Transgender Hysteria (not what the title makes it sound like!)

Ok, the whole 'transgender rights' thing has shown up in front of the Supreme Court, so I'm going to start seeing articles and discussions and accusations and justifications on the subject, left, right, and center. I've spent some time thinking about it, and would like to present an alternate view. It starts with a question that is going to seem odd, and will probably need a small history lesson and slightly larger science lesson. I'll try to avoid being pedantic about it. So strap yourselves in...

What rights should society give to hysterical women?

I don't mean women who are laughing hysterically, or acting hysterically in grief. The term "Hysteria" used to be a genuine medical term with a genuine medical definition. Technically speaking, Hysteria was a psychoneurosis marked by emotional excitability and disturbances of the psychogenic, sensory, vasomotor, and visceral functions. (The term 'visceral' means 'involving the inner organs'.)

In practice, this became something to diagnose women with if they seemed to show emotional 'excess' (or too much restraint), sleeplessness and irritability, 'excessive' interest in sex, or even such vague and dangerous symptoms as "arguing/causing trouble with others". In short, there was this view of what women should be within society and, if they didn't meet the expectations, they had Hysteria.

So what rights should we give women who have been diagnosed with this condition? I am sure that the early Women's Rights groups would have had several ideas to offer. How about the right to not be involuntarily committed to a mental institution for the diagnosis? How about retaining the right of ownership to your own property, whether that be a house or simply a bag of trinkets? How about the right to talk about politics, read about religion, and other such activities that suggested, in that time period, a disturbance in a woman's brain?

Well, actually, Hysteria was often treated by masturbation, or by high-pressure cold water showers. So should they be asking for the right to masturbate in public?

Imagine that. Imagine a group of women before the Supreme Court, demanding the right to masturbate in public, as a necessary accommodation to their medical condition of Hysteria. Since they're actually arguing for their rights in front of a court, you know they all have to have it by the old historic definition. Ridiculous, right? Well, let's take a moment and divert from history into science.

What is the difference between a man and a woman. The transgender argument must start here. If we can't define the boundaries they want to cross, how can we discuss their efforts to cross them and society's proper reaction? So let's talk biology. I suspect that many people these days believe that the only difference between the male body and the female body is the reproductive system. Let's dispel that myth. Did you know that archaeologists can unearth a single part of the skeleton and know whether it belonged to a man or a woman? The pelvic bones are noticeably different, but there are other differences throughout the entire skeleton. The male skull has a taller and narrower brow and a more pronounced jawbone; the man's arms and legs are longer, and the bones tend to have more pronounced corners.

So let's put the skeleton aside for a moment. Did you know that every single internal organ has a different size and efficiency in a man than in a woman? Some are larger, and some are smaller. One of the complaints of feminists is that most medication dosage and effectiveness has been derived from studies on males. The female, in the pharmaceutical world, is often treated like a smaller man. I have sat in on several discussions among women with ADHD, for instance, and they all agree that all ADHD medication becomes ineffective during the few days before the onset of menstruation.

That doesn't mean that the reproductive system isn't part of the picture, of course. The body is fully interconnected, with each system supporting and affecting the others, and that's the point. A woman's heart beats at a faster resting rate on average than a man's. Her heart is smaller. That's okay, though, because her blood has less hemoglobin and more water in it by volume. It moves more easily through her circulatory system. Now here's where it gets interesting: a sex hormone is responsible for this difference. Testosterone prompts higher production of hemoglobin, making the blood thicker. In a woman, higher testosterone makes the blood more like a man's.

See, the entire body is affected by the sex hormones in various ways, and the entire body is optimized for the changes made to the body by the sex hormones. The heart, lungs, liver, spleen, kidneys, stomach and intestines - all of these changes by gender, larger or smaller, more slow-twitch or fast-twitch muscles, blood volume and ideal heart rate/blood pressure - it's all geared towards the health of the male body or the female body as a whole. Once you change part of it, like the sex hormones, you are giving your body all sorts of conflicting instructions to produce certain muscles, deposit fat in certain areas, change your blood composition, change the chemical content being processed by your liver etc. in a way that puts a great deal more wear and tear on your body. Transgender/transsexual transition surgery is done only on the reproductive organs; the transgender person is not given the heart, liver, kidneys, adrenal glands, or skeletal structure of the other sex.

Back to Hysteria, just for a second.

