[This is a series of arguments about the work of Jerry Leach.
I took the liberty of reformatting the quotes for readability. This article originally included a deceptive article posing as Dr. Milazzo's original article which Jerry created to make her look bad. I explain this on Doctoring Documents. FYI, Dr. Milazzo is a transwoman. This article is duplicated as Fair Use. It was originally accessible from his website in July 2007.]
Greetings to you, Dr. M,
Your article concerning "Can Therapy Cure Gender Dysphoria?" displays so many assumptions and misleading as well as scientifically uninformed inferences, it seemed at first not worthy of a response. But if I do not respond, you could then take that to mean that I agree with what you have said about me personally as well as your grossly inaccurate misrepresentations of current scientific data. You have followed the all-too-typical slanderous procedures of the homosexual and transsexual community's political agenda. Smear tactics are so common in our world today, aren't they? If you don't agree with someone, do what you can to discredit him/her while ignoring the substantive and factual matters of the topic at hand. You who claim to be so inclusive and tolerant end up revealing your exclusivity and intolerance of anyone else's views than your own. I'll never forget the brazen declaration of Eric Pollard of the Act-Up Homosexual Organization in his comments published in The Washington Blade, a major homosexually oriented newspaper. Remember when he laid out the working model for the Gay Agenda, where he said, "I and others within our politically active Gay Rights Group have learned to apply subversive tactics to accomplish our ends, using any means necessary, drawing our main tactics and strategy from the voluminous Mein Kampf, which we have studied thoroughly as our working model."
Anyone who displays intellectual/academic integrity can surely recognize that you are not really well-versed on the subject at hand, nor are there signs that you have done your most basic homework on transgenderism. Your article is rife with innuendo and erroneous conclusions, all of which are incongruent with the most recently published medical findings. Your first three sentences sets the premise for the model upon which I and many others like me base our position that transgender dysphoria is a direct result of the emotional wounds a person suffers between the ages of birth and 3 to 5 years. In addition, it is the model upon which we base our great hope for a better outcome than what you proscribe in your deterministic, fatalistic approach, using the surgical suite as the end-all-procedure. Your approach clearly does not ascribe to the combination of sound psychiatric medicine coupled with dependence upon a "Higher Power," both of which have credible evidence that steadfastly undermine your hypothesis. One of our male-to-female transsexual friends, who had sex change surgery many years ago, and is now in the transition process of returning to living in their God-given male role, said of your article:
"Dr. M has a huge vested interest in disqualifying you; just one look at his website displays his bias and very probable personal reasons that he would like your name erased from the list of viable contenders or competition."
Another post-operative male-to-female transsexual exclaimed,
"He makes so many weak comparisons. For example you can say that a common trait of homosexuals is a bad relationship with their dad ... and even straight people have that. But we are not talking about groups of people here; we are talking about individuals. Just because my lack of a father figure contributed largely to, if not directly responsible for my GID, does not mean that every boy without a Father figure will end up a transsexual. If this is what he is trying to use to somehow prove symptoms of GID, then he is terribly in error! A cough is a symptom of many illnesses. Just because one has a cough doesn't mean they have lung cancer. He offers very weak and incomplete, non- scientifically based arguments. He tries to put down and disqualify your experiences because you do not have a MD behind your name. Your observations are not gained from a course of study, but your career training has taken shape out from your personal battles with the condition. What you have done in the past has not prepared you for the position you now hold as an International spokesperson for us; the information you have gleaned from other professionals in the field has trained you for your counseling position, not a series of courses at some sterile and politically correct graduate school. What does one do in order to become a Psychologist? They get their degree by learning from other people's work. You have done the same thing, but haven't done it to earn some kind of educational requirement, or degree. You may not be a certified and credentialed or state licensed clinical social worker or professional physician – but you have learned so much in your own personal walk and now pass it on to people like me. The fact is, you do hold a Master's Degree from a well respected liberal seminary and are not some uneducated fanatic trying to deceive, or conceal your own miserable plight by your work. You have and are running the race...and we get the full benefit as you pass on the baton to us."
Another transgendered person raised objection at your naive assumptions and dishonest statement given on the first page:
"Many years of experience have shown that therapy and medications cannot change one's gender identity. As a result, the current accepted treatment for gender dysphoria is directed toward ways to help one cope with his stress, and may include cross-gender hormones, part-time or full-time cross-living, supportive counseling and/or surgical reassignment." This person simply said, "Is this person awake? Has his bias totally blinded him to some of the most current medical discoveries which support a longer and harder look at the transsexual phenomenon, even to the American Medical Association's consideration of disallowing the afore-recognized hormonal and surgical treatment as the best modern medicine has to offer? It is plain. Dr. M is uninformed on what is presently taking shape in the medical community itself about the whole matter."
