Customer Reviews

Transsexualism: Illusion and Reality (Disseminations: Psychoanalysis in Contexts)

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The author is the psychiatrist-in-chief of the Alfred Binet center in France and has treated many transsexual clients. On the back of the cover her book promisses "Transsexualisms first defining study". This would require a good literature review, new research data, case studies or new interpretations of older data. Instead the reader finds slapstick images, generalising one-liners and moral bravado.

According to the author, psychotherapy is able to turn TSs around, and the author believes her clients sickness responsible for her lack of succes. The transsexuals she saw, without exeption, flee her psychoanalytical treatment. They falsely resolve the psychological conflict at the root of their gender problem throug surgery. Thus they remain sick as before and sadly "mutilatated" after. All of her clients, without exeption, suffer from amnesia in regard to the conflicts in their clildhood, are borderline psychotic, in denial of their homosexuality as well as their birth sex, and have a stereotypical barby doll image of the men or women they become. When they do not fully pass in their chosen sex they are "pathetic". They suffer the delusion that their post-operative genitalia entitle them to man- or womanhood. In many asides the author assures her readers she is a caring analyst, a feminist and a philosopher. The author uses philosopher Paul Ricoeur, one I esteem deeply, to validate her opinion that TSs should opt for a life in their birth sex. Ricoeur, in my understanding, is concerned with the limitations of human experience in general. Applying it to gender dysphoria may be considered a leap out of context.

On the back of the cover, this book ensures a full review of the literatur on TS, but it is honest to say the author leaves out many studies not useful to clarify her broad vision.

The author has been working extensively with transsexual clients in a French clinic specialized in their care. I am surprised that a therapist so talented was elected to treat these clients. They do not open up about their doubts and ambivalancies. The aim of any therapeutic enterprise (to find an individual approach and treatment plan) was never fulfilled. This must be very sad to both author and clients.

I must noe that it is possible that this author's client population and treatment setting may be very different from the clients I see. Many of these have chosen for a partial medical treatment, and some for no medical treatment at all. How to reconcile this with Cliland's findings? It may be that the author has a less divers clientele in her office. If her book reflects a very negative psychoanalytical stance towards the medical treatment of gender dysphoria in the French medical community, might it be that only the most desperate cases may make it to the obligatory visits to the authors office? A client-population so traumatised by their gender conflict, they suffer from all it's secondary terrors as well? Like borderline and personality disorders? This is, of course highly speculative.

Clinical practice in other countries is less negative, resulting in generaaly good mental health among the transgender population I see. They show a precise and painful memory, not of the certainty of being a member of the other sex, but of doubt, uncertainty and desire. All those fragile human feelings they hoped to grow out of but did not, in spite of their best efford. At some time this feld reality came in conflict with the lives they wanted for themselves. The story is not one of denial of a biologic reality, it is one of admittance to one not coveted by psychoanalysis. This falls outside it's grasp. My clients are not borderline, not combattative, and share willingly their doubts, worry, sadness and mourning. They come to various medical and non-medical solutions. How can I as a responsibly acting clinician reconcile this with this author's noions?

It might help, and this is only a suggestion, if this psychiatrist-in-chief stops hearing Freud's and Lacan's voices, and started listening to her clients. She might hear something. have I done my clients right? Have I ben the best people-helper I can be? Have I listened? Who was I preocupied with? My clients?

Arianne van der Ven

Colette Chiland admits she's a psychiatrist of the 'old school' in Europe. Which means her background is not medical, but in the humanities. In fact, her book is nothing but a philosophical/ethical analysis of transsexualism viewed as a problem stemming from social mores.

Which is not the case, since a true understanding of 'gender dysphoria' requires a medical background.

Books on the ethics of SRS and such were fairly common during the 70s. Several of those are revisited, and the sources cited by Dr. Chiland are all for the most part 30 years old or more. Her research is outdated because she does not want to take into account the more current, medical view of 'gender dysphoria' as something that has a biological basis.

Some of the generalizations are almost laughable. For example, she talks about 'gender dysphoric boys' who draw two women: one like a good fairy, the other like an evil witch. According to her, one of the root causes of transsexualism in genetic males is such splitting of the mother image. Wanting to disappear the witch, they want to become the fairy.

And that is not even the most farfetched bit.

Even so, the book may have some value as a different view on the social implications of transition and such. I'd say it's an interesting read for anyone with a background in the humanities. Anyone familiar with the idea of a male phallocentric narrative as the core of modern social order will see whence the author is coming.

