Jun 16 2023
Being Trans Is Not A Mental Illness
On the current episode of the SGU, because it is pride month, we expressed our general support for the LGBTQ community. I also opined about how important it is to respect individual liberty, the freedom to simply live your authentic life as you choose, and how ironic it is that often the people screaming the loudest about liberty seem the most willing to take it away from others. That was it – we didn’t get into any specific issues. And yet this discussion provoked several responses, filled with strawman accusations about things we never said, and weighed down with a typical list of tropes and canards. It would take many articles to address them all, so I will focus on just one here. One e-mailer claimed: “It is obvious to me that the 98% of trans people have a mental illness that should be treated like any other mental illnesses.”
Being trans itself is not considered a mental illness, but this deserves some extensive discussion. It’s important to first establish some basic principles, starting with – what is mental illness? This is a deceptively tricky question. The American Psychiatric Association provides this definition:
Mental illnesses are health conditions involving changes in emotion, thinking or behavior (or a combination of these). Mental illnesses can be associated with distress and/or problems functioning in social, work or family activities.
But this is not a technical or operational definition (something that requires book-length exploration to be thorough), but rather a quick summary for lay readers. In fact, there is no one generally accepted technical definition. There is some heterogeneity throughout the scientific literature, and it may vary from one illness to another and one institution to another. But there are some generally accepted key elements.
First, as the WHO states, “Mental disorders involve significant disturbances in thinking, emotional regulation, or behaviour.” But then we have to define “disorder”, which is typically defined as a lack or alternation in a function possessed by most healthy individuals that causes demonstrable harm. “Significant” is also a word that’s doing a lot of heavy lifting there. This is typically determined disorder by disorder, but usually includes elements of persistent duration for greater than some threshold, and some pragmatic measure of severity. For example, does the disorder prevent someone from participating in meaningful activity, productive work, or activities of daily living? Does it provoke other demonstrable harms, such as severe depression or anxiety? Does it entail increased risk of negative health or life outcomes?