What happens when your son tells you he’s really a girl? Inside the families embracing the new world of gender variance

Some medical professionals see gender variance as a natural characteristic of human diversity, similar to sexual preference, that should be accepted and even celebrated. An article in Macleans (Jan 6, 2014) explores the lives of supportive families and their trans and gender variant children..

The Public Health Agency of Canada published comprehensive recommendations in 2010 for schools to support gender-variant students and several provincial governments have added “gender expression” to the list of prohibited grounds for discrimination. The tides may be turning but the need for education is high. The negative judgement of trans individuals suggests there is a 17% higher risk for suicide and even higher risks for being bullied by others.

The Macleans article also has a short video embedded within and pictures throughout, providing a glimpse into the daily lives of trans and gender-variant children and their families. This is an excellent introduction and movement towards educating the public and advancing the needs of trans youth – which is a natural characteristic of human variation.

You can read the article here: http://www2.macleans.ca/2014/01/13/what-happens-when-your-son-tells-you-hes-really-a-girl/

 

In the United States the National Gay and Lesbian Task Forces and the National Center for Transgender Equality conducted a survey of 6,450 trans and gender non-conforming individuals from all 50 states. This study was the first of its kind and provides us with a clear picture of what needs to change in order to stop the injustice in their lives..

Discrimination against trans and gender variant individuals provides critical data for policymakers, community activists and legal advocates to confront the appalling realities. Respondents experience higher levels of poverty and a staggering 45% of those survey reported attempting suicide. Harassment and discrimination in education was reported at alarmingly high rates and include physical assault (35%) and sexual violence (12%). Harassment was so severe that it led to almost 15% to leave school in K-12 settings or in higher education..

Abuse by Police, discrimination in health care and public accommodations, employment discrimination and economic insecurity, as well as housing discrimination, barriers to receiving updated documents (identification and personal records). The 6,450 individuals all reported that family acceptance was of great importance, although the majority reported experiencing family rejection. Despite all of the harassment, mistreatment, discrimination and violence faced by trans individuals the study demonstrates their determination, resourcefulness and perseverance. This report is a call to action for all of us, especially for those who pass laws and write policies. Inaction is a form of violence that will negatively affect trans and gender variant people. Take up the call for human rights for transgender, transsexual, trans, and gender variant people and confront the patterns of abuse and injustice. Let’s learn (and teach) the values of human variation to our children, to each other and let’s learn more ourselves!.

You can access the full report titled “Injustice at every Turn” here: http://www.TheTaskForce.org or here: wwww.TransEquality.org. You can also get more information about the survey at: http://www.EndTransDiscrimination.org

Ontario allowed decades of child abuse – Lawsuit goes ahead

Carol Goar with the Toronto Star has written an article about the Class action lawsuit pitting survivors of an inhumane psychiatric institution against their tormentors and announces that they will finally go to court.

There can be no turning back. The trial date is set. Courtroom 5 in the old Canada Life building is booked for two months. The two sides have agreed in writing to be there. The witnesses are ready to testify.

“We’re going ahead no matter what,” said Kirk Baert, the lead lawyer in a historic class action suit against the government of Ontario.

He never doubted this moment would come. His clients were less sure. For three years, the province used every tactic in the book — withheld documents, missed meetings, deadline extensions — to delay the case. Baert’s greatest concern was that hundreds would die waiting.

Approximately 3,900 former residents of the Huronia Centre, a provincial facility for developmentally disabled children, are still alive. There were 4,500 when Baert launched the $1-billion lawsuit in 2010.

He intends to prove beyond reasonable doubt that the Ontario government knew about the physical, sexual and emotional abuse of these vulnerable youngsters and did nothing to stop it. “Even convicted murderers got better treatment,” he maintains, rehearsing one of the lines he will use in court.

The trial begins on Sept. 16. Baert will deliver a three-hour opening statement chronicling the tragic history of the Huronia Regional Centre, once known as the Orillia Asylum for Idiots. He will then call on the two lead plaintiffs, Patricia Seth and Marie Slark, to recount what happened to them at Huronia, what they saw, how they survived and how they are scarred by the discipline meted out by sadistic provincial employees. Both women are in their late 50s

Seth, diagnosed as “mildly retarded,” was surrendered by her family at the age of 7. She spent 14 years in Huronia. She remembers being hit with a radiator brush for misbehaving and held upside down by her heels in ice-cube-filled water for refusing to eat.

