From Donald to Deirdre

How a man became a woman--and what it says about identity.

Deirdre McCloskey from the December 1999 issue

(Page 6 of 6)

Oh, yes, Doctor, whatever your dopey list says. The psychiatrist's eyebrows returned to normal.

Sleep of the Just

There's no case, Deirdre would argue, for letting psychiatrists get at a gender crosser. People say, "Wait a minute. It's an irreversible step. Better check it out." But the psychiatrists don't know how to check it out. They know nothing about it and are not interested in learning. To make them assess gender crossers is like making a brain surgeon do open-heart surgery. It's not in their competence. The excitement these days in psychiatry is about drug treatment of psychoses. It's wonderful that some clinical depression and even schizophrenia can be helped with drugs. But gender crossing is not a psychosis, and there is no medical evidence that it is associated with psychosis in any form. We might as well have psychiatrists check out people with brown hair or people with cheerful dispositions or people who like to visit Venice as often as they can. Just to make sure.

And The Step is not irreversible. When Deirdre made this point people would get indignant. They at least know that much. "What are you talking about? Someone cuts off his penis and you say it's reversible?" Please, listen. Operations--not that the operation is the essence of it all--can be reversed, sometimes. For example you can take out cheek or breast implants. True, with current techniques reconstructing a penis is very expensive. That's the only advantage that males-to-females have over females-to-males in cost and effectiveness: Because it's easier to remove than to make, their male-to-female operation is a fifth the cost of the female-to-male one, a compact, low-end car instead of a Mercedes. But so what? Forget about reconstructing the penis. Many men do not have penises, on account of war or accident or disease. This does not for most purposes make them less men. A man is a man because of his look and behavior, not because of what is secretly in his pants. And beyond the contents of pants, one's behavior and dress can be changed back. The hormones, too, have partly reversible effects. Deirdre would smile and say, "If I stopped female hormones and started testosterone, in five or six months I'd be acting like a jerk again!" The joke worked best if there were lots of other women present.

Anyway, Deirdre continued, we need to ask whether we want to invite psychiatrists to have power over all the comparably important business of life. Having a baby is well and truly irreversible, more so than gender reassignment. A new human being is brought into the world. Well, shouldn't everyone have many years of psychological counseling before having a child? And getting married, though reversible at some cost, like cheek implants, is pretty serious too. So likewise is choosing a career, or buying a house, or taking up golf. If these were treated the way gender crossing is treated we would need for each a certification from psychiatrists achieved through hours and hours of expensive conversation; maybe some drugs; or, if nothing else works, hooking 'em up to the house current. Such certification and treatment would be absurd for the reasons it is absurd for gender crossing. The psychiatrists don't know anything worthwhile about having a child or buying a house or being a gender crosser, as most psychiatrists admit. And even if they did know, in matters not affecting other people's rights we regard ourselves as free individuals. The freedom question is, why not? There's no case for a special enslavement of gender crossers to the psychiatrist except that there are so few crossers that no one troubles to care.

Gender crossing is also called "gender dysphoria," Greek for being uncomfortable with your birth gender. Being uncomfortable with, say, poverty or brown hair or lack of fluency in French is not labeled a disorder. A threat to order, the order that gender is irrevocable. Deirdre was surprised that psychiatrists allowed themselves to be cast as gender police. Nowhere in the literature has a cure been reported for the "disorder," except the cure of letting people be who they wish to be, which has done its work for tens of thousands.

A resolution was passed in August 1997 at the annual meeting of the American Psychological Association in Chicago, a quarter of a century after homosexuality was removed from the Diagnostic and Statistical Manual. Homosexuality "is not a mental disorder and the American Psychological Association opposes all portrayals of lesbian, gay and bisexual people as mentally ill and in need of treatment due to their sexual orientation." A year later the American Psychiatric Association said the same. Most American gender crossers want the same liberation from psychological/psychiatric torture. They want gender identity "disorder" removed from the list of madnesses and another sentence added to the resolution of 1997: "The same is true for gender crossing and cross-gendered identification." The Canadian gender crossers object, because under their national health service they get money for the operation as long as the "disorder" is in the DSM. Consistent Canada. Merci bien.

Dee would sometimes wake up at night and be unable to sleep, though it was rare. The sleep of the just, she said to herself. But she watched for signs of doubt. She worried that at 3 a.m., stripped of the day's masks, doubt would surface. It never did, and she slept better as Deirdre than as Donald.

She could recognize doubt. Donald couldn't sleep for doubt when he was chair of economics at Iowa. He knew from the experience that he should not go into administration. Just or unjust, you have to be able to sleep. The new president of Harvard in the 1990s had a similar problem and took a year's leave. When Donald left a permanent job at the University of Chicago in 1980, he knew doubt at 3 a.m. His wife would become angry if he talked of his Chicago doubt, for it was tedious after a while to listen to the whining. My ex-wife would like Deirdre better if she knew her, she reflected. No angst.