Protest to this outrageous smear-tactic by you, Dr. M, against others such as ourselves who offer hope for restoration is coming into our office daily. One recent letter, written by a medical research specialist said,
"Unfortunately, the comments which you have received from this physician are terribly misinformed."
There are two themes running through his paper:
1) That psychotherapy does not reverse or change gender identity or reverse gender identity dysphoria;
2) A personal attack on the credibility of your own diagnosis as a transsexual; rather relegating you to the category of a "mere transvestite fetishistic male."
I shall address both of these below.
Issue 1: "He states ‘many years of experience have shown that therapy and medications cannot change one's gender identity..." how does one explain then the increasing numbers of former transsexuals who now claim to be recovered and free of the condition? Jerry is but one example. Also, "The crucial question is how effective such treatment may be for others – a claim which scientific literature to date does not support." For this I would draw his attention to the documentary last year in which Dr. Kenneth Zucker, one of the world's most experienced researchers and clinicians in the area of GID, and currently the chief editor of the prestigious Archives of Sexual Behavior states: "Psychotherapy can be effective in treating transsexuals so that they eventually give up their desire for sex change, even if there was a biological predisposition for it."
Or, you could send him the e-mail you received from Dr. Zucker where he says that "with GID persons it is just called therapy, NOT reparative therapy." This research specialist continues, "Since Dr. M provides no direct references or credible supporting evidence for his terribly misinformed statements, and resorts to psychodynamic terminology, e.g.., accuses you of being a victim merely of ‘reaction-formation,' is unbelievable coming from a supposed professional. Let me provide you with just a few current scientific references, which indeed show the falseness of his assertions with regard to scientific and psychotherapeutic success in reversing and treating Gender Identity Disorder.
For starters, let's take a look at:
Chiland, C. (2000) The Psychoanalyst and the Transsexual Patient: (Int . J. Psychoanal. Vol 81(Pt 1):21-35.)
She concludes that transsexualism is a narcissistic disorder in which the constitution of the self has been profoundly impaired and that it is only since analysis have embarked on the treatment of non-neurotic patients that the condition has become accessible to psychoanalytic psychotherapy or indeed psychoanalysis. The difficulties not withstanding, the author considers that such work is worthwhile and that patients can and do benefit from it.
Meyenburg, B. (1999): Gender Identity Disorder in adolescence: outcomes of psychotherapy.
Adolescence. Summer; 34(134):305-313.
This paper reviews reports of GID in which adolescent psychotherapy patients initially desiring sex reassignment changed their minds following psychotherapy.
Mosler, T. & Wosheim, H.A. (1995): Transsexualism: An extreme form of sexual identity disorder. Fortschr.Med.Apr. 10:113 (10):140-143. Recently there have been reports of successful psychotherapeutic treatment resulting in the preservation of the original biologically given sex. Also reports of successful psychotherapeutic treatment of transsexuals.
Sugar, M. (1995) A clinical Approach to Childhood Gender Identity Disorder: American Journal of Psychotherapy. Spring; 49 (2): 260-281.
A review of gender identity disorder is presented along with a case of a four-year-old boy. An overview of some of the biological theories of gender identity disorder directs our attention via the clinical material to conflict/defense as the most useful. The youngster's cross-gender behavior, possible contributions to it, treatment issues related to parental input, boundaries, and transitional objects are considered. The necessity of close communication, cooperation, and proper guidance to parents, as well as involving them in individual therapy is stressed.
Loeb, L.R. (1992) Analysis of the transference neurosis in a child with transsexual symptoms.
Amer. J. Psychoanalysis Vol. 40 (2): 587-605 states My observations, as reported previously (Loeb & Shane, 1980) and shown in the present case, is that the transsexual symptom complex can develop out of intrapsychic conflict and be resolved in a fully developed transference neurosis. As he came to understand his conflicts the boy's transsexual symptoms vanished.
Pfafflin, F.(1994) Transsexual Defense. Psyche (Stuttg). Sept. - Oct;48 (9-10) 904-931.
The patient's insistence on being acknowledged as a woman is regarded here as a creative defense connected with inadequate separation and individuation.