Slark, similarly labelled, was committed to Huronia at 6 years of age. She spent nine miserable years there, then was sent to an “approved home” under Huronia’s supervision, where she was drugged and sexually molested.

Others were more savagely beaten but they have lost their memories, they can’t communicate or they are among the 2,000 children buried in Huronia’s cemetery.

One of those victims was Richard, an 8-year-old boy with Down syndrome. His sister, Marilyn Dolmage, was so upset by his death that she trained to be social worker and got a job at Huronia. She will describe children locked in caged cots, being punished for bodily functions they could not control, cowering from the staff.

Compelling as his witnesses’ testimony will be — and Baert expects to call 10 more former residents, 10 former employees of Huronia, doctors, child development specialists, historians, demographers and managers of similar institutions o the stand — he regards the government’s own paper trail the most incriminating piece of evidence.

“I don’t need to win this case with witnesses. It will prove itself on the documents. They (provincial officials) kept recording that there was a problem, but they never did anything to fix it.”

Huronia closed in 2009. The abused children became its “forgotten victims.”

The legal team has amassed 65,000 records — letters from distraught parents, bureaucratic memos, ministerial directives, police reports, eyewitness accounts, coroners’ reports, inspectors’ reports, newspaper exposés and the findings of three provincial commissions of inquiry. They tell the story in graphic detail.

Baert, a partner at Koskie Minsky, specializes in David-vs.-Goliath class-action suits. In 2007, he won a $4-billion judgment on behalf of aboriginal students sent to government-approved residential schools. In 2010, he won $36 million in damages for homeowners in Port Colborne whose properties were contaminated by Vale Inco’s nickel operations.

He is confident he will win this case. “They underfunded this institution because they could. They knew the people held there couldn’t fight back.”

Every so often Baert’s professional mien slips. He detests bullies. He is disgusted by public officials who refuse to accept responsibility for mistreating vulnerable children.

“Huronia has no excuse for doing a crappy job” He catches himself. “I won’t say crappy in court.” Then Baert pauses. “Maybe I will. What they did stank.”

The original article can be found here: http://www.thestar.com/opinion/commentary/2013/09/09/ontario_allowed_decades_of_child_abuse_goar.html

Reproductive Autonomy: Control of Sexuality A Panel Discussion at Pride Week, University of Alberta

Wednesday March 20, 2013 at 3:00 pm – 4:00 pm in Education South Building at the University of Alberta the Living Archives on Eugenics is sponsoring a panel discussion featuring Professor Lise Gotell, Chair of Women’s and Gender Studies and Dr. Lane Mandlis, with Moyra Lang, and Professor Rob Wilson. ASL interpreting services will be offered at this event. Find us on Facebook http://www.facebook.com/#!/events/270019033131796/?fref=ts

Continue reading

What sorts of academics should there be?

from Carl Elliott, “How to be an academic failure: an introduction for beginners”, The Ruminator Review, but also:  whitecoatblackhat.com/academicfailure/

Carl visited us up in Edmonton a few years ago, courtesy in part due to the work he was doing at the time on big pharma and also as a member of the What Sorts Network.  In addition to enjoying and learning much from his public lecture, we also had a great informal, roundtable session with about a dozen people that was focused on his then-developing work on a particular case in psychopathology that involved a senior professor who had murdered his spouse.

I also had a fun dinner with Carl in which he confessed his slight ill-ease with me.  This was caused by the fact that every time I started speaking, I managed to disappoint his expectation that I would sound just like The Dude.  “Damn it, how can that be?” he wondered aloud, almost with sufficient pathos for me to consider peppering our conversation with some of the many lines I know from heart from The Big Lebowski.  But despite the short-term fun this would have involved, I thought that this might actually exacerbate the problem in the long run, so I resisted the temptation.  “But that’s just like, your opinion, man.” I still hear a small voice inside my head say.

