Ben Shapiro: "Transgender is a mental disease"

Dan Wilson

Senior Member.
Ben Shapiro is a lawyer and author who has gained a following as a political commentator. He has weighed in on a variety of current issues, one of which being transgenderism and transgender rights. He has a lot of specific talking points and examples that I do not want to touch on in this thread. What I do want to talk about here are these specific claims.
Source: https://www.youtube.com/watch?v=fHhJNsgNovU&t=189s
1:37 The idea that transgender surgery accomplishes anything for people that are 'transgender' is nonsense... 2:33 [Transgenderism] is a mental illness... 4:53 There is no such thing as a female brain existing in a male body, it just doesn't work that way that's not how biology works- there's nothing more unscientific than this notion of magical transgender fluidity...
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These views are widely held by and influential to some voters and lawmakers. They are misleading at best.

Shapiro mentions that there is nothing in biology to support the idea that transgenderism is a real phenomenon distinct from a delusional mental illness. He frequently says that biology makes you either male or female. This, of course, refers to the fact that people are normally born either as female with two X (XX) or male with one X and one Y (XY) chromosomes.

While this is mostly true, many biological males and females are born every year with sex development disorders. These abnormalities can have a variety of effects including serious health issues, ambiguous genitals, abnormal puberty, and hormone deficiencies. The time at which individuals born with one of these conditions are diagnosed can depend on how mild or severe the effects are and it is thought that many are never diagnosed. Whether or not any of these characterized conditions have any strong influence on transgenderism has been poorly studied but from this we know that genes have a profound affect on traits that influence cultural perceptions of male and female.

Is there any biological basis for someone to be transgender? There are no definitive mechanistic answers that science can offer us yet but we can say some things for certain. We know that genes on the X and Y chromosomes help determine the level of hormones in the body which ultimately influence what we would typically classify as "male" or "female" characteristics. We also know that measurable physiological differences can be associated with transgender individuals. For example, particular regions of the brain look different between men and women. http://www.sciencedirect.com/science/article/pii/S0303720717304306?via=ihub
In general, using the term “sexual dimorphic” is correct only regarding a few brain characteristics, while most do not overlap or have a minimal overlap between the two sexes (Cosgrove et al., 2007; Joel, 2011; Juraska, 1991; Koscik et al., 2009; Koscik et al., 2009; Lenroot and Giedd, 2010; McCarthy and Konkle, 2005).
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http://www.sciencedirect.com/science/article/pii/S0091302211000252?via=ihub
As sexual differentiation of the brain takes place at a much later stage in development than sexual differentiation of the genitals, these two processes can be influenced independently of each other. Sex differences in cognition, gender identity (an individual’s perception of their own sexual identity), sexual orientation (heterosexuality, homosexuality or bisexuality), and the risks of developing neuropsychiatric disorders are programmed into our brain during early development.
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When we compare the pre-operation brains of males transitioning to females to normal males and do the same thing with females, we see that the brains of transitioning individuals resemble the sex they are transitioning to rather than their biological sex. http://www.sciencedirect.com/science/article/pii/S0022395610001585#sec2.1
Our results show that the white matter microstructure pattern in untreated FtM transsexuals is closer to the pattern of subjects who share their gender identity (males) than those who share their biological sex (females). Our results provide evidence for an inherent difference in the brain structure of FtM transsexuals.
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http://www.sciencedirect.com/science/article/pii/S0149763415002432
The available data from structural and functional neuroimaging-studies promote the view of transsexualism as a condition that has biological underpinnings.
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While specific genes have yet to be identified in this case, twin studies have also suggested that transgenderism has a strong genetic component. https://www.ncbi.nlm.nih.gov/pubmed/12211624
Overall, the results support the hypothesis that there is a strong heritable component to GID. The findings may also imply that gender identity may be much less a matter of choice and much more a matter of biology.
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In summary, the biological determination of gender and gender identity is not black or white. A complex set of genetics, development, epigenetics, and experience contribute to gender identity in ways we don't fully understand. Despite our lack of a complete understanding, we can say with certainty that our current understanding of science and the data support the idea that biology plays an important part in influencing an individual's gender identity.

