Gender Identity Disorder: Analysis of a Cyberspace Support Group
Storm A. King
May, 1995
Cite as:
King, S. A. (1995). Gender Identity Disorder: Analysis of a Cyberspace Support Group. Retrieved [fill in todays date here] from the World Wide Web: http://www.concentric.net/~Astorm/gender.html
This paper will analyze notes posted to a cyberspace group devoted to sexual identity issues to demonstrate the value of such publicly posted self reports of strategies for dealing with issues surrounding this disorder.
These notes are posted by people experiencing gender identity conflicts, and constitute a support group for these individuals, one that meets in cyberspace. The therapeutic value to the participants is shown in notes
that are examples of how such cyberspace groups offered emotional assistance and advice on coping strategies. Messages that include reports of an individual meeting the criteria for the DSM IV diagnosis of Gender Identity Disorder are documented, in what is a non-clinical setting. Suggestions are made for the ethical use of the notes from cyberspace support groups for the study of this kind of psychopathology .The issue of sexual orientation and sexual identity is fraught with debate. Controversy surrounds the basic conceptualization and assessment of gender identity incongruity. Some claim that biological events dictate sexual desires, and speak in terms of sexual imperatives. Other researchers cite evidence that psychological factors, especially developmental ones, are primary in determining ones sexual orientation and satisfaction with ones biological sex. They write about a persons sexual preferences (Baumrind, 95). There is an inability to distinguish the relative importance of determining ones gender identity among the complex biological, psychological and sociological factors involved (Strickland, 95). The existence of people that are convinced that they were born the wrong gender is not a question of debate. These people are often in great internal conflict and constitute one of the most victimized minorities in our culture. As such, people with gender identity disorders are more at risk of suicide than the general population, and their mental health is more at risk (Hershberger, 95). The value of family acceptance and support in dealing with this condition has been consistently documented. Assistance with satisfying ones emotional needs has been shown to be a buffer against the deleterious effects of social ostracization and victimization for people that experience an
incongruity between their gender and their sexual imperatives (Hershberger,95). In a recent article summarizing the state of research into sexual orientation and identity issues, several approaches were identified as valuable and in need of further development. These included research that focuses on individuals, and research that looks at the development, structure and functioning of neighborhoods and communities of people with alternative sexual preferences (Patterson, 95).This paper will demonstrate the value of analyzing publicly available communication between individuals and a similarly oriented group around the issue of gender identity incongruity. Individual coping skills can be determined and their value assessed. The value of participation in such a virtual neighborhood is documented by self reports. Cyberspace support groups offer a new means by which people with gender disorder conditions find each other for the purpose of giving and receiving emotional support. The level of concern for each other shown by participants who have never seen or heard each other in person is a new phenomenon; one not explained by previous studies of group therapy and live self-help groups. The therapy inherent in the exchange of experience, strength and hope in these virtual communities seems to be real, valuable, and, in many ways, unique to this format (King, 94). The level of self disclosure, in what is a public forum,
is astounding and seems to constitute a form of denial. The perception of privacy in the public interactions of cyberspace participants is a phenomena deserving further study.The potential for cyberspace support group participants to be the victims of overeager researchers warrants appraisal. Due to the lack of precedents for this kind of research, this paper is an attempt to set the ethical guidelines for the reporting of research by psychologists and others that use cyberspace for participant observations. Protecting the anonymity, as well as the privacy, of participants is paramount. No mention of the name of the group studied will be made, and no clue as to the type of group will be given. No interaction between the researcher and the group occurred. Whether the group studied was a national, international or local one is not revealed. The type of forum studied could be a bulletin board, or an email list. The quotes from the group under study will reveal no clue as to its origin, and no names will appear in the report, not even pseudo names. The ability of other researchers to duplicate findings from such individual cyberspace case studies, derived from public notes, is not dependent of exact replication. It is the responsibility of the individual researcher to insure the continued free participation in these valuable groups by members, unencumbered by suspicions of their being studied.
The opportunity to observe self disclosure among people with gender identity disorders is valuable in many ways, and justifies the seeming deception involved. One of the DSM IV criteria for diagnosis of gender identity disorder is that the condition causes clinically significant distress or impairments in social, occupational or other important areas of functioning. This is a rather vague standard. The ability to evaluate occurrences of this distress, in a non clinical setting, could assist in a refinement of this criteria. Future issues of the DSM may benefit from these kind of observations in obtaining more accurate prevalence rate and common course descriptions. A determination that participation in cyberspace support groups held therapeutic value for socially isolated patients could make more treatment options available to clinicians that work with gender identity disorders.
Case one.
