ELI5: How the shingle virus stays in your body all of your life and why it isn't killed while in there.

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I mean as a cis man, I don't feel male...I don't mean to trivialize the distress you felt, but I honestly would be just as able to accept being in a female body.

What evidence is available suggests you're wrong about that. But of course you've never felt any other way and it presents no conflict, so it sort of fades into the background. The best single case-study we have on the subject is the famous David Reimer case.

Reimer was born a normal boy, with no apparent gender issues. After a botched circumcision that left his male genitals unrecoverable, it was suggested that he be raised as a girl under the notion that one doesn't have any such fixed identity. His parents agreed, and he was raised as a girl opposite his twin brother. Reimer displayed symptoms we would expect of a trans man: he was depressed, avoided most traditionally-feminine attire, and so on. When he finally did learn what had happened at age 14, he immediately transitioned back to living as a man.

It's not a perfect case study - there were substantial abuses by the psychiatrist involved in the case - but it nevertheless provides a decent basis for the notion that gender identity has at least a partial inborn component. For the more social component, we can look at Norah Vincent, a female journalist who spent more than a year living as a man to investigate differences between the sexes. By the end of the experiment she was so depressed she actually checked herself into a mental hospital out of concern she might be suicidal.

More mild examples of a non-trans person experiencing dysphoria might include a man with gynecomastia or a woman who gets a mastectomy for breast cancer - both tend to be pretty distressed about it.

Like if the rider of a horse were to identify himself as a mare or a stallion.

The difference there is that a human brain does not - so far as we know - have the capacity to develop into a horse's. But it does have the capacity to develop into both sexes.

I wonder if perhaps it might be less of a feeling of being "different on the inside" than it is a feeling of the physical sex characteristics not belonging to the body? Perhaps it is a neurological issue where those parts of the body don't fit the brain's internal map of the body?

I think that's part of it, but not necessarily the whole. Given that human society has historically been quite strongly gender-differentiated, I don't think it's at all out of the question that there's some coded social notions in there too. Those need not - and probably don't - match up with the "stay in the kitchen" 50s-style gender roles, but given how many differences in behavior exist between the sexes it seems at least plausible.

There's also a component of really strong repression in most trans people. Many of us feel substantial relief just admitting how we feel after going "NO, BAD, MUST BE MAN" to ourselves for our entire lives. That isn't really gender identity per se, but a socially-encouraged tension within one's mind. The image I have in my head is one of gears grinding together when I remember how I felt before admitting what was up.

What do you think of the idea that this might be a primarily physical condition that produces mental side-effects? If it is structural rather than chemical, that would explain the resistance to psychiatric treatment. I suppose if this is the case, I couldn't hold the assumption that a trans guy has a perfectly healthy male body, since there may be a legitimate physical abnormality.

That is the interpretation I'd argue for. I'd classify it as an endocrine disorder (or more properly, as the long-term consequences of a prenatal endocrine disorder).

I hope you agree that since childhood gender dysphoria does spontaneously resolve in most cases

I don't consider that fact established. The study you're referring to, if I recall correctly, dealt with kids with gender-variant behavior being presented for such by their parents. Those children did not express an identity incongruent with their bodies, they just acted in ways outside of social norms for their sex. So what that study says is not "gender dysphoria goes away", but rather "most boys who are feminine do not turn out to be women". The only study I'm aware of on long-term outcomes of those who transition is this one, linked in the post I linked you to to begin with. That study showed no changes of heart and 100% satisfaction with transition - literally not one single person regretted it.

something as drastic as sex reassignment as anything but a last resort.

I don't see it as nearly as "drastic" as I think you do. Hormone treatments are essentially puberty. It's no more "drastic" than allowing a child to mature through adolescence. Yes, it's something that should be taken seriously and given proper consideration, but the bar for me is "usually produces positive results", not "will literally kill someone if they don't". That latter was originally the standard for trans folk, and I think it's largely responsible for the incredibly poor mental health of trans people in the early cohorts. It's selection bias: when you only let people who are suicidal transition, it should hardly be surprising that the people who transition are frequently suicidal.

On the other hand, I cant help but be unnerved when I see trans identity being glorified as if transitioning were a matter of fashion rather than mater of survival.

Well yeah, sure, and neither can I. I'd give quite a lot to be able to shut Tumblr up about the subject, because most of them don't know a goddamn thing about what they're talking about. I gathered all this data during my own questioning precisely because I didn't trust such stupid activism, and I'm actually publishing a board game shortly that is essentially one big Tumblr parody. Please don't think that they represent the broader trans community, because they don't.

/r/explainlikeimfive Thread