We now know that Hysteria isn't a thing, not really. It's a catch-all for a variety of medical conditions, many of which actually do affect the female reproductive system (such as endometriosis or fibroids) or brain differences (such as ADHD or autism, both of which present differently in women than in men). It would seem bizarre to us to diagnose a woman with autism and then explain that this meant she had to try to masturbate regularly and thus seek accommodations through the Supreme Court to pleasure herself in the workplace. In fact, to divert from that a little, autistic people are now speaking strongly against the application of ABA therapy in the 70's, 80's, and 90's, causing trauma and, sometimes, lasting physical damage, in order to force autistic people to mimic 'normal people' instead of the newer, gentler, Cognitive Behavioral Therapy (CBT), which focuses more on coping techniques and self-advocacy.

But instead of asking ourselves if there is treatment for the differences in the brain that seem to set apart many transgender people, whether it be chemical or cognitive behavioral therapy, we seem caught in the Dark Ages of trying to treat thoughts in the mind by throwing every single other system in the body out of whack. The activists and their insistence on 'transgender rights' are advocating a type of ABA for these people, with the only 'natural' endgame being a chemical and surgical process that belongs back in the annals of Medieval and Victorian medicine along with Hysteria.

Transgenderism starts with the belief that your thoughts and emotions and patterns of behavior do not fit into that of your birth sex. Hysteria starts with the belief that your thoughts and emotions and patterns of behavior do not fit into that of your birth sex. Can't we do better than fighting over whether the government should be able to order a business to allow a 'transitioning male-to-female' person to wear dresses to work in a formal-attire environment?

A Primer for Handling Anxiety Attacks

As part of my unfortunate, perpetually-undiagnosed "female complaint", each month at PMS time I do what I call "reaching into the grab bag". The "grab bag" is a hypothetical place filled with the entire list of possible PMS symptoms, which can be found on just about any medical website. I "reach into the grab bag" and I pull out three symptoms more or less at random. Those are the ones I have to deal with for that given month. The symptoms are discarded within a day or two of actual onset of menstruation, and next month I reach in for another three, at random.

This month, I happen to have picked out "anxiety attacks".

Now this is not terribly new for me. I have been officially diagnosed with "Generalized Anxiety Disorder", which basically means that I may get anxiety attacks sometimes for no particular reason. Oh, we are sure that there is a reason. Perhaps there is a hormone drop, or surge, or a neurotransmitter glitch. The problem with finding an intermittent error in any system, as I'm finding with a really bizarre personal computer problem involving a disappearing hard drive, is that if you don't catch the problem in the middle of happening, the diagnostics all check out as normal. Suffice to say that I have identified a few triggers, but have no hopes of catching all of them.

So I have decided to take a moment and create a primer, for family, friends, and whoever might benefit from the information, on how to identify and treat an anxiety attack from the perspective of the sufferer's family member, friend, or whoever happens to be accompanying her when it happens. I am doubly encouraged by a scene the Disney movie Frozen. Anxiety sufferers cringe at the reprise to "For the First Time In Forever", in which Elsa very clearly displays every sign of a physical anxiety attack, and Anna does everything wrong in trying, with an open heart and honest desire to help, to make things better. I know you guys want to help your friend. I'm going to help you figure out how.

Step 1: Identifying an anxiety attack

Anxiety attacks often start with a surge of panic. At this point, I know the feeling well enough that I don't actually feel "afraid", so I could dispassionately describe it as an adrenaline surge. It's the same feeling you get when you are driving down a snowy road, you turn the wheel, and nothing happens. In fact, the entire anxiety attack pretty much follows your physical symptoms after you do something like that. The person may start trembling, sweating, or shivering, may rest her hand near her neck to feel her heart pounding, may blink rapidly, and her breathing will change. If she's a pro at dealing with the attacks, her breathing may become deeper, slower, and more deliberate. If she doesn't have a handle on it, her breathing may become shorter, faster, and shallower. If the attack is severe or she doesn't know how to identify or manage it, she might even start to cry.

There may be no obvious trigger, and anxiety often builds to an attack (secretly and in the background) rather than hitting the rapid onset that you would feel if you had just entered a genuinely dangerous situation. She may have been mall-walking for an hour and a half and suddenly get hit with a full-fledged attack while doing nothing in particular. Even when you have been having anxiety attacks for years and are pretty well used to them, the opening surge still blindsides you.