One of the more common topics in the group I observed was the subject of the effects of sex reassignment surgery. This group contained many who were considering the surgery, some who were current candidates for surgery, and others that had already had such surgery. Programs for sex reassignment surgery have been in existence since 1953. Only about two thirds of those who have this operation report improved adjustment after surgery (Holems, 91). This note clearly demonstrates the dilemma and stress faced by many who seek, or consider, sex reassignment to resolve their gender incongruity. As is the custom in all cyberspace forums, the > mark is used to indicate a note that the poster is quoting a previous post in order to reply to it. This conversation originally revolved around the ability of post sex reassignment patients to achieve orgasm.
-----------------------------------------------------------------------> The way I see things, in my own humble way, is that the post-ops who are
> proclaiming their orgasms in public while agonizing in private are simply
> using the coping skills they learned in transition -- "say something
> enough times, and it will become true", and "picture things as you want
> them to be while waiting for them to arrive." Also, I see them as trying
> to protect their psyches until they are able to come to terms with the
> fact that their surgical outcomes weren't what they had wanted. Is there
> anything wrong with this? No -- unless you try to use those proclamations
> as evidence of what to expect.
I have done this....This is the reason for my latest battle with my suicidal feelings. I told myself I was a woman and thus needed a transition and Surgery to complete the picture. Well, the fact of the matter is that I STILL feel miserable....perhaps a little less than before but MY idea that "I am a woman and therefore I am a woman." no longer seems to cut the mustard. recently, I got my packages from 2 different SRS (sex reassingment surgery) surgeons....After reading each of them I cried and vomited halfway through.
I cannot go through with this. And right now I am not sure what to do....I am in therapy but apparently
that is not helping too much and the worst part is that the "WHY should I BOTHER" question keeps on recurring. I have poured my heart out to try to make my transistion a success but the results have been nothing short of abysmal. so...I am frozen in place....I cannot bear the thought of surgery nor can I
bear the thought of dying.....and believe me..right now I really want to die , but it wont happen cause I am too afraid to do it....so I am doing my best to burn as much energy as I can so I CAN sleep. I can run but I can't hide...my time is running out.
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This is an instance where the level of clinically significant distress is easy to define, the poster of this note was near suicidal over his situation. The follow up notes in reply to this letter were extremely supportive and full of sound advice, something that does not always occur in such support
groups (Roan, 95).Case Two
This message is typical of many that are attempts to share experience with gender incongruity feelings, for the benefit of any readers that may need additional role models to identify with. By describing the progression, from childhood on, of their inability to resolve their sexual identity issue, this poster provides a wealth of information for others that may be currently struggling with the same kind of issues.
--------------------------------------------------------------------------So who am I? I often ask myself that question and I am hopefully coming to a full resolution to the answer. I followed one of the "typical" TS paths, although at the time I thought I was the only one doing so (which of course is part of the "typical"ness of my story). I don't have many early memories of any type, except for being miserable, being a sissy, preferring female friends and male friends only on one-on-one basis. I don't know exactly when I first cross-dressed, although my sisters dug up a picture of me very young when they had "dressed" me up . I did a lot of cding in my teens including some forays out in public. My mother caught me once, threatened me with therapy (which I assumed would lead to me being declared insane since that's what I thought I was) and then never bringing it up again. I tried growing a moustache to convince myself I was male, but only ended up looking foolish (I am now thankful for the lightness of my beard - which will soon be gone). In my late teens, I was once accidentally kicked severly in the groin and
remember feeling most upset when the doctor said how lucky I was that no damage was done. I wished that the damage had been bad enought they would have had to "change" me. But I kept quiet. I cd'd off and on with the typical cycles of purging and restarting through college. I then tried marriage thinking that having found a female I really cared for, I would no longer need to feel like I neede to be a female but that I could concentrate on being a male. I should have realized right away this wasn't going to work when the first time I visited her parents we went to Canada and I was wondering if it was easy to get hormones (birth control) pills in Canada. But I was slow and still basically convinced I was crazy, so life went on for a number of years and 2 children. I secretly "dressed" and fantasized about life as a female, but never had the guts to tell (name of wife) about it. I kept convincing myself that this was just a crazy side of me that I could keep controlled and under wraps-especially feeling that I was "nuts" and alone in this. But the pressure grew inside to confront myself and evnetually I discovered I was not alone. My "dressing" became more frequent
and I started "going out". I finally broke through my cowardice and told my wife. WE tried therapy, we tried allowing small amount of dressing, we tried all out suppression. With that step I started drinking and eating
heavily. My wife realized this was no good and we separated.-------------------------------------------------------------------------
One approach to understanding the value of self-help, or mutual help, support groups is to view them as normative communities, where the occurrences of the distressful symptoms are redefined for new participants as normal occurrences for people facing a common condition (Humphreys, 1994). This note places emphasis on the typical experiences of gender identity sufferers, and thus "normalizes"' such experiences for the group. The therapeutic value for someone who is struggling to understand their feelings is tremendous, and manifests as relief, when they discover that their behavior is not unique, when judged from the standards of, and experiences of, people like themselves.Case Three
This next note is a graphic description of one persons experience with the issue of post SRS (sexual reassignment surgery) sexual satisfaction. It is an example of the level of self disclosure achieved by some in this cyberspace support group. It offers hope to those considering SRS, and thus increases their ability to cope with the distress that occurs in someone gender conflicted.