As a result of struggling with their gender identity, the transgender community is more prone to suicide and mental health issues. As far as treatments go, gender reassignment therapy is an option that is being done more often as time goes on. Shapiro claims that this kind of treatment does nothing for patients. In the scientific literature, however, the data support the idea that socioeconomic factors and particular treatment methods following surgery can have significant positive impacts an individual's mental health following reassignment surgery. http://transgenderinfo.be/wp-content/uploads/2013/01/QOL_Motmans.pdf
Recent research into the self-reported physical and mental health-related quality of life (QOL) of transgender individuals reveals lower scores when compared with a general population sample but suggests a positive impact of certain medical interventions.
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The evidence is strong that individuals passing for the sex they are reassigned to, following up surgery with hormonal treatment, and having access to the resources that assist them in achieving these goals have significantly positive effects on their quality of life. The idea that these treatments do absolutely nothing for these individuals is not supported by the data.

Transgenderism and gender ambiguity is nothing new with records of such individuals being described in a variety of cultures throughout history. Considering the persistence of transgenderism is human history and what we know about genetics and development, there are strong clues that transgenderism is rooted in but not completely determined by biology. To say that there is nothing in biology to support an individual's identification with the opposite sex is completely inaccurate.
 
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What is a "male brain" and a "female brain"? Scientifically. How would I detect if I have a "male brain" or a "female brain"?
 
What is a "male brain" and a "female brain"? Scientifically. How would I detect if I have a "male brain" or a "female brain"?
There are many notable examples of sexual dimorphism between male and female brains. In one of the papers referenced, the authors talk about white matter distribution differences between the two and compare trans individuals to control groups. Another measurable difference is gray matter content. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110817/
When conducting post hoctests, we revealed a number of regions where women had larger [gray matter] volumes compared to men. Importantly, these sex effects remained evident when comparing men and women with the same brain size. Altogether, our findings suggest that the observed increased regional [gray matter] volumes in female brains constitute sex-dependent redistributions of tissue volume, rather than individual adjustments attributable to brain size.
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Other differences appear in but are not limited to the hippocampus and amygdala.
 
This is from the Mayo Clinic Definition of Mental Illness:


Mental illness refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. . . .
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Causes
By Mayo Clinic Staff

Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors:

  • Inherited traits. Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.
  • Environmental exposures before birth. Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression.
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http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/causes/con-20033813

Since the mind is not a separate entity from the brain, and the brain is an integral part of the biological body, one could logically argue that all mental illness has a biological basis at some level. It is therefore a non-sequitur to contend that a biological basis invalidates a diagnosis of mental illness.
 
The claimed divide between a psychological problem and a neurological problem is artificial. Depression (or schizophrenia!) is a psychological problem? But dementia is a neurological problem? This is merely a vague intuitive idea. Psychological problems inhabit a weird world of causeless abstraction. Intuitive thought, as I've argued elsewhere here, is based on simple associations and feelings. In intuitive thought the mind is just a causeless abstraction that isn't tied in an analytical way to cause and effect.

"It just happens... (struggling) because that's the nature of things!"

But neurological problems are put into another category that is tied to cause and effect in a physical system. This itself is an interesting issue. It's simply based on how we feel about different mental states.

Psychology is when the mind is simply doing its natural thing; by the very nature of things, reality pours into the mind as water fills a container. But a neurological problem is the mind artificially interfered with by a physical fault.

It's an old fashioned idea that shouldn't be taken seriously anymore.
 
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Since the mind is not a separate entity from the brain, and the brain is an integral part of the biological body, one could logically argue that all mental illness has a biological basis at some level. It is therefore a non-sequitur to contend that a biological basis invalidates a diagnosis of mental illness.
This is a good point. It is true that you can't disentangle biological events from mental events. In this case, Shapiro claims that identifying as transgender is a mental illness and then goes on to say that there is no biological basis to justify such thinking. This does not make sense in the context of definition but what he means to say is also incorrect. Inherited traits, environmental stressors during development, and brain chemistry can have profound influences on how an individual identifies as a gender. It could be argued that transgenderism is a form of mental illness but pseudoscience often succeeds by portraying facts in selective and misleading ways.
 
In listening to the video, I hear Shapiro saying there is no biological basis for classifying these people as women, but I don't hear him saying that there is no biological basis for the problem of gender dysphoria. His position is not unreasonable. The Y chromosome, which determines biological maleness, has 200 genes, according to one source mentioned in Wikipedia. Other sources come up with different numbers, but 200 is in the ballpark. According to an article in "Nature:" [EXThe male-specific region of the Y chromosome, the MSY, differentiates the sexes and comprises 95% of the chromosome's length.][/EX] http://www.nature.com/nature/journal/v423/n6942/full/nature01722.html
That article mentions 156 transcribing genes. If one of these genes is defective, that might make a man think he is really a woman, but the other 99.5% of the genes in the Y chromosome still indicate male. It would be much more realistic to classify such a person as a man with a mental illness caused by a defective gene, rather than as a woman.

