The Burden of Autogynephilia | with Lisa Shupe. Our liberated culture itself refuses to acknowledge that aspects of sexuality can be harmful. Shupe is telling us how hard it is to live with a fetish because fetishes destroy relationships

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[–]wafflegaffWoman. SuperBi. 8 insightful - 1 fun8 insightful - 0 fun9 insightful - 1 fun -  (3 children)

Can't believe no one has yet commented on this. Gut-wrenching. Watch the whole thing. Thank you for finding this and sharing it with us. A much-needed exploration of what it might be like to experience this, from someone who seems to have a clear view of the costs to himself and those around him. Really hope he finds some competent professionals who can help him without forcing him to play along with their own ignorance and biases first.

[–][deleted] 6 insightful - 1 fun6 insightful - 0 fun7 insightful - 1 fun -  (2 children)

I'm still trying to get through the whole thing.

[–]wafflegaffWoman. SuperBi. 6 insightful - 1 fun6 insightful - 0 fun7 insightful - 1 fun -  (1 child)

It's worth it, keep going.

[–][deleted] 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (0 children)

https://pbs.twimg.com/media/E9Ul08UWUAs_Qmm?format=jpg&name=4096x4096

There's two entries in the DSM-V paraphilia section. One for not one of the eight specifically called out, and also one for "this person has a paraphilia that we don't have a name for."

Obviously I'm a proponent for Blanchard's larger-encompassing idea of autogynephilia replacing the transvestic entry. You can see how that's too narrow to encompass Shupe.

It's negligent of the clinicians Shupe was dealing with to only look at the eight. A cursory search of the Internet readily reveals the existence of more than eight paraphilias.

The specific call-outs have to do with frequency and use for the legal system. Listing every paraphilia would not be a worthwhile exercise. I think the clinicians probably just didn't give a damn.

Obviously Shupe is in the paraphilic disorder camp. From the interview, I agree with Shupe's assessment of treatment. Stabilization with sex-drive reducing medication, psychotherapy, with the goal of trying to reduce or eliminate the medical treatment due to the consequences of yanking the endrocrine system around. It's not good.

Shupe seems idealistic that he can eliminate the paraphilia with conversion therapy. The outlook on that, to me, is very grim. I think he's got a few options: orchiectomy, life-long sex-drive reduction, or psychotherapy that ideally would allow him to healthily integrate his sexuality into his life. Given the history, the latter does not seem viable.

Shupe is interesting. I need to look into him some more, why he had this "aha" moment wrt. autogynephilia. If you only look at the microcosm of the individual, well, there are transsexuals who don't believe in AGP and they're much happier than Shupe is. You'll never be able to disabuse Shupe of the concept of AGP at this point, and IMHO it would be highly unethical to do so. People who have been mislead, yanked around, lied to, etc., and think they discover the real truth (Shupe has) will never let go of it.

Shupe mentioned borderline personality disorder and this history screams BPD. I'd certainly treat for that. This is probably the comorbidity that's really kicking his ass. I view BPD as a contraindication to treating for "trans" but that's a whole new topic...

Ultimately, physicians and psychotherapists in the United States do not receive training in sex psychology. I regard this as a problem, on many accounts, not just paraphilia, and agree with Shupe.

This highlights an existing problem in the USA with medical care: doctors are more like technicians. They're punished for thinking on their own. They also think the training they receive in med school is sufficient for their entire career. This is a problem across many professions in the US.

[–][deleted] 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (1 child)

I love BB, and will try to watch the whole thing ... but anyone willing to give a synopsis or bullet points to help all of us out who don't have time to watch an entire full length movie on Jamie/Lisa Shupe?

I know he was the first person to become "non-binary", and has flip-flopped around in identities since then. And maybe now he realizes he is AGP?

[–]wafflegaffWoman. SuperBi. 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (0 children)

I mostly listened to it while doing other things, which is how I found the time; it's mostly just the two of them talking on camera to each other. The below might not be 100% accurate since I was not taking notes (perhaps someone else watching it now or soon can compare), but yes, he realizes now that he has AGP. And has now spent years trying to figure out what works to treat or manage it, while doctors demonstrate that they know little to nothing about AGP and/or don't take it seriously. He's found that he has to frame it as being primarily gender dysphoria (i.e. say what they want to hear) in order to get help that works, such as chemical castration (with a variant of Lupron whose name I forget) and estrogen. His natural testosterone flares up his symptoms. But he is pretty confident that the AGP preceded and contributed to feelings of gender dysphoria. He's also aware that what controls his symptoms isn't great for his physical health in some ways, but would rather cope with that than experience un-managed AGP.

That's the trap he's currently still trying to find his way out of—how to get ongoing treatment so he can live a more normal life, without having to use female pronouns and a female name and play along with the ignorance / biases of doctors.

As GatitoMalo mentioned, he did get a diagnosis of BPD at one point, and that does need to be taken into account when coming up with a treatment approach. (BPD is also a diagnosis that can bias providers against a patient, though, unfortunately, so I wonder if that has had any influence here. Shupe expressed no awareness of this possibility, but I wonder, given some of his experiences this year alone with doctors, including a traumatizing stint in a psych ward. More about that stigma here: https://www.nami.org/Blogs/NAMI-Blog/June-2017/The-Stigma-Associated-with-Borderline-Personality)

[Edit to remove redundant verbiage.] Overall, he doesn't think doctors get it, and his explanations of his experiences with trying to sort out how to treat it lend weight to that perspective.

[–]strawberrycake 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (1 child)

What a sad tale. This man is so distressed and the amount of malpractice directed toward detransitioners is insane. The part that really chilled me was when he recounted the doctor’s notes saying something like “patient claims to be male and denies being female”. Like, we have descended into some real lunacy.

This is a medical scandal in the making. Either the activists will suppress information like this or this behavior will be looked back on horrifically like lobotomy.

[–]wafflegaffWoman. SuperBi. 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (0 children)

Agree on all counts. Thank you for including that quote, as well. That is so incredibly violating of what should be a trusting relationship between patient and doctor. And so reminiscent of so many other horror stories.