-----------------------------------------------------------------------During the first few weeks after surgery (perhaps as a result of residual testosterone) I was really turned on by myself and the appearance of my surgery. I mean, I would face rhythmic vaginal contractions which were
quite reminiscent of male erection. W onderful. I had no localized sensitivity to manipulation. To touch my new clitoris didn't stimulate any automatic sexual response. Dilations were not physically pleasurable --
just an investment in my functional future. I did not, however, find them an onerous duty. Still, dilations offered nothing approaching a sexual stimulation as I had known it as male. Friends who had SRS earlier told me that quite a lot of new sensation would eventually (at about 6 months after SRS) develop. I was doubtful but they were right. Rather extraordinary electric sensations spread through my body when the shower hits my clitoral-urethral area. It is quite a pleasant sensation. I can achieve a modest clitoral erection now by manipulation but unlike the male erection-orgasm-ejaculation sequence which brought me an extraordinary tension-release cycle within a very few minutes, clitoral manipulation does not take me (I am not very patient) past a mild tension in 10 or 15 minutes and so-far I've always become too bored with the process to continue it longer. I reach nothing like the tension levels I felt as a male and so I doubt that any wonderfully explosive release (via some analog to male orgasm-ejaculation) would ever be achieved. I give up. I have no vaginal G-spot but then I've never believed females had one either and so do not feel cheated by its lack. Vaginal probing does not turn me on. One of the surprises of my path during the past few years is to discover that while I have wonderfully formed breasts, they are *not* as sensitive as they were 10 years ago as male. My nipples are not nearly so easily stimulated to erection. I believe this is entirely due to low testosterone levels and if they were again high, they would recover their earlier
sensitivity. I don't think this is simply a psychological condition -- at least, I think, my hormone levels have much greater importance in my sexuality than they may have in the sexualities of other people.------------------------------------------------------------------------
For clinicians dealing with gender identity patients, getting client involved in a peer group, where the experience of others is available, is an often used approach. These groups server as an adjunct to psychological counseling. This note demonstrates that cyberspace groups can be a valid referral source, for patients so inclined or for whom a live community of gender conflicted people is not available.Case Four
In the DSM IV, one of the criteria for gender identity disorder is the persistent discomfort with his or her sex or sense of inappropriateness in the gender of that sex. This note is a clear, dramatic example of someone who has that experience. One of the unstudied aspects of self help groups is their potential to harm members, rather than help them (Humphreys, 1994). This note has the potential to increase a readers level of distress, if they were to identify closely with the poster.
------------------------------------------------------------------------WIll SRS make me more feminine. I don't think so. In all reality SRS is the icing on the cake. I WANT THE ICING. Each time I see that usless piece of flesh between my legs it is a reminder of a very unhappy time in my life (most of the first 47 years). There are parts of my past that I will always cherish, but most I do not want to be reminded of. If the surgeon said that I could not have sex after SRS and that I would have absolutely no feeling in the vagina area, I would still opt for SRS because it will make me complete.
I was willing to give up family, friends, job, social events, etc. when I started RLT and HRT. If I had to lose all that I have remaining in order to have SRS then I would give that up to. Because a surgeon cannot guarantee that you will be able to orgaism after SRS is the most asinine reason in the world not to have SRS. There is absolutely no guarantee that you will make it to your destination anytime you get into your automobile or another person's automobile. I know of no M>F TS that has the means for SRS that will not have it nor want it. It is the ultimate goal. It is in fact the light at the end of the tunnel. If the only surgery that could be perfomed is the removal of my penis and testicles, then I would opt for that. It would make me that much closer to a female. As long as I still have that little, useless piece of flesh between my legs I will not be complete. Whatever the results, SRS is in my future. I have paid the surgeon and I am scheduled for SRS. I have many sacrifices to reach this point and I can say that I have absolutely no regrets because I know that on the evening of (date of scheduled surgery) I will be a complete woman although somewhat
sore.-------------------------------------------------------------------------
Notes like this could be very useful to prepare psychologists who are in training to deal with gender disorders. The level of self hate and desperation expressed is hard to comprehend, and it would benefit anyone considering working with such people to be exposed to written self reports like this one prior to encountering such people in a clinical setting.Case Five.