The problem with brain studies is that brain tissue is malleable. Brain tissue can be developed or atrophied, analogous to muscle tissue. A Scientific American article which is generally sympathetic points this out: [EXOf course, behavior and experience shape brain anatomy, so it is impossible to say if these subtle differences are inborn.][/EX]https://www.scientificamerican.com/article/is-there-something-unique-about-the-transgender-brain/ So you have a chicken or the egg problem.
 
The Motmans study has two serious flaws. First, it has a self-selected study group, consisting of the people who returned the questionnaires. It is more likely than not that the 37% who did not return the questionnaires had worse health outcomes than those who did. Second, it represents one point in time.

The Swedish study by Dhejne, et. al, in contrast followed all 324 surgical gender change patients in Sweden over a 30 year period, and had a more pessimistic assessment of health outcomes.
Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043071
 
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It's an old fashioned idea that shouldn't be taken seriously anymore.

Before I post what I was about to post... are you referring to Psychology being old fashioned or the idea that neurons misfiring causing dementia is old fashioned? Its probably staring me in the face and Im just not seeing it yet this morning so I want to make sure Im clear on what you're saying before I put my foot in my mouth lol.
 
This is from the Mayo Clinic Definition of Mental Illness:

Causes
By Mayo Clinic Staff

Mental illnesses, in general, are thought to be caused by a variety of genetic and environmental factors:

  • Inherited traits. Mental illness is more common in people whose blood relatives also have a mental illness. Certain genes may increase your risk of developing a mental illness, and your life situation may trigger it.
  • Environmental exposures before birth. Exposure to environmental stressors, inflammatory conditions, toxins, alcohol or drugs while in the womb can sometimes be linked to mental illness.
  • Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that carry signals to other parts of your brain and body. When the neural networks involving these chemicals are impaired, the function of nerve receptors and nerve systems change, leading to depression.
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http://www.mayoclinic.org/diseases-conditions/mental-illness/basics/causes/con-20033813

Is Post Traumatic Stress Disorder (PTSD) not a mental illness?
 
Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.
ben Shapiro in that video is talking about suicide rates being better AFTER surgery.. not compared to the general population.

The truth is, in the video and other talks he gives, Ben says:
1:43 "suicide rates are the same before and after the surgery and they are both in excess of 40%"

stats from UCLA https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf
Capture.JPG


The problem is.. if you read any of the text in the study... they do not ask participants WHEN they attempted suicide, so we don't know if they attempted it before or after their surgery.

“Have you ever attempted suicide?” with dichotomized responses of Yes/No. Researchers have found that using this question alone in surveys can inflate the percentage of affirmative responses, since some respondents may use it to communicate self-harm behavior that is not a “suicide attempt,”

....
In addition, the analysis was limited due to a lack of follow-up questions asked of respondents who reported having attempted suicide about such things as age and transgender/gender non-conforming status at the time of the attempt.



