Yesterday, someone I met on here reached out to me to talk about her experiences of splitting, a symptom of BPD, and how, as a trans person, it had affected her perspective in this debate. I’d got on well with her, initially, but found she was increasingly hostile towards me.
It had felt uncomfortable, and unexpected, as the tenor of my own communications hadn’t changed. Her message yesterday morning was kind and incredibly helpful in explaining to me the massive shift in our interactions.
Splitting, she explained, was a type of black and white thinking “It's all or nothing mentality. There's no room for nuance or balance”. She described how, while splitting, it was impossible to see me&other women as a “complex human being with your interests at stake”
Instead, we are conceptualised only as people actively working against trans people,& seeking to deliberately harm them. I’ve tended to think trans people who make these claims are being deliberately misleading but she thinks they are splitting&reacting through paranoia&fear.
Knowing that even contrary to the evidence we are genuinely perceived as a threat to their existence&as people who hate them is a revelation to me. It leads me to be far more aware of the toll these debates must be taking on them.
She added “If you sincerely want to reduce harm in these situations for everyone involved, be compassionate to trans people that are saying absurd&vile things. That will disarm us. We thrive on adversity. We feed on hostility. It feels good.”
I’ve thought about this a lot in the last 24 hours. I’ve thought about what my personal responsibility is, and is not, to vulnerable people who are experiencing something that interferes with their ability to accurately perceive the conversations we are having.
It would seem to me that arguing with them increases their pain (&my exasperation), without any chance of the result that they’ll understand my point of view. The compassion she mentions might consist of talking as fairly to them as possible but also knowing when not to engage.
The people to engage are the people who will not suffer for the conversation&who won’t subject us to abuse as a result of our wish to protect women&girls. The ones who will solve this in the end are the general populace,&the policy makers/others in positions of influence.
The trans people who do come at us on the Internet are as harmed by these discussions as they tell us they are. It is just not for the reason they believe it to be. To me, that warrants some compassion.
She suggested I could write about this, and I was quite touched by her willingness to take the time to explain what was going through her head when we talked, and how it lead to the responses I was seeing. I think it’s a form of courage to be that honest.
My first question was how many trans people could really be experiencing splitting. My understanding is that it is primarily a feature of BPD, and in my prior reading about the co-morbidity of personality disorders with gender identity disorder, BPD was one of the least common.
I started looking into it. The first thing I found was that this is a topic that has often been discussed. One study entitled “The frequency of personality disorders in patients with gender identity disorder” by Meybodi, Hajebi and Jolfaei had this to say:
This feels hugely relevant to the current debate. We intellectually know we are talking to struggling people, but it’s easy to perceive them as simply being entitled and difficult. I have often felt that we are being held captive by angry misogynists who ought to know better.
They are being held captive too.We can’t fix that, but society must. What it is doing now is failing in that responsibility.Instead of offering proper care, it is placing the burden onto women’s rights&restructuring social systems in placating ways,regardless of consequent harms
A lot of what we are seeing is governments and institutions choosing popular, easy options to the current concerns, rather than doing anything remotely resembling problem solving. Pushing self ID instead of reducing wait times for patients is a prime example.
Further, pushing a kind of medical self ID where evaluating patients properly is reframed as conversion therapy shifts the responsbility of outcomes away from doctors&onto the patients, thus giving them almost a carte blanche. As we see with their responses to detransitioners.
It paves the way for surgery&medication being a default response to even gender discomfort. Hence, doctors in America getting away with prescribing a “touch of testerone” to,& performing mastectomies on,NB females.

Cultural narratives are feeding the monster of medical neglect.
Though misogyny and lack of care for women informs much of what we are seeing, socially, the utter dismissal of those who are unwell,&the complete disregard for the welfare of a marginalised population is consistently in evidence. If you see through the cheerleading&fireworks.
I have so many concerns and questions about it. The medical profession is dropping the ball so hard it has lodged in the earth’s core.We are seeing this abdication of responsibility in all areas of the treatment of trans people. Including,&especially egregiously, with children
In my down the rabbit hole research, today, I hit something which concerned me further. A throwaway line by a Dr.Heller about a study from over a decade ago that demonstrated 50 percent of transsexual patients lost their desire to change sex when treated with Tegretol.
Finding more information on this is largely impossible. I did however stumble on the case of a prison inmate called Long who had been in prison for murder most of his life. He had gender dysphoria and was trying to get permission from the court to present as a woman in custody.
A Dr.Bockting was brought in as a witness.He personally considered Long to have a “GID not specificed” rather than transsexualism. His clinical experience was that tegretol was one of a number of drugs that was extremely helpful in treating gender dysphoria.
As well as treating obsessive-compulsive features of crossdressing and compulsive sexual behaviour. He believed for Long, in combination with other drugs, it would “improve his impulse control and alleviate his despair”.
Heller works in the treatment of patients with BPD, and if the study he mentioned about tegretol holds true even for a much smaller subset of patients than 50 percent of transsexuals, we are failing to alleviate their despair by giving them only life changing treatment options.
Taking a drug used more commonly in treatment of epilepsy is several orders of magnitude less overwhelming than puberty blockers, cross sex hormones, surgery&the attendant social consequences. At the least, it could be on the table for adults who want to try it,&safely can.
Our countries should prioritise enough funding, enough resources and enough research to offer far better options to all patients experiencing dysphoria. Including the young girls identifying as trans in sudden, vast numbers. Instead, there is all this chaos&political motivation.
That one act of reaching out, yesterday, from a trans person I’ve met on here, has lead me to a lot of interesting, and concerning reading, as well as helped explain to me the hostility I keep experiencing from people I believe I am treating as fairly as I can.
What a mess this whole situation is. For women, and trans people, alike. What a medical scandal, too. I honestly believe that many trans people are being consumed by the callous machine of current medical ignorance, in the way emerging patient groups throughout history often have
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