Still, Dr. Chiland seems to come to the subject with an axe to grind, and although at times interesting, in the end the book is irrelevant to those to whom it is addressed: experts in the field and the transsexual men and women out there.

PS: This book's cultural context is France or, more widely, continental Europe. Some of the references and names cited will be rather obscure to the American reader, and the ideas proposed by such names, unknown. Dr. Chiland has stretched the area covered by post-structuralist theory to what is now more properly treated by medicine, although in the end she clings to a dated essentialism where men are born men and will die men, and women are born to have children. Love and marriage are, for her, means to an end (having children); and transsexualism is a narcissistic disorder because it goes against such end.

Very outdated and condescending. Perhaps this is attributable to the translator. I hope so. In once instance, MTFs are referred to as "pathetic." I threw this in the garbage today and will hopefully forget I ever bought it and read it.

Chiland's book is without a doubt one of the most offensive pieces of transphobic propaganda I've read which has been published within the past few decades. At the superficial level, the language she uses to describe trans people- "disturbing people," "deluded," "mutilated," "narcissistic," "caricatures," "often... ugly bab[ies]... horrible brats who would never elicit the comment: `What a gorgeous little girl you have there!'" (as a "cause" of being a transman), and so on- is not only officious (and false) but revealing of a deeper loathing and culturally-inspired disgust felt toward and misunderstanding of trans people. She does little more than regurgitate and misrepresent all the tripe presented by feminist separatist (like the ones running the Michigan Womyn's Festival a few years ago; the people who claim that trans people are just male stereotypes of real women and men. These people shouldn't, of course, be confused with the majority of feminists, who are mostly accepting or at the very least tolerant of trans people), by work, which she references, on the subject by conservative psychologists that is decades old (one of whom quotes Deuteronomy 22:5 as an epigraph, another who documents the "curing" of a transwoman through having her exorcized(!), which Chiland thinks is worth noting as a valid "cure"), by applications of Freud to the subject, by the standardized checklists resulting from the work of people like Harry Benjamin, and by early studies on "feminine boys" and "post-operative suicide" (which even she has to admit doesn't happen at such a high rate as she most likely expected, although she still manages to display the data in a disingenuous fashion) and wraps them all up in (partially) meaningless little anecdotes. The only thing she manages to reveal with her anecdotes is that she is a sadist to whom trans people should never, ever be referred (she offers a vignette in which she coldly feeds several young transmen exaggerated negative aspects changing sex until she forces them to tears, running them off and infuriating their parents); although, to be fair, she does grudgingly admit that "[f]rustrating as it is for the reader and myself, the prime consideration must be professional secrecy" just to let the reader know that she isn't willing to toss *all* of her "professional" ethics out the window in her attack on trans people.
Beyond the problems stated above, there are several disturbing themes in here piece of work. The first is, of course, her main argument, that trans people shouldn't ever be given the hormones and surgeries which make them appear less like the "caricatures" the author labels them and should instead be "cured" through psychotherapy, in the same fashion that shrinks were trying to "cure" gays and lesbians (if they even recognized the existence of the latter) up until a little after the middle of last century. This argument is pure garbage and can only be presented as valid through anecdotes in which the trans person was traumatized into suppressing their identity by a so-called professional or another agent- very much like the "treatment" of homosexuality. The second is the argument that "transsexualism" as it exists in the "West" today is purely a creation of the media(!) and the misuse of medical technology. She backs this argument, which is pure bunk, up by appealing to the notion of a "third gender" (which is a nice thought in terms of social acceptance, but should not be used to categorized most, much less all, trans people) a niche for the gender-changers, with comparison to other cultures: the hijras, the "berdaches," the "liminals" of Polynesia (in this section she gets away with saying that "homosexuality is `optional,'" even if it is in reference to a group which she can comfortably Other), the third gender of the inuits. She neglects, however, to take into consideration the fact that most hijras are castrated, that many in all of the examples given will use female or male hormones when given the opportunity, and appears to forget entirely that there is an eastern part of Asia in which many, many trans people receive hormones and surgery, or that there exist any Americans south of the US, who use hormones, silicone injections, surgery, and other methods to look more like men or women; all of these things she ignores when talking about how the penis and testicles are "the most precious parts of [the male] body" and how their removal is, she implies, a sin against humanity, or when she mocks transmen who want to have their breasts removed (although she, ironically enough, later openly taunts a transman who hasn't had an ovariectomy or a hysterectomy). Another theme is the tired, dead one that transwomen and transmen- but particularly transwomen- are just playing out stereotypes that feminism has so long fought against. A really dangerous idea which she espouses is one which is, unfortunately, all to dominant in the field of psychotherapy: that of professionalism, a positivistic approach to psychology as a Science (big S) which disregards the opinions, thoughts, or ideas of anyone not trained in that specific field (as most trans people are not) as invalid or irrelevant. She doesn't care what trans people think or say, all that is relevant is what she interprets and opines, or what other "professionals" (transgender sex workers, McD's workers, factory workers, they don't know what the hell they're talking about! They surely haven't the knowledge of "gender identity disorder" which she has!) interpret so long as they are psychologists (no sociologists or modern academic feminists or biologists or economists or computer/technology scientists here!) and agree with her. The Benjamin Standards of Care, the DSM-IV, and those transphobic "professionals" of decades ago tell her all she needs to know.
Because she takes a Freudian approach, her conclusion is merely a regurgitation of his theories and philosophy applied to trans people, claiming that all "transsexuality" stems from a disorder caused by childhood trauma that is (she appears to be influenced here by the right-wing pundits of the US) shaped by the (evil liberal) media into a craving for the escape from one's self into "The Other" sex. Her solution is to more strongly reinforce gender roles in children. There is no way that any trans person could read this and not be offended, and I would hope that there is no way that any shrink, or any other "professional," for that matter, could read this and take it seriously. This isn't psychology, this is a proselytizing philosophy that doesn't bother to take into account realities.