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In listening to the video, I hear Shapiro saying there is no biological basis for classifying these people as women, but I don't hear him saying that there is no biological basis for the problem of gender dysphoria.
If he understood this and considered these individuals to have gender dysphoria (arguably a mental disease), why not say that? Why not say that there is some form justification for these individuals feeling the way they do? Instead, he misleadingly portrays them as insane which leads me to assume he does not understand the science behind this issue.
According to an article in "Nature:" [EXThe male-specific region of the Y chromosome, the MSY, differentiates the sexes and comprises 95% of the chromosome's length.][/EX] http://www.nature.com/nature/journal/v423/n6942/full/nature01722.html
That article mentions 156 transcribing genes. If one of these genes is defective, that might make a man think he is really a woman, but the other 99.5% of the genes in the Y chromosome still indicate male. It would be much more realistic to classify such a person as a man with a mental illness caused by a defective gene, rather than as a woman.
This is only a part of the story. While many intersex and sex development disorders involve sex chromosomal abnormalities, they can also be independent of genes found on sex chromosomes. For example, congenital adrenal hyperplasia (CAH) is a case where a genetic woman can end up developing without a vagina and instead have a functional penis. It is caused by a gene on chromosome 6. CAH is the most common disorder of sexual development and, just to be clear, although they may have ambiguous genitalia, most CAH patients think of themselves as girls. A 2012 review, however, concluded that, depending on the disorder, a measurable fraction of individuals who suffer from a sexual development disorder also experience gender dysphoria. https://www.nature.com/nrurol/journal/v9/n11/full/nrurol.2012.182.html
Gender dysphoria generally affects between 8.5–20% of individuals with DSDs, depending on the type of DSD. ... Patients with 5α-reductase 2 (5α-RD2) and 17β-hydroxysteroid dehydrogenase 3 (17β-HSD3) deficiencies exhibit the highest rates of gender dysphoria (incidence of up to 63%).
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The problem with brain studies is that brain tissue is malleable.
The brain is indeed malleable. This does not mean that everything in the brain is subject to dramatic changes, certain regions in normal brains will always look a certain way. The sexually dimorphic brain has been very well studied and reproducible differences have been found. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3896179/pdf/pnas.201316909.pdf
In this work, we modeled the structural connectome using diffusion tensor imaging in a sample of 949 youths (aged 8–22 y, 428 males and 521 females) and discovered unique sex differences in brain connectivity during the course of development.
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Also, to reiterate a point from earlier:
http://www.sciencedirect.com/science/article/pii/S0303720717304306?via=ihub In general, using the term “sexual dimorphic” is correct only regarding a few brain characteristics, while most do not overlap or have a minimal overlap between the two sexes (Cosgrove et al., 2007; Joel, 2011; Juraska, 1991; Koscik et al., 2009; Koscik et al., 2009; Lenroot and Giedd, 2010; McCarthy and Konkle, 2005).
The Motmans study has two serious flaws. First, it has a self-selected study group, consisting of the people who returned the questionnaires. It is more likely than not that the 37% who did not return the questionnaires had worse health outcomes than those who did. Second, it represents one point in time.
The significant finding from the Motmans paper is that individuals undergoing reassignment surgery have the greatest chance for a good quality of life when they are accepted as the gender they are being reassigned to. For example, those following up reassignment surgery with hormone therapy and plastic surgery in order to acquire more masculine/feminine features fare better than those who did not. This ultimately affects how a society may perceive and treat them. This is discussed in the Swedish study and contradicts Shapiro's claim that bullying has nothing to do with transgender suicide rates. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043071/
The poorer outcome in the present study might also be explained by longer follow-up period (median >10 years) compared to previous studies. In support of this notion, the survival curve (Figure 1) suggests increased mortality from ten years after sex reassignment and onwards. In accordance, the overall mortality rate was only significantly increased for the group operated before 1989. However, the latter might also be explained by improved health care for transsexual persons during 1990s, along with altered societal attitudes towards persons with different gender expressions.[35]
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Is Post Traumatic Stress Disorder (PTSD) not a mental illness?

I guess so. It is defined in DSM5. Does it fit the above criteria? To some extent at least, it does.
https://mentalhealthregimen.com/signs-of-post-traumatic-stress-disorder-and-treatment-options/
Although PTSD is not considered a hereditary disorder there is a strong genetic component to the disorder. Genetics may account for 30% of the variance of post traumatic stress disorder.
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PTSD is often associated with low levels of cortisol and there is research suggesting that PTSD sufferers may have disrupted levels of cortisol or cortisol receptors.
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So there is a genetic component in some cases, and there is a brain chemistry issue. That said, you would think that the list of causes should also mention post-natal environmental stressors.
 
The claimed divide between a psychological problem and a neurological problem is artificial. Depression (or schizophrenia!) is a psychological problem? But dementia is a neurological problem? This is merely a vague intuitive idea. Psychological problems inhabit a weird world of causeless abstraction. Intuitive thought, as I've argued elsewhere here, is based on simple associations and feelings. In intuitive thought the mind is just a causeless abstraction that isn't tied in an analytical way to cause and effect.

"It just happens... (struggling) because that's the nature of things!"

But neurological problems are put into another category that is tied to cause and effect in a physical system. This itself is an interesting issue. It's simply based on how we feel about different mental states.

Psychology is when the mind is simply doing its natural thing; by the very nature of things, reality pours into the mind as water fills a container. But a neurological problem is the mind artificially interfered with by a physical fault.

It's an old fashioned idea that shouldn't be taken seriously anymore.

New guy here: Do any people 'in the field' try to divide them?
They're admixed and interactive. The reason one to might single one aspect out is to research it or manipulate it (as in treatment).
 
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