The Riddle of Gender - Deborah Rudacille [75]
“Social rehabilitation” of the two groups was compared using a number of socioeconomic indicators, including job and educational levels, psychiatric and arrest history, frequency of change of residence, and cohabitation with “gender-appropriate” or “gender-inappropriate” partners. A numerical value was assigned to each of these categories in the Adjustment Scoring System. “Most of the scoring is self-evident,” Meyer and Reter note, though “if the patient is male requesting reassignment as female, a gender appropriate cohabitation or marriage means that he lives with or marries a man as a female; a non-gender appropriate situation would be one in which the patient, while requesting sex reassignment, nonetheless cohabitated or married as a man.” Male-to-female transsexuals who had female roommates, girlfriends, or wives were thus assigned negative scores, while marriage to a “gender-appropriate” partner was scored +2, a marker of successful adjustment on a par with a rise in socioeconomic status.
Critics have noted that “the most serious problem with this scale is its arbitrary character… it assigns the same score (—1) to someone who is arrested as someone who cohabits with a non-gender appropriate person. From this same set of cryptic values comes the assertion that being arrested and jailed (—2) is not as bad as being admitted to a psychiatric hospital (—3) or that having a job as a plumber (Hollings-head level 4) is as good (+2) as being married to a member of the gender-appropriate sex (+2). On what basis are these values assigned?” The same authors note that “there is confusion on the variable of cohabitation, particularly since Meyer never specifies whether this implies seuxal intimacy, interpersonal sharing or both. One can infer from the scoring assignment that a transsexual would be better living with no one (o) than with a person of the non-gender appropriate sex (—1) … Does Meyer mean to say that living in isolation is more adaptive than living with someone whatever his/her sex?”
Similarly, continued interaction with therapists and psychiatrists after surgery is viewed as a negative (psychiatric contact = —1, outpatient treatment = —2, and hospitalization = —3), as is failing to improve one’s socioeconomic status (as measured by the Hollingshead job scale). Meyer and Reter’s “objective” values of adjustment seem exceedingly value-laden in retrospect. Moreover, their failure to include any measure of personal satisfaction or happiness in the Adjustment Scale has been almost universally criticized, especially since “none of the operated patients voiced regrets at reassignment, the operative loss of reproductive organs, or substitution of opposite sex facsimiles (except one, previously noted),” as Meyer and Reter acknowledge. In other words, despite their unchanged socioeconomic status, continued tendency to change jobs and residences, and generally insecure and unsettled lives, those who underwent sex-reassignment surgery at the Johns Hopkins clinic appeared nearly universally happy with the results.
Ben Barres, the Stanford neurobiologist who transitioned in his early forties after a lifetime of gender dysphoria, confirms the importance of including affective data in any study attempting to assess the success of sex-reassignment surgery. “I’ve never met a transsexual who wasn’t enormously psychically better [after the surgery],” Barres says. “And the studies I’ve read say that something like 95 percent are very happy that they did it. And in medicine, you don’t usually find that kind of success rate. That’s unheard of, to find a treatment that has a 95 percent success rate. So it seems to me that the actual facts are totally opposite to what this guy [Meyer] said.”
The feelings of happiness and contentment expressed by postoperative transsexuals are irrelevant in the view of Paul McHugh, who closed the Johns Hopkins clinic after the Meyer study. “Maybe it matters to them, but it doesn’t matter to us