Here’s how his recent article, with all its sage advice on academic failure, begins:

How to be an academic failure? Let me count the ways. You can become a disgruntled graduate student. You can become a burned-out administrator, perhaps an associate dean. You can become an aging, solitary hermit, isolated in your own department, or you can become a media pundit, sought out by reporters but laughed at by your peers. You can exploit your graduate students and make them hate you; you can alienate your colleagues and have them whisper about you behind your back; you can pick fights with university officials and blow your chances at promotion. You can become an idealistic failure at age 25, a cynical failure at 45, or an eccentric failure at 65. If failure is what you’re looking for, then you can hardly do better than the academic life. The opportunities are practically limitless.

Call me arrogant, but I like to think I have a knack for failure. Having started and abandoned one abortive career, participated in the dissolution of a major bioethics center, published dozens of articles nobody has read and given public lectures so dull that audience members were actually snoring, I think I have earned my stripes. It is true that I am not an alcoholic yet. I do not have a substance abuse problem, and no university disciplinary proceedings have been brought against me so far. I am still a novice at failure. Many other people in my own field have succeeded at failing in a far more spectacular fashion than I have, some of whom are rumored to be living in South America. But I am learning. And I think I have something to contribute.  Read more

The DSM Drama (“Part V”)

Dr. Stefan P. Kruszewski, in an opinion piece written for ABC News entitled “Doctors’ Conflicting Interests Can Cost Money and Lives, and Hinder Medical Discoveries,” warns against the danger of medical practitioners recommending specific drugs as part of treatment while being paid to speak, advocate, and do research for the companies that manufacture them.

After writing a letter expressing concerns about such practices to the Journal of American Medical Association, the associate editor responded (via e-mail) by shrugging such concerns off as trivial.

During the review process, an associate editor at the journal asked the question (and inadvertently copied me on an email that had been sent to another associate editor), “What’s the big deal? What’s all this [expletive deleted] about conflicts of interest?” (see link)

Kruszewski, however, thinks such practices are actually very dangerous.  He writes:

But I do worry, because drug promotion and clinical decision-making that are brokered on the backs of dollar bills have a greater chance of causing serious adverse outcomes, including illnesses and death. If a physician embellishes the effectiveness of a drug or minimizes its risk, that directly hurts you and me.  Physicians who are heavily supported by pharmaceutical companies and medical device makers are not forming independent, unbiased decisions. Instead, their brains have been lined with gifts, perks and money, which influences their rose-colored opinions. (see link)

The conflict of interest does not stop at Dr. Kruszewski’s worries and the problem he points to can unfortunately be traced to the DSM (The Diagnostic and Statistical Manual), which is an authoritative taxonomy of mental disorders.  Worries of financial conflicts plagued the fourth installment of the DSM (the DSM IV) and with the DSM V on the horizon, similar criticisms are voiced.

The manual, published by the American Psychiatric Association, details the diagnostic criteria for each and every psychiatric disorder, many of which have pharmacological treatments. After the 1994 release of DSM-4, the APA instituted a policy requiring expert advisors to disclose drug industry ties. But the move toward transparency did little to cut down on conflicts, with nearly 70 percent of DSM-5 task force members reporting financial relationships with pharmaceutical companies — up from 57 percent for DSM-4. (see link)

The greatest risk of conflict of interest remains with the taxonomizing and eventual diagnosing of disorders that are intimately linked with the manufacturing of drugs intended to treat these disorders.  Katie Moisse writes:

Some of most conflicted panels are those for which drugs represent the first line of treatment, with two-thirds of the mood disorders panel, 83 percent of the psychotic disorders panel and 100 percent of the sleep disorders panel disclosing “ties to the pharmaceutical companies that manufacture the medications used to treat these disorders or to companies that service the pharmaceutical industry,” according to the study. (see link)

This is not to suggest, of course, that medical professionals have malicious intent or that they are only interested in the health of their own bank accounts.  However, there remains a serious worry about the taxonomy itself as well as about future diagnoses and treatment.  To add to the turbulent atmosphere surrounding the DSM V, the introduction of certain new diagnoses has also been criticized.