This review was initially posted for another book by Chiland, but is of equal applicatiobn to this book.

So-called TS activists have started a campaign against this book as they did with J.Michael Bailey. Anyone interested in transexuality should read both vews as nothing is proven. The hostility that many TS direct at alternative views is confrimation of a mental disorder point of view.

Chiland advances the mental disorder view in both of her books on the topic (that is, both that have been translated into English). For those who are not transexual, reading either must be tempered with the understanding that other views are more popular and perhaps more accepted; for transsexuals reading either, understanding that nothing is proven and that present treatmeent is based strongly upon the model Chiland presents is necessay.

This is a truly fantastic book. From the viewpoint of transsexual activists, perhaps the most politically incorrect book on the subject, but from any other view the most insightful and "tell-it-like-it-is" view of transexuality available today, perhaps ever. It does not pander to the subject, but treats it in the cold light of reality. As a transexual woman who can deal with reality, I am overjoyed that a book finally exists that dispells the mythology concerning the subject. Chiland easily deals with the most prevalent of TS statements ("I am a woman") and treats them with respect, but also with the logic that most ignore. She points to the finacial aspect of SRS as a motivation for some doctors and the need to face the question of SRS directly. Her book is unique, for it does not avoid the basic questions posed by transsexuality but rather addresses each in turn, with a logic that will force all but the zealots to think. Caregivers need to read this; transsexual patients need to read this. This book says what it real, not what is myth. Transsexuals who believe in the mythology will be irrate for it does not offer blind support(although it certainly offers compassion) and questions some of their most basic and firmly held beliefs, It questions what has become a standard medical answer in North America and elsewhere. The transsexual "lobby" has become active in the past years, attacking without mercy those who differ with their mythology. J. Michael Bailey of Northwestern University has been a favoured target. As this book becomes known, it shall be attacked by those who wish us all to follow the demanded cant of "I am woman","I am man". Some may regard it as an attack akin to Janice Raymonds "Transexual Empire" of long ago. It is far from that. While Chiland questions the very foundation of transsexulity and Moneys seperation of "sex" and "gender", there is none of the questionable scholarship and feminist rhetoric to be found in these pages. This book is firmly based in experience and logic. I suspect that many American readers will react much as they did when France opposed the War in Iraq, with emotional zeal and blind adherance to their view. That is a shame, for Chiland deserves and very careful consideration by all who are or deal with transexual patients. She raises questions that demand answers not blind following of a possibly misguided solution. The truth hurts. For some, this book will hurt greatly. For those who pause and reflect rationally, it will raise issues long put to the back of the mind, uncomfortable issues that many elect to ignore. Issues that have been ignored for far too long... A major step in our understanding of this difficult subject.