women and transsexual men to refer to, respectively, genetic males and females with gender dysphoria, and the terms nontranssexual men and nontranssexual women to refer to others. Their terminology is the best I have heard. I have written (Denny, 1991) that the term transsexual should be replaced by transsexual person or better yet, by person with transsexualism, in keeping with the “people first” philosophy which has been prevalent in the field of mental retardation for more than ten years. There are no “transsexuals,” only persons with transsexualism.

I contend that the term “deviance,” the terms “male transsexual” and “female transsexual” used to refer to persons born, respectively, male and female, the use of the word “normal” when referring to persons without gender dysphoria, and similar usages are inherently transphobic, unsubtle indicators of disrespect of persons with gender dysphoria. I am hereby calling on HBIGDA to take a position on language usage so that it can be standardized in a way which will do away with such discriminatory terminology. And even more importantly, I respectfully request that HBIGDA members re-evaluate their attitudes about persons with gender dysphoria in light of the emerging data which indicate that persons with gender dysphoria are just like “normal” people, and especially in light of the increasing numbers of persons with gender dysphoria who are members of HBIGDA.

Thank you.

Most Sincerely,

Dallas Denny, M.A.

TN Licensed Psychological Examiner

Executive Director

American Educational Gender Information Service, Inc.


Bolin, A. (1988). In search of Eve: Transsexual rites of passage. South Hadley, MA: Bergin & Garvey Publishers, Inc.

Denny, D. (1991). A word on terminology. Chrysalis Quarterly, 1(1), 1.

Denny, D. (1992). The politics of diagnosis and a diagnosis of politics: The university-affiliated gender clinics, and how they failed to meet the needs of transsexual people. Chrysalis Quarterly, 1(3), 9-20.

Denny, D. (1993). Letter to the editor: Response to Charles Mate-Kole’s review of In search of Eve: Transsexual rites of passage by Anne Bolin. (South Hadley, MA: Bergin & Garvey). Archives of Sexual Behavior, 22(2), 167-169.

Devor, H. (1993). Sexual orientation identities, attractions, and practices of female-to-male transsexuals. Paper presented at the Thirteenth International Symposium on Gender Dysphoria, 21-24 October, New York, NY.

Jenny Holzer Truisms. Online HERE. (Viewed 10/5/2011).

Kuhn, T. (1962). The structure of scientific revolutions. Chicago: University of Chicago Press.

Money, J., & Primrose, C. (1968). Sexual dimorphism and dissociation in the psychology of male transsexuals .The Journal of Nervous and Mental Disease, 147, p. 472.

Warren, B.E., Ritter, Y., & Pollack, R. (1993). The gender identity project: A community-based approach to affirming transsexual identity. Paper presented at the Thirteenth International Symposium on Gender Dysphoria, 21-24 October, New York, NY.