A bit of history is in order. The first transsexual to really catch the public's eye was Christine Jorgensen. During the 1950's when her story became public, many people who thought they were the only people in the world to have "those" feelings learned for the first time that there were in fact others like them. Christine went to Dr. Benjamin and started hormone treatments prior to her trip overseas for her sex change operation. As a result of the publicity that surrounded her on her return the the States, Dr. Benjamin received a barrage of inquires about treatment for transsexuality. In 1966 he published a book about the subject.
Very little was known about transsexuality at this time. Dr. Benjamin's book was one of the first to open up the subject and in the next ten years several gender clinics opened their doors. The foremost of these clinics was at Johns Hopkins under the direction of Dr. Money. The great nature vs. nurture debate about the roots of transsexuality was underway. Dr. Benjamin wrote in his book about his feelings that there was a biological reason for the condition stemming from hormonal influences prenatally. Dr. Money was convinced that the main source was early conditioning, with a possible biological predispostioning. It is important to remember that at this time the difference between gender identification and sexual orientation was not generally considered or even understood by most "professionals". The clinic at Johns Hopkins set up a standard for judging who should receive treatment for transsexuality based first on sexual orientation and second on if a patient was at risk for suicide. As a result a number of homosexuals, who in those pre-pride days saw anything as better than being gay, applied for and received SRS. Many of them did kill themselves afterwards when they found out that gay men weren't interested in someone with the "wrong" sexual equipment.
Ironically, many true transsexuals were turned away from treatment because of sexual orientation, and many who did get into the program were the ones at the very highest risk for suicide. As a result a quickie followup study done at Hopkins conducted with an eye towards shutting down the gender clinic, found that SRS was not much benefit to transsexuals. The high rate of suicides among the "graduates" of their program was predestined by the very criteria they used for treatment but that was not even considered. With the closing of the biggest gender program in the U.S., smaller programs across the country closed their doors as well one after the other.
It was into this void that the Harry Benjamin International Gender Association came about. A group of psychotherapists set out to write standards of treatment for transsexuals with an eye towards preventing the mistakes made at Johns Hopkins and other places. A set of guidelines were written that outlined how a therapist could reasonably be able to tell if a patient was transsexual and to make sure that only people who had some training in understanding GID (Gender Identity Disorder) would make those assessments.
This was and remains a noble goal. The problem is that Harry was right. Almost all the evidence now tells us that transsexuals are born, not made. The problems they have are societal, not personal in their source. We have the tools to "fix" what we now know to be a birth defect but withhold treatment with those tools until a patient can prove that they are in fact transsexual. This is done from the desire to prevent a "horrible mistake", such as happened at Johns Hopkins. It results in a system where, in the words of many trannys, they are forced to "jump through the hoops" prior to any medical treatment at all. As we all have heard, the road to hell is paved with good intentions, and the road to treatment for transsexuality can become hell itself.
Let's take a closer look at the situation. Transsexuality makes people nervous. We challenge the basic notions of male and female simply by existing. To a normal male, the idea of losing his sexual equipment is the worst possible thing he can imagine, so how on earth could anyone actively seek this? This is the "horrible mistake" that the system tries to prevent. What seems hard to understand for many is that a transsexual feels that the horrible mistake was being born with the wrong body parts to begin with and they are not "normal" men or women. In todays world of gay and lesbian pride the odds of someone wanting to escape a gay lifestyle through SRS is very unlikely. Most people who say they need hormones or surgery are in fact transsexuals. So what if someone does slip through the system and gets SRS and later regrets it? This is the "big" fear that the soc. is designed to prevent. Well, realistically they find themselves left in the same position that a true transsexual starts from, only they got there through their own choice, The true transsexual didn't have a choice. How is this anymore horrible than that transsexual's position? It may be a radical notion in todays world, but maybe people should be responsible for their own choices if they are adults and in their right minds.
Why do so many transsexuals resent the HBIGA soc.? A closer look at the premises it starts from reveals the answer. One of the first things mentioned is the probability that someone who feels themselves to be transsexual is in fact delusional. Not a very nice thing to say about someone seeking treatment for a birth defect is it? Unlike a more common birth defect such as an extra finger, for example, transsexuality cannot be seen with the eye. It is felt inside, but that in no way makes it any less real. Because it cannot be seen or tested for, we must "prove" it's existence prior to even being allowed to see a doctor for treatment. The proof consists of extended psychotherapy, which isn't cheap. In the end, all the therapist can do is confirm that the transsexual is in her right mind and doesn't waiver from the conviction that she is a transsexual. There is no other test that means anything at this time. The soc. is designed mainly to prove that if the transsexual is delusional, it's a really strong delusion that withstands all the pressure that the system can bring to bear on it. Nowhere does it acknowledge that the condition is physical and not mental and that's the problem. It assumes a mental illness and not a birth defect.
If the evidence showing that transsexuality is a birth condition is correct, the moral position of withholding medical treatment is just plain reprehensible. No one would stand being treated this way for any other condition. The only reason that we put up with it is the fact that we are told by the very way society treats us that we are not quite human. Once someone gets past the shame and guilt that society tries to force on transsexuals and develops some self pride and self esteem, they find the situation intolerable. Many of us don't want or need therapy. We came to terms with ourselves before we sought out treatment, we looked long and hard inside ourselves and came to the conclusion that we are who we are and what we now need is medical treatment in the form of hormones to bring our bodies more in line with our souls and possibly SRS to complete the journey. We seek that treatment only to find that we cannot get it without proving our sanity.
There is an alternative to the HBIGA soc. It was written by the International Conference on Transgender Law and Employment Policy, Inc. It starts from the basis that we are suffering from a birth defect and are entitled to the same treatment for our condition as anyone else with a medical problem is. It states that the expression of gender identity is our right and we should be entitled to change our bodies the same as anyone else who seeks to change something they don't like about themselves. Not surprisingly it was written by transgendered professionals and not outsiders. I urge you to get a copy of this standard of care before you seek out treatment and present it to your doctor. It provides for safeguards for medical professionals the same as the HBIGA soc without making us out to be mentally ill.
In conclusion, I have nothing against therapy. The pressures society forces on transgendered people can lead to a host of personal problems and they can be helped with the care of a therapist. A good therapist can act as a guide through the process of finding and dealing with your trangenderedness. I strongly object to the premise that transgendered people are mentally ill and require that therapy before they can receive needed medical help. That is just plain insulting and it's high time the HBIGA got that message loud and clear