The DSM-5 has also drawn criticism for introducing new diagnoses that some experts argue lack scientific evidence. Dr. Allen Frances, who chaired the revisions committee for DSM-4, said the new additions would “radically and recklessly” expand the boundaries of psychiatry.  “They’re at the boundary of normality,” said Frances, who is professor emeritus of psychiatry at Duke University. “And these days, most diagnostic decisions are not made by psychiatrists trained to distinguish between the two. Most are made by primary care doctors who see a patient for about seven minutes and write a prescription.” (see link)

I think we have a serious problem on our hands if drug companies get to determine the taxonomy of mental disorders and medical doctors diagnose and prescribe drugs in accordance with the financial interests of these drug manufacturers.  Even if things are not as bad as they sound, they seem to be getting worse (“with nearly 70 percent of DSM-5 task force members reporting financial relationships with pharmaceutical companies — up from 57 percent for DSM-4”).  Should we start going to the accountants of pharmaceutical companies for advice?  Now that would be absurd, but if pharmaceutical companies have as much sway over what is defined as a mental disorder and what treatment is pursued as Moisse suggests, then perhaps we might as well just bypass the middleman (the local mental health professional) and go directly to the source!  Why are individuals who are directly funded by drug manufacturers allowed to make executive decisions on the DSM V?  James Scully, APA director, sees no other way.

APA medical director and CEO Dr. James Scully insisted the DSM-5 development process “is the most open and transparent of any previous edition of the DSM.”  “We wanted to include a wide variety of scientists and researchers with a range of expertise and viewpoints in the DSM-5 process. Excluding everyone with direct or indirect funding from the industry would unreasonably limit the participation of leading mental health experts in the DSM-5 development process,” he said in a statement. (see link)

Lisa Cosgrove, associate professor of clinical psychology at the University of Massachusetts-Boston is of a different opinion:

Cosgrove said she believes there are plenty mental health professionals with no financial ties to drug companies. If necessary, experts with conflicts could still participate in the process as non-voting advisors, she said.  “My best hope would be for the APA to respond in a substantive way to the concerns we’ve raised,” she said. “They have an opportunity here to make a correction that would give the appearance, if not the reality of developing a diagnostic instrument that’s objective and has integrity.” (see link)

I hardly think that the mental health professionals with no financial ties to drug companies live at or just above the poverty line, so why, unless a researcher is explicitly doing research for a certain pharmaceutical company, does the profession open itself to such criticisms by allowing the kinds of practices Kruszewski and Cosgrove object to?

“Finding Purpose After Living With Delusion”

An article from the New York Times tells the story of Milt Greek, who experiences psychotic delusions to save the world.

So after cleaning the yard around his house — a big job, a gift to his wife — in the coming days he sat down and wrote a letter to the editor of the local newspaper, supporting a noise-pollution ordinance.

Small things, maybe, but Mr. Greek has learned to live with his diagnosis in part by understanding and acting on its underlying messages, and along the way has built something exceptional: a full life, complete with a family and a career.

Greek, and a growing number of others, have looked to their delusions as being rooted in fears, and other psychological wounds, with the goal of recovery through understanding. It’s a process that Continue reading

Templeton Positive Neuroscience Awards

Apparently, I’m an “honorary distinguished senior advisor” to this project, where I assume that “honorary” means “unpaid”, “distinguished” is a typo, “dis” for “ex”, and “senior” means “old”.  The complete information on the award recipient projects may be of interest to some readers of the blog. Congratulations to Laurie Santos especially for her grant on the origins of altruism!

Positive Neuroscience, U of Penn

Positive Neuroscience / Psychology

Award-winning researchers to explore human flourishing
from neural networks to social networks

The Positive Psychology Center of the University of Pennsylvania and the John Templeton Foundation (www.templeton.org) have announced the recipients of the Templeton Positive Neuroscience Awards. The project will grant $2.9 million in award funding to 15 new research projects at the intersection of Neuroscience and Positive Psychology.

The winning projects will help us understand how the brain enables human flourishing. They explore a range of topics, from the biological bases of altruism to the effects of positive interventions on the brain.