Oppenheimer, A. (1991) The Wish for a Sex Change: A Challenge to Psychoanalysis? Int.J. Psychoanal.72 (Pt 2):221-231.
On the basis of the author's observations, the determining psychological factor is stated to be the hatred of masculinity.
Marks, I., Green, R., Mataux-Cols, D. (2000) Adult Gender Disorder Can Remit. Psychiatry Jul-Aug; 41 (4):273-275.
If evaluated over many years, GID's and paraphilias can be less fixed than is often thought.
Stermac, L. et al. (1991) Group Therapy for Gender Dysphoric Heterosexual Men.
Kuchenhoft, B., (1988) Transsexualism as a symptom of personality disorder and its treatment. Dec;59 (12):734-738
Puri, B.K. & Singh, I. (1996) The Successful Treatment of the Gender Dysphoric: Patient with Pimozide. Aust. NZ.J. Psychiatry; June; 30 (3):422-425.
Kersting, A., et.al.(2003) Dissociative Disorders and Traumatic Experiences in Transsexuals.J.Nerv.Ment.Dis.Mar; 191(3):182-189.
The total score for the dissociative symptoms revealed no significant differences between the transsexuals and the psychiatric inpatients. Further investigations are needed to throw more light on the phenomenological correlation between transsexualism and dissociative identity disorders, using taxometric analysis.
Issue 2: "This physician states that Jerry Leach may not have had transsexualism or GID, but rather transvestic fetishism. It seems that this physician is totally unfamiliar with the concept of "autogynephilia transsexuals," who probably make up the most of those both pre-op and post-op. If this person were to read about the sexual arousal and masturbation in autogynephilia patients/transsexuals, and then read your book manuscript, Flight Toward Woman, there would not be any misunderstanding that you would even qualify as a "ego-dystonic transvestite fetishist." The physician needs to read about the enormous amount of publications of Ray Blanchard on autoerotic arousal in transsexuals.
What you are doing, Jerry, is not reparative therapy. It is not fundamental religious zealotry! It is mainstay psychotherapy, which has been reported successful with many cases of Gender Dysphoric patients, although there is tremendous pressure from the social activists to politicize these things, and make statements about how Sex Change Surgery is THE ANSWER, in absence of credible or verifiable data to support such erroneous and broad-sweeping claims. I would ask this Physician, "Have you read the book, The Gene Illusion: Genetic Research in Psychiatry and Psychology under the Microscope?" written by Jay Joseph, Psy.D.?" (ISBN 1898059 47 0) Paperback $18.00
Take a quick look at the Table of contents:
Twin Research: Misunderstanding twins from Galton to the 21st Century.
The Twin Method: An environmentally confounded research method.
A Critique of Studies of Twins
The Heritability Concept: A measure of inheritance, or inherently misleading?
The Genetics of Schizophrenia 1: Overview
The Genetics of Schizophrenia 2: Adoption Studies
Is Criminal Behavior in Genes? Studies of Criminal & Antisocial Behavior
Genetics and IQ
Molecular Genetic Studies in Psychiatry and Psychology: An exercise in futility?
Where Do We Go From Here?
Description: Jay Joseph's book provides a rebuttal of the evidence cited in support of popularized genetic theories.
"Far from establishing the importance of genes, this book shows that family, twin, and adoption studies are plagued by researcher bias, unsound methodology, and a reliance on unsupported theoretical assumptions. Furthermore, he demonstrates how this research has been used to support the interests of those attempting to bolster conservative social and political agendas."
What are the forces that shape who we are? Or how we live? Or how we act? Are we shaped by our environment, or by our genes? Increasingly, we are told that research has confirmed the importance of genetic factors influencing physical and psychiatric disorders, personality, intelligence, sexual orientation, criminality, and so on.
Much of the scientific data has been produced by the fields of behavior genetics and psychiatric genetics. This book looks into other factors than the traditionally bleak view of humans and their future laid out by those claiming that heredity is of overriding importance; that human suffering is not caused by people's genes. Rather, it comes from well-known and well-documented psychologically traumatic events and environments. This book is essential reading for anyone seeking an alternative to the increasingly popular, yet mistaken view that "genes are destiny." So, Dr. M, in your introduction, you demonstrated a very clear, pre-determined bias, which does not acknowledge or find any alignment with current medical viewpoints on transsexuality, better described as Gender Identity Disorder. (GID) Your opening remarks that "one's core identity is known to be permanently formed by early childhood ... many years of experience have shown that therapy and medications cannot change one's gender identity..." is so out of sync with the times in which we now live.
