Standards of Care (SOC)

Posted: fredag 12 september, 2008 by Tarald in English, My transition, Psychiatry
Tags: , , , ,

Until recently, I’ve believed that if the Norwegian Gender Clinic would just use the Standarsds of Care provided by WPATH, everything would be fine. I’ve thought that the SOC is ok. In my reading of the SOC I’ve only marked the parts that the gender clinic doesn’t follow.

Then I read Cedars post at Taking up too much space and realise that the SOC really can be used to defend the basic ideology at the gender clinic:

1)Procedures, not transition, not identity. There’s an almost universal assumption that these standards of care are in case a patients decides to “change hir mind” about transitioning. Putting aside of the implications of protecting trans people from themselves for a moment, transition regret is a red herring. No medical procedure can force you to live in a particular gender permanently. If I’ve been on estrogen for 10 years, have bottom surgery, facial surgery, the works, and decide I want to live as a man again? I start taking T, bind my tits, pack, and it’s no big deal. Yeah, it kinda sucks for me, but I’m not really any worse off than a female assigned at birth transsexual man (and, in fact, my situation would be remarkably similar to his).

–The point is, your informed consent is *not* about “being” a man or a woman (which no one can really truly understand in advance), it’s about the effects on your body (which, while variable, are fairly predictable). If I want an orchi, I need to be willing to take either estrogen or testosterone for the rest of my life, and be willing to either store sperm or not have more biological kids–and what gender I plan on living as in the future is fairly irrelevant.

This point is particularly salient if, like me, you transitioned before having any medical intervention. A doctor cannot prevent you from living as a particular sex by not providing treatment–a doctor can only increase the risks associated with doing so. Which is to say, if a doctor refuses medical therapies it’s not a matter of “correct diagnosis” as it is so commonly framed by SOC apologists, it’s not a matter of refusing transition but a matter of refusing treatment known to reduce associated health risks such as discrimination, murder, and harassment. Trans people who don’t transition when refused medical treatments are managing their health risks as best they can in the absence of basic medical care, something no one should have to do.

3)Boundaries, mental health, abuse, and control–

The SOC are damaging to trans people’s mental health and growth, particularly in the setting of boundaries. Normally, one can say ‘what you just did to me was fucked up, you can’t do that or I just won’t be in a relationship with you; I have other options,’ but through the SOC therapists and doctors create a unified front through which to drastically reduce your options. They create a power relationship with you where you can’t say ‘no’, where you can’t keep the most fundamental control of your body and person to yourself. Medical professionals have the power to protect you from violence, and by withholding it until certain standards are met they use the threat of violence to maintain immense power to determine what you can and can’t do with your life, your body, and your appearance; they also take advantage of the intense emotional pain of body dysphoria to do the same thing. Even if individual professionals do not intend to impose rigorous standards on a person’s gendered actions, the fact remains that the institutional power arrangement concentrates power in the professional’s hands, power over things so basic to one’s body sovereignty and self-determination that one cannot afford to risk the potential consequences of rocking the boat. By creating a unified front, the SOC effectively force trans people to do what their provider wants them to do, without much hope that they could be held accountable. How are we preparing trans people to resist emotionally and physically abusive partners? Aren’t we telling trans folks that it’s ok for another person to control you, financially for instance telling someone that if they don’t have sex with you then you’ll kick them out of the house / they won’t get any spending money next month / etc? The SOC constitute direct abuse, a mix of sexual, emotional, physical, and financial or something separate but equally abusive…

I agree! And I want to thank Cedar for making me think new thoughts. I still think it would help transpeople in Norway a great deal if the gender clinic would use the SOC, but it still wouldn’t be perfect.

Kommentarer
  1. Cedar sier:

    🙂 You’re welcome!

    What does the Norwegian Gender Clinic do?

Legg igjen en kommentar

Fyll inn i feltene under, eller klikk på et ikon for å logge inn:

WordPress.com-logo

Du kommenterer med bruk av din WordPress.com konto. Logg ut / Endre )

Twitter picture

Du kommenterer med bruk av din Twitter konto. Logg ut / Endre )

Facebookbilde

Du kommenterer med bruk av din Facebook konto. Logg ut / Endre )

Google+ photo

Du kommenterer med bruk av din Google+ konto. Logg ut / Endre )

Kobler til %s