The Positive Neuroscience Project (www.posneuroscience.org) was established in 2008 by Professor Martin E.P. Seligman, Director of the Penn Positive Psychology Center, with a $5.8 million grant from the John Templeton Foundation. In 2009, the project announced the Templeton Positive Neuroscience Awards competition to bring the tools of neuroscience to bear on advances in Positive Psychology. Seligman founded the quickly-growing field of Positive Psychology in 1998 based on the simple yet radical notion that what is good in life is as worthy of scientific study as what is disabling in life.  Read the full press release from the PNP website.

Experimenting on the vulnerable at Columbia University

Last week the New York Times and LA Times reported violations of FDA mandated dosage levels in the chemicals used in clinical PET (positron emission tomography) studies at a major lab, the Kreitchman PET Center, at the Columbia University Medical Center.

Most people who participate in experimental studies of drug treatments are vulnerable–either via poverty, mental illness, other disability, race–and while they consent to participate.  That consent carries with it an acknowledgment of a higher risk, but it’s also based on the basic trust that the studies are at least in accord with federal and other regulations (e.g., university research ethics boards approvals, when done in university environments).

The practice of chasing “willing subjects” to all corners of the globe became widespread as these approvals onshore became harder to gain for domestic populations, a story told in The Constant Gardener that had at least one kind of less-than-fully-evil outcome, as reported last year by The Independent.

So what is going on at Columbia University? (apart from damage control by their administration)  Below the fold is the LA Times article; here’s the link to the original article, and here’s a h/t link to the AHRP blog post by Vera on this story. Continue reading

What sorts on psychiatry

Here are a few What sorts posts on psychiatry

Does anyone remember “lobotomy”?

Is your dog on prozac?

Marcia Angell on Big Pharma

NYT on DSM-V

Defending Electroshock

What sorts of people?  Empathy deficit disorder–do you suffer from it?

Pride in maddness–the new visibility

Lennard Davis on SSRIs

Over at his blog column at Psychology Today, distinguished disability theorist Lennard Davis has just posted “Five Reasons Not to Take SSRIs”. Selective Serotonin Reuptake Inhibitors, the best-known of which is Prozac, have been massively prescribed for the past 15-20 years by doctors and psychiatrists, especially for depression. Davis begins:

For the past five years, and in my recent book OBSESSION: A HISTORY, I have been questioning the effectiveness of Prozac-like drugs known as SSRIs. I’ve pointed out that when the drugs first came out in the early 1990’s there was a wildly enthusiastic uptake in the prescribing of such drugs. Doctors were jubilantly claiming that the drugs were 80-90 per cent effective in treating depression and related conditions like OCD. In the last few years those success rates have been going down, with the NY Times pointing out that the initial numbers had been inflated by drug companies supressing the studies that were less encouraging. But few if any doctors or patients were willing to hear anything disparaging said about these “wonder” drugs.

Now the tune has changed. …

To read the full post, click here.

Pet pills, “ASD”, sexual morality, exclusion, and a fairytale

and not all five in one post, but each in its own, as I run 5 more posts from What sorts from roughly mid-2008 to early 2009.

Is your dog on Prozac?

Autism spectrum research and disability language alternatives

PZ Meyers on the enhancement of sexual morality: a modest proposal

The ethics of exclusion, the morality of abortion, and animals

A fairytale for my grandchildren

Does anyone remember “lobotomy”?

Picture of brain surgery

The New York Times recent Surgery for Mental Ills Offers Both Hope and Risk raises, for me, one big question: why the enthusiasm for bringing experimental brain-fu*king to the public’s attention right now? As the article reports but does not underscore in the name of balance, the history of psychosurgery is one of moral and medical failure, though failures recognized only in retrospect. What could be so different now? That we’re not considering lobotomies (which sever the frontal lobes) but cingulotomies (which sever into the anterior cingulate) and capsulotomies (which sever the connections between the cortex and the medulla that make up the internal capsule)?

h/t to ARPH’s Psychosurgery promoted by the NYT: Here we go, again; for a more optimistic take on this, see also Mind Hack’s Psychosurgery : new cutting edge or short, sharp shock (the only comment up there gives some pause, however).

Mad Pride on National (US) News

FYI:

**********************************************************
MindFreedom Update — Tuesday, 25 August 2009

Unite for A Mad Pride Revolution in Mental Health

Tonight on ABC-TV USA News Show Primetime:

MAD PRIDE DEBATED!