In an article entitled ‘Are Transsexuals Born That Way?' (Published in the Christian Medical Fellowship (UK) Journal ‘Triple Helix' Autumn 2000), Dr. Neil Whitehead states:
"Groups such as transsexuals and homosexuals therefore argue that their biology determines their sexual orientation. This strikes a chord with many, particularly sympathetic Christians. This is a modern argument since only fifty years ago over 90% of homosexuals believed that they were not born that way, while in today's world, most transsexuals think that their longing for sex change is innate, biologically derived and unchangeable - a standpoint that is known as ‘determinism.'"
Whitehead adds, "Biologists discarded behavioral determinism decades ago, yet politicians and activists still cling to this theory ...while transsexuals and homosexuals argue that studies have shown that their brain microstructure is more feminine ... " the most unequivocal evidence is that structures are produced by long-continued behavior. It is known that the brain changes physically in response to our behavior ... transsexual brain differences are therefore more likely to be the result of transsexual behavior, rather than its cause."
Whitehead concludes, saying, "Behavior genetics, for all its faults, has established that all behaviors are a mixture of genes, family environment, unique circumstances, and individual choice. No one forces us into a given behavior. So, is it possible to change? Definitely..."
An academic Psychiatrist in the United Kingdom, has stated (August 02):
"In the case of transsexualism, there is no consensus amongst clinicians about the effectiveness of psychological treatments but there is evidence that, in a proportion at least, their perceived quality of life may be improved by cosmetic and reconstructive surgery. Surgery and prolonged hormonal manipulation involves numerous and painful interventions reflecting an extraordinary level of conviction. But commitment and conviction is a feature of many psychiatric conditions in which individuals hold the beliefs that do not fit the facts.
The degree of conviction with which a conviction is held should not determine its validity."
Further, a Specialist Registrar in Forensic Psychotherapy, in the United Kingdom has written on transsexuality, saying: "Recently the Royal Society of Medicine organized a one day conference devoted into the thinking of the future planning of treatment resources for transsexual patients. (Sexual Health and Reproductive Medicine Section: April 02). "During this day there was a distinct scarcity of any attempts at psychological understanding of these individuals or helping to understand themselves of to treat the conflict in any other way other than surgically. Other than the group which I run I know of no other form of psychoanalytical based psychotherapy group clinicians in the U.K. offering a forum for such patients to understand themselves. Instead, there seems to be an abundance of interest in achieving a fine tuning of surgical procedures in the hope that this will offer a ‘long term solution' to these patient's problems. Our extensive collected experience in working with these patients and attempting to understand their transsexual conflict has proved that there is no simple, unified aetiology for this condition and we feel that a single treatment approach, especially one involving little or no psychological input is of great concern."
Dr. M, we transsexuals together think you might better spend your time and energies seeking a more informed understanding of transgendered persons; encouraging and supporting those who feel personal purpose in not aligning with the traditionally accepted cultural views which offer only one recourse, surgical intervention. Society changes its' mind on anything; facts do not! Truly, the transgendered individual is among the most misunderstood and personally maligned minority in our world. That is the very reason we offer a compassionate alternative to what is today the "one-fits-all-mentality" of those who should know better. Of course, we also include the very missing spiritual dynamic of today's so-called experts, stating that with the help of our ‘Higher Power' we can find, along with the much needed professional psychotherapy, a resolution to the emotional turmoil within referred to as Gender Identity Disorder. Surely, you do not claim that your article or outdated treatment plan offered decades ago by Dr. Harry Benjamin is the best or only alternative in our modern age, do you? If you do, it is then clear that you need to do some more serious homework. Just the few references cited in this response should cause you to pause and more carefully reflect on your non-scientifically based conclusions.
I look forward to hearing about your new discoveries as you apply yourself to the task of updating yourself in the recent and current literature of the times in which we live. It is quite apparent to me that you have much more than a professionally-focused interest in this subject. Reflected in your words is an obvious personal pain and search for your own Truth. I am here to address that pain ... and offer the help that you and others like us despair of really being available. Thank you so much for asking me to respond to this article. Perhaps what I have said herein will have prevented you from inevitable embarrassment. I sincerely hope so. But more than that, I want you to know that I am eager to come alongside of you in your journey towards wholeness, if you should decide to obtain help.
Jerry Leach, M.Div., AACC