In the February 3rd New York Times Magazine, Chuck Klosterman (‘The Ethicist’) addresses the following Question from a reader:

I’ve been living the life of a married man for 20 years. I have a successful career and three children. All this time, however, I have battled gender dysphoria and the deep sadness that comes from living a lie. From the earliest age, I’ve been unhappy being male. I believed I would find happiness only once I was true to myself. I recently had my self-diagnosis confirmed, and I’m initiating a transition to living as the real me. There is a cost involved: pain to my family and stress on my career. Ethically, is it right to be “true to myself” even if that authenticity ends my otherwise happy marriage and damages the emotional stability of my three children? If I had to maintain the lie, the emotional cost would be tremendous; a transition would share the pain with all who love me but might result in happiness. What’s the ethically correct thing to do? NAME WITHHELD, MASSACHUSETTS

The following is my response (which I also sent the the New York Times).

In Response to Chuck Klosterman’s February 3rd ‘Transition Point’.

Chuck Klosterman (The New York Times ‘Ethicist’) response to a (natal) Massachusetts man’s question on gender transition wraps itself around the idea of measuring happiness. He talks about the potential happiness of the transitioning man vs. the loss of happiness of his wife and kids. He notes that there already “is happiness in your life”, and that the transition “might do damage” to the children who “lack the intellectual and emotional maturity to comprehend what’s really happening”.

What is really happening? As a therapist who has specialized in Transgenderism for the past 18 years I know that people of this age come to see me when they can no longer live with their Gender Dysphoria. It’s not about happiness; it’s about no longer being able to continue as they have in the past. Gender Dysphoria is an intense, psychologically painful and anxiety laden state which can intensify over time to the point of being intolerable. Gender is our first and most intimate identity, and to have that be wrong in some way is deeply disturbing. I have had many people say some form of: “there is no choice, it’s either this or I kill myself”. Furthermore, transitioning is a process of becoming who one authentically is. I think that’s a pretty good lesson for kids.

The ‘problems’ inherent in all this is that there is significant stigma and discrimination around being transgender in our society. The only way to combat this is for brave people to acknowledge and be who they are and try and maintains good relationships with those around them. I think if we envision a person in other (and now less) stigmatized groups in Mr. Klosterman’s article, the issue becomes clearer. For example – an African American man in, say 1940 wanting to marry a white woman, or a gay person of the same era wanting to be an “out” school teacher… all things that the individual’s family would have not been too happy about. Transgenderism is at the point in its own unique history of discrimination evolution where these groups were 30 years ago. Is it easy to have a family member who is a member of a stigmatized group? No. Is the answer to have that person disavow their membership and suffer in silence in order to not embarrass anyone? I don’t think so.

Mr. Klosterman’s “advice” is a good example of a person attempting to grapple with the issue of Gender Dysphoria while possessing only surface knowledge of the subject. When public figures, doctors, psychiatrists and others do this – they do harm. This is decidedly ‘un-ethical’. Mr. Klosterman – please do your homework and write a better response.

Ami B. Kaplan, LCSW

New York City Psychotherapist

Member of the ‘Policy and Procedures’ and ‘Child and Adolescent’ Committees of WPATH – the World Professional Association for Transgender Health.

www.amikaplan.net, www.tgmentalhealth.com