As Predicted: Last Half of ABC-TV Show Plays Up Violence

ABC-TV just posted the text for the second half of their story tonight on MAD PRIDE, and it looks like the show will end as many experienced activists predicted:

Over-emphasizing a gory violent incident by a person with a psychiatric diagnosis.

Tonight, Tuesday night, 25 August 2009, the Mad Pride piece is slated to air on ABC-TV’s national Primetime show “Outsiders” at 10 pm ET and PT in the USA, but check your local listings for the exact time.

Said David Oaks, Director of MindFreedom, who is interviewed in the show, “After 33 years of activism, I am not surprised about media exploitation of violence. But let us remember the many people killed by the violence of forced psychiatric drugging. ABC-TV ignores this institutional violence. Most of us in MindFreedom are psychiatric survivors. We remember. Nothing will stop us from speaking out, not even predictable bias by huge corporations like Disney.” Disney is the owner of ABC-TV.

~~~~~~~~~~~~~~~~~~~~~~

* ACTION * ACTION * ACTION *

Join the debate!

Read both Part One and Part Two of the text of ABC’s Mad Pride story on their web site, and add your comment now to the debate in BOTH parts:

Part 1:

“‘Mad Pride’ Activists Say They Are Unique, Not Sick”:

http://abcnews.go.com/Health/story?id=8382903

Part 2:

“For One Family Decision to Reject Treatment Ends in Tragic Death”:

http://abcnews.go.com/Primetime/story?id=8399298

Prevention is not the answer

Alchemical Musings has written a sharp (as a tooth and nail) account of some pretty troubling directions in biological psychiatry, which is moving toward the territory of prevention.

As he notes:

Instinctively, preventative health care seems like a good thing. Western medicine is often criticized for primarily responding to acute crises, instead of proactively promoting health and well-being. However, the reductionist flattening of minds into brains leads to categorical errors which pervert the Hippocratic principle to “do no harm”. Applying the medical paradigm of treating risks (instead of disorders) to mental conditions stretches the dangerously elastic diagnostic net beyond the breaking point.

CFP, Brain Matters: New Directions in Neuroethics

When: September 24 – 26, 2009
Where: Lord Nelson Hotel, Halifax ♦ Nova Scotia ♦ Canada
Abstract Deadline: March 1, 2009

See the full call for papers here; summary of plenary speakers and topics beneath the fold. Note the following:

“Trainee Award Abstract Competition – Up to 15 monetary awards will be given to trainees whose abstracts for an Oral Presentation or Poster Presentation have been accepted by the Abstracts Committee. Awards will be made on the basis of merit.”

Go trainees! Continue reading

Marcia Angell on Big Pharma

From the latest NYRB, here’s the start of Marcia Angell’s review of three recent books on medicine and money, with a focus on psychiatry, DSM, and Big Pharma:

Recently Senator Charles Grassley, ranking Republican on the Senate Finance Committee, has been looking into financial ties between the pharmaceutical industry and the academic physicians who largely determine the market value of prescription drugs. He hasn’t had to look very hard.

Take the case of Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and chief of pediatric psychopharmacology at Harvard’s Massachusetts General Hospital. Thanks largely to him, children as young as two years old are now being diagnosed with bipolar disorder and treated with a cocktail of powerful drugs, many of which were not approved by the Food and Drug Administration (FDA) for that purpose and none of which were approved for children below ten years of age. Continue reading

NYT on DSM-V

A few snippets from Benedict Carey’s recent New York Times article Psychiatrists Revise the Book of Human Troubles on the ongoing revisions to the Diagnostic and Statistical Manual of Mental Disorders, expected to be published in 2012:

Is compulsive shopping a mental problem? Do children who continually recoil from sights and sounds suffer from sensory problems — or just need extra attention? Should a fetish be considered a mental disorder, as many now are? Panels of psychiatrists are hashing out just such questions, and their answers — to be published in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders — will have consequences for insurance reimbursement, research and individuals’ psychological identity for years to come. The process has become such a contentious social and scientific exercise that for the first time the book’s publisher, the American Psychiatric Association, has required its contributors to sign a nondisclosure agreement.

You can read the whole article right here.