Fred D. Oremland, M.D. (Psychiatry)
Reprinted from the:
Proceedings of the Second Interdisciplinary Symposium on Gender Dysphoria Syndrome
Edited by Donald R. Laub, M.D. and Patrick Gandy, M.S.
Stanford University Medical Center
February 2-4, 1973.
Introductory note by Lynn Conway:
There were many reports of innovative efforts in counseling and in the hormonal and surgical treatment of transsexualism presented at this important early Stanford University conference on gender dysphoria.
However, included among the papers in the symposium proceedings were several speculations on the “causes” of transsexualism. Here we reprint one of those papers - a presentation of an early “rogue theory” of transsexualism - namely that it is a form of “gender envy”.
It is revealing that the author (a psychiatrist) had the nerve to actually publish this theory. He apparently had no clue how ridiculous and absurd his “scientific psychiatric reasoning” would appear to any intelligent common-sensible readers.
By doing this, Oremland reveals the way in which many psychiatrists then, as now, think and speak “in tongues” - much as do preachers in various arcane religious sects - and somehow imagine that they are communicating deep wisdom from on high in the process.
Perhaps this indulgence in cult-speak results from the long-term effects of immersion in Freudian analysis of self and others, i.e., from trying ever so hard to understand and apply various non-sense psychoanalytic “theories” to the real world (much as fundamentalist religious zealots attempt to apply literal readings of scripture to modern real world dilemmas).
Whatever the reason, it is amazing that many serious scientists then (and even now) believe that such psychiatrists actually know what they’re talking about.
And do remember folks, it is modern versions of psychiatrists like Oremland who conjure up and then "vote" on what new "mental illnesses" to add to the DSM.
Anyways, here it is, for all to see: Psychiatrist Fred Oremland, M.D. presents his theory of transsexualism as “Gender Envy.”
Fred D. Oremland, M.D. (Psychiatry)
Historically, there is only one natural occurring graft in the human being and that is the fetus. Correspondingly, there are no known varieties of "corn" that can exist without man's help. These observations embody ultimates in a plant and the human.
The procedures for cultivation or impregnation are not difficult; however, the motivations and protoplasmic reactions are most difficult to understand because of variation, developmental changes and a chemical matrix which deals each time with the concept of life and death.
One cannot just glance over mythology, be it Greco-Roman, Oriental or relative prehistoric findings, without slipping into cauldrons of information. These sources are important in theory or translations to language, terra cotta, metals and stone such as marble. The concepts are so fundamental that relationships between the present and the past become vivid and vital. One can look back to the savage tribes of Scythia or the unisex of Sausalito and the nature of procedure becomes familiar, but the science of motivation suffers in its own ignorance and must continue looking for those few islands of delightful "facts" that can be demonstrated, reproduced and open new and unknown sealed areas. Great attention has not been paid to the science of sex; nor has it been ignored. Many findings have been established with competence and provide a perspective that does not spring entirely from social origin.
Sexual differences on the cytogenic level have been demonstrated by the works of Humphrey on amphibians, Barr and Bertram with their discoveries of "diagnostis chromosomes" in the cat, and from the work and exposure of idiograms establishing the human chromosomal count at 46 rather than 48. The variations—mostly bad for the individual—described by Turner, Ford, Klinefelter, Wilkins, De Court and many others leads to the conclusion that "nature" may emphasize its blunders in the form of humans that do not and cannot conform to a given set of rigid standards. Eponyms have been used to comply with deviations and they are often misleading to the point of diminished endeavor—a fatal mistake for the scientist and his work. Karyotypes are, of course, an artificial grouping of chromosomes based largely on their size or morphology in a particular state of maturation. Unhappily, they tell very little about the exact number of genes.
Genetic sex is microscopic: phenotypic sex is anatomical and physiological. Mental sexuality is open to picturalization and largely influenced by each individual in terms of society and anxiety.
It is important to note that karyotypes are the darlings of the printed page and its pictures—not the living cell. The particular procedure now in use came from excellent work in japan. Hypotonic solutions were used, the cells crushed, and magnification placed the carrier type from the large chromosomes to the small ones. These neat clumps do not exist in the cell and are manufactured for presentation, not reality.
Lilly's observations in 1916 probably formed the foundation of a new perspective for investigating sexuality. This work was done on cows and, most especially, abnormal heifers which were called "freemartins" or "chimeras." Both the hormonal and immunological responses became apparent in the ensuing years.
In a curious way, sexuality can be looked upon as a genetically determined defect which robs the individual of one primary function or another. As in most ecobiological areas, male and female systems operate in ubiquitous social and physical environments.
The clinician must consider therapy when he is certain that one exists. Gender envy is a functional part of the human mind and is not exotic or rare. It is not, but it can become, a psychopathological mode of gratification. As a developmental phase it is auto-erotic, and only when it becomes a predominant factor in gratification can it be considered for surgical therapy.
Sexual dysfunctions are relative to organic syndromes and ambivalence. At the very least, they interfere with procreative functions and offer various profiles of defense against the unwanted fetus or its surrogates. It is important that the concept of male or female does not rest on dysfunction, but remains close to function.
When gender envy becomes linked to the opposite somatic sex, it will displace child-bearing conflicts. The narcissistic armor will be present, but excessive amounts of internal and external anxiety will come forth as phobic compulsive behavior. This is fundamental to understanding why an individual requests sexual alteration. Economy of time prevents further elaboration about this type of psychic organization. However, it must be mentioned that "homosexuality" can not only be cured; it can be prevented.
Gradually, hormones, surgery and psychotherapy are replacing jails, death and various forms of torture.
Freud's work on "homosexuality" is well known for its excellent descriptions and limitations regarding the prognosis and responsibility that should be assumed, but there is a good reason not to accept this as definitive. Not many years ago, lepers had to wear clappers in order to announce they were in the area. Etiological agents were either bacteria or a virus. At the present time, some enzymes act or become very similar to the concept of a virus. Perhaps some day it will be possible to find a gene or a combination which will explain various codes of behavior. So far we are not especially close.
When a person requests a change in somatic status, the criteria must be balanced against techniques available, and there is no further need of technical triumphs over judgment. Sexuality is, for the most part, losing its mysteries, but the rate will have to be accelerated. When a "male" insists on having an opposite likeness, it is possible. Hormonal therapy and surgery become companions and when the scars are healed the disease will be altered—not cured. There is great difficulty in the resolution of oedipal components. Much of this phase is complicated by the transition of parents to surrogates, and imitation becomes reality. The method by which this is transmitted is hypertrophied rationalization, hostility acid a constant renunciation of guilt.
This often is translated into depersonalization, intellectual reverses, a marked reversal of affect and a highly stylized form of fixed rationalizations.
As the pattern becomes more formidable, estrangement from the body is excited and the person becomes a hated stranger to his or her body. This is more easily understood in terms of social isolation or desolation, occupational difficulties, drugs, financial truancy, suicide attempts and a moderate degree of sexual satisfaction. The adaptive function of the mind in distress finds help in maintaining an image that "should have been," rather than actual perception with structural imbalance.
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