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Saturday, October 02, 1999Treat loss of gender identity as an illness
Humane 20th-century moviegoers gasp in horror at the treatment scenes in The Madness of King George. The insane king is tied up in straitjackets, bled with leeches, and -- in one horrible scene -- seared with red-hot glass cups. As we exit the theatre, we silently give thanks to live in a more enlightened time.
But do we really? The strange case of a California high school teacher reminds us how barbarically we still treat some of the severely mentally ill.
Since 1990, the now 44-year-old David Warfield has taught history and journalism at Center High School in Antelope, Calif. -- a town about 16 kilometres northeast of the state capital of Sacramento. His performance reviews were satisfactory, and by most accounts he was an able teacher. Over the past few years, however, Mr. Warfield's behaviour has become increasingly bizarre. Last May, at the end of the 1998 school year, he announced in class that he believed himself to be a woman. He told his students that when class resumed in the fall he would be wearing women's clothing and makeup. He would change his name to Dana Rivers. He intended to use the female staff washroom. Within the year, he would undergo surgery to amputate his penis and implant artificial breasts.
Mr. Warfield gave interviews to the local press about his intentions, provoking some alarm among students and parents. In August, shortly before classes began, the county school board voted to suspend Mr. Warfield with full pay. Mr. Warfield has since filed a legal challenge to the firing, catapulting him from local celebrity to national controversy.
Mr. Warfield is not the first "transgendered" U.S. teacher. In 1998, a Minnesota school hired a man who goes by the name of Alyssa William to teach seventh- and eighth-grade music. That same year, Minneapolis school librarian David Nielsen arrived at the high school at which he worked in high heels and a skirt and proclaimed himself Debra Davis. There also appear to be at least a couple of similarly afflicted men at work in the San Francisco school system. If Mr. Warfield is not the first man in women's clothing to be hired by an American school, he appears to be the first to have sued when he was fired.
He's unlikely to win his case. The state of California does not offer legal protections to men who want to wear dresses to work, although the cities of San Francisco and Seattle do. But while Mr. Warfield is likely to lose his battle, his supporters have begun to win their war. The human-rights code of one state, Minnesota, forbids employers to fire people for presenting "an identity not traditionally associated with [their] biological maleness or femaleness," and gay-rights activists are pressing the states and towns that already forbid discrimination on grounds of sexual orientation to extend their law to what's been redubbed "gender identity."
And here's where we enter George III territory. Gender-identity disorder -- gender dysphoria to give it its formal name -- is a mental illness. People who suffer from this illness will often seek to mutilate themselves. These acts of mutilation are euphemistically called sex-change operations, but they are no such thing: Our sex is encoded into our genes and is unalterable. A "sex change" is, bluntly, a castration (of men) or a hysterectormy (of women) combined with plastic surgery.
Gender dysphoria is hardly a unique illness. Extreme depressives, the autistic, schizophrenics, and other mentally ill people often express their distress by taking knives to their bodies. Where gender dysphoria is unique is that it is the only mental illness whose victims have persuaded their government to pay for this self-mutilation: In the United States, "sex changes" can be subsidized by Medicaid; in Britain and Canada they are paid for by the National Health Service and Medicare.
It is more than a little shocking to discover just how threadbare the psychiatric literature on gender dysphoria is. The theory that surgery is the right way to treat a man who wishes to be a woman is supported by the flimsiest and scantiest of research. So why do we do it? Like George III's doctors, it is because we are in thrall to dubious medical ideas. We desperately want to believe that the differences between men and women are imaginary -- or, as the professors say, "socially constructed." And if those differences are socially constructed, then a man can become a woman with nothing more than a little bleeding and a new tube of lipstick.
Unfortunately for the future reputations of the doctors who perform these operations, the science of the brain every day brings new evidence of the profound reality of the differences between the sexes. It won't take anywhere near as long as 200 years for the sex-change operations of the late 20th century to look as cruel and stupid as the cupping and bleeding of the late 18th century look today. And when that time comes, we will understand -- as we really ought to understand now -- that the question about a man like Mr. Warfield is not whether he may use the ladies' room, but why the doctors who ought to have treated his disturbed mind hacked his genitals off instead.
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