One of the many hard issues for gender identity disorder people to deal with is the impact of their condition on their family and friends. Many become estranged, and turn to others like them as substitute families. Cyberspace groups are good sources of possible real life friendships and advice. In this note, a member asks about an interpersonal issue that many in the group have faced, or expect to face. The notes that were replies to this were full of advice and support.
---------------------------------------------------------------------> I am wondering how the children of male-to-female transsexuals feels
> about their father before and after surgery. Are they accepting him/her
> still as a father? How do the children cope with the changes in their
> family-situation? I would like to find out some experiences.That's a very good question that I'd like to explore further. Is anyone aware of any good research on the subject? I am a MtF and am starting hormones next week. I have four children: a 14yo daughter, and three sons - 12, 9 and 7. My relationship with them is my single largest concern over transitioning. Currently, neither they nor my ex-wife know about my TSism. To make things worse, my ex is raising them in the Mormon church and (IMHO) they are getting a very narrow-minded view of the world. My daughter recently referred to a school teacher as a "fag" after he admitted to shaving his legs since he was a bicyclist. I'm wondering when she will notice that I shave my legs, arms, chest, back, etc. Despite the way they are being raised, I love my kids with all my heart and have a great relationship with them. I'm trying to gradually introduce them to concepts which will make them think on their own about acceptance of other people, but I know it will still be a shock to them when they find out about my transsexuality. I would really like to find some good research regarding the best way and time to discuss these issues with them. Frankly, one option I'm considering is the possibility of moving out of state when I start RLT in order to avoid any unneccesary turmoil to their lives. It would be extremely hard for me to be away from them and not have the frequent weekend visits, but more than anything I want to do what is best for them. I've tried to deny my transsexuality for many years because of them, but can no longer do so. I think it's better to accept that they have a transsexual parent rather than a dead one (unfortunately, many of the Mormons around here - including my parents - probably wouldn't agree). Does anyone have advice?
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The distress this person is reporting to the group is a significant factor in his life. His love for his children is conflicted by his desire to change his gender. This is an example of how a clinically significant level of distress observable in a non-clinical setting. Unsolicited self reports of this nature can be used by clinicians to better understand the psychopathology and progression of such disorders. The request for advice is common in groups of this type. He requests a referral to "some good research." The group represents a resource to him that may not be available for him from any other source. Requests of this kind are almost always answered, often from several different members.Conclusion.
The growth of cyberspace support groups is paving the way for many who were without support for their feelings of gender incongruity by providing them the opportunity to reach out and type to someone. As a normative society, these groups function very well to help members place their individual
experiences with in the framework of others that have had similar life circumstances. The value of these groups as an adjunct to therapy needs to be recognized.The study of such groups will prove useful for clinicians and others interested in the formation of and functioning of community support. Observations of clinically significant levels of distress, in a non clinical setting, may allow better definitions of this criteria for the purpose of assessment.
The extent to which such involvement in gender oriented cyberspace groups alleviates the victimization of this minority is in need of further research. The effects of not having visual or tonal clues to guide such asynchronous communications is an under documented aspect of cyberspace
support groups in general, and gender ones in particular.The personality factors and living conditions that would make a client a good referral to such groups as an adjunct to formal treatment remains an unstudied question. Finally, the level of self disclosure in public cyberspace forums must somehow be accounted for. In the case of gender disorders, this may prove to be a function of the social isolation and the lack of other avenues to express deep feelings and intimate thoughts to others that have experiential understanding of this condition.
References
Baumrrind, D. (1995). Commentary on Sexual Orientation: Research and Social Policy Implications. Developmental Psychology , 31, 130-136.
Hershberg, S. L. & D'Augelli, A. R. (1995). The Impact of Victimization on the Mental Health and Suicidality of lesbian, Gay and Bisexual Youths. Developmental Psychology , 31, 65-74.
Holmes, D. (1991) Abnormal Psychology . HaperCollins Publishers, Inc., 470.
Humphreys, K. & Rappaport, J. (1994). Researching self-help/mutual aid groups and organizations: Many roads, one journey. Applied and Preventive Psychology , 3, 217-231.
King, S. A. (1994). "Analysis of Electronic Support Groups for Recovering Addicts". Interpersonal Computing and Technology: An Electronic Journal for
the 21st Century ,2,3, 47-56
http://www.notredame.ac.jp/ftplib/Articles/CMC/King94.txtPatterson, C. J. (1995). Sexual Orientation and Human Development: An Overview. Developmental Psychology , 31, 3-11.
Roan, S. (1995). Digital Doctoring. The San Jose Mercury News, March 1, page D1. Reprint from the Los Angeles Times.
Strickland, B. R. (1995). Research on Sexual Orientation and Human Development: A Commentary. Developmental Psychology , 31, 137-140
copyright 1995 by Storm A. King
Created and maintained by Storm A. King
last updated 01/2006
