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Understanding Gender or Sex Transitioning

In this article, I try to disentangle the complex perspectives on transitioning

Psychological issues, just as do paintings, look very different in different frames. Therapists, in fact, do consider reframing to be a basic cognitive tool. It is another way of saying, “Well, what if you looked at it this way instead of that way?” And it is an effective intervention with those who are able to exercise or learn this cognitive flexibility.

For all of you still confused by the current issue of transitioning gender or sex, let me try this framing of perspective as a perceptual and cognitive clarification. I will use several different frames rather than just one, as multiple views are always more informative.*

The Frame of Biology

Biologically it is not possible to change sex and misnaming sex as gender, in the word “transgender” does not either alter biology, as biology is expressed in every cell of the body and not simply in those features available to human vision.* Sex in humans is dimorphic. Gender can morph or change; sex can only in the philosophical mind, but not the biological one.

The Frame of Surgery, Medicine and Pharmaceuticals

Medical interventions such as surgery, along with pharmaceuticals such as estrogen, testosterone or puberty blockers, create visible changes to secondary sex characteristics. Pharmaceuticals have as yet unknown side effects, which is the name given to undesired and possibly dangerous effects by pharmaceutical epistemology. As yet, we do not know the long term effects of either.

The Frames of Psychology and Sociology

There is a long academic history of research into gender,* which was named by the pioneers in the field, of which I am one. We discovered “gender” to be the psychologically and sociologically created behaviors that society expects or demands of the two sexes, female and male. These qualities are subject to change and to personal and cultural choice. They are psychologically and sociologically constructed and thus can be dismantled or deconstructed by conscious effort and social change.

The Frame of Diagnosis and Assessment

Gender dysphoria, as named by psychology and psychiatry, is currently listed in the DSM5.* In actual practice, it is my observation that it is not being assessed deeply and sufficiently, particularly in adolescents and children. At these ages, individuals go through many crises of identity and they are generally treated developmentally and with psychotherapy. However, gender dysphoria has become a “vital sign” leading all the more directly to gender transition as the appropriate treatment.

More recently, it has been argued that neither surgery nor puberty blockers should be administered to minors, many of whom change their minds and revert back to their biological sex. Additionally the long term effects of puberty blockers, in particular, are not yet known and may be harmful to this group*.

The Frame of Economics

This frame is informally known as “Follow the Money.” The industry that has grown up to treat gender concerns surgically and pharmaceutically profits handsomely. Much of the funding to support the transgender movement comes from wealthy individuals who have themselves transitioned, prominent among whom is Jennifer Pritzker.*

The Frame of Human Rights

Perhaps the strongest support for transitioning and transgender rights comes from the Human Rights perspective. This frame takes on the issues of bathrooms, sports and other arenas. Currently, it has supported transgender rights in all these arenas.

Various LGB groups have argued that the transgender movement is, at its core, misogynist and homophobic, encouraging children and adolescents who might otherwise be gay to transition to a straight role. Transition in such governmental systems as Iran and Turkey may even be mandatory to avoid a death sentence. Additionally, some of the rights requested by male to female transitioners appear to violate the rights of women.

This presentation of the frames is intended to help the reader to form her/his own conception of the science and other issues involved in this controversial topic. However, I urge you not to do so on the basis of one article or one opinion. This is a complex and dynamic topic that requires depth of understanding of all the above areas.


Kaschak, E. 1992, Engendered Lives: A new psychology of women, Basic Books, New York.

Kaschak, E., 2015, Sight Unseen: Gender and race through blind eyes, Columbia University Press, New York.

DSM5, 2013, American Psychiatric Association, Washington, D.C.

Jennifer Pritzker, Wickipedia.

Mayo Clinic, Puberty blockers for transgender and gender diverse youth, 2020.

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