Step 2: Shift your focus

In the scene from Frozen, the first mistake Anna makes is to assume that Elsa is "afraid", and that figuring out what is frightening her and easing her fears will make her reaction go away. This is actually 100% wrong. Whether the trigger is emotional or physical, the anxiety attack response is utterly and fully physical, and "solving the problem" will do absolutely nothing for the symptoms. In fact, attempting to "solve the problem" will be useless on two fronts: you are repeatedly applying a potential (probably a likely) trigger for the attack, and she is not going to be able to deal with any underlying emotional state in a reasonable manner. If she had an attack of leg cramps, you wouldn't push her to keep jogging while telling her that she can 'get through this'. You'd let her stop until the cramps ease and help her work them out of her leg. You need to do the same thing here.

So the wrong thing to say is, "Are you scared?" or "What are you afraid of?" or "How are things going at home?" The right thing to say is, "Are you having an anxiety attack?"

Now that isn't to say that being a counselor is the wrong thing to do overall. There is obviously an underlying stressor causing the problem, and you might want to talk to her later on and find out if it's emotional. Never do it during the attack, or even in the immediate aftermath. You want to be in "nurse mode" with your friend right now, not "counselor/psychologist mode".

You may have noticed by now that I keep using the phrase "anxiety attack" instead of "panic attack". I almost wish I could invent another word for it. When I have an attack, I am not "panicking". In fact, I'm probably completely calm to all outward appearances. I am having a physical reaction, like cramps or hives. (I am not entirely typical. Usually the person having an anxiety attack will have an emotional reaction as well. In that case... it is still merely a physical, chemical reaction and ought to be treated as one.)

Step 3: Managing an attack

Now that you know that you're dealing with a physical/medical event, you will find it much easier to learn how to treat the attack. The first and best thing to do, especially with someone who has a history of anxiety attacks, is to ask, "What can I do?" and "What do you need?" Then listen. That seems obvious, but in that Frozen scene, it is one thing that Anna does not do. Her sister puts out very clear "back away" signals and even states clearly that she is making it worse, but she just keeps persisting, certain that the Power of Friendship will solve the issue. Some people may feel better if you hold hands, or give a hug, but some will not, and it is neither your fault nor a rejection of you as a friend.

Because I am sensitive in a number of ways I don't understand, I perceive people as if they have 'zones of influence' or 'zones of personality' (commonly called 'auras', mostly in spiritual circles to which I do not belong) extending for a short distance around them. When I am dealing with an anxiety attack, I am managing my own 'aura', doing a balancing act. I do not need your 'aura' getting into my zone and throwing off all my readings. Now that's my personal experience. Frequent sufferers generally already know what works and can tell you what you can do, or just communicate whether they need closeness or space. If you are going to hug or hold hands, for heaven's sake keep yourself calm, because they might be feeding off your mood in hopes of stabilizing theirs.

There are several medical/physical steps that can shorten an anxiety attack. Forcing yourself to breathe deeply and slowly will slow the heartbeat and help kick the body off of its adrenaline surge. Massaging the vagus nerves (roughly where the jawbone meets the ear and just behind it) will also help. You could give your friend a drink and encourage her to sip it slowly once the initial surge starts to recede. Do not give her anything with caffeine in it. She should probably avoid caffeine completely for the rest of the day. Visualization also helps, but it has to be a place that she finds relaxing, not a place that you find relaxing. Though the two may coincide, don't depend on it!

If your friend has a chronic problem, she may have been prescribed medication. Alprazolam (Xanax) is a fairly common "take-as-needed" medication for anxiety attacks. Check the bottle and do her a favor - offer to drive home. Most anti-anxiety medications cause mild or marked drowsiness.

Anxiety attacks typically peak within the first ten minutes and take about a half hour to really resolve. Serious problems like allergic reactions and cardiac difficulties (she might mistake an anxiety attack for either of these, and might even be convincing to bystanders and helpful medical staff) will continue or get worse.

Step 4: Aftermath

Anxiety attacks are like earthquakes. They tire people out, and the larger ones commonly have 'aftershocks'. Your friend might need to cut your trip/visit short, eliminate an event from her schedule, or simply needs to go right home as soon as the symptoms subside. If she decides to power through the rest of the day (whether she powers through or goes home, she is just as frustrated with cutting it short as you are), just keep an eye out and be aware that the attack will have sapped her energy and lowered her ability to cope with stress triggers. If you leave the mall to find that your planned dinner spot is crammed full of noise and bright light, feel free to suggest a different spot!

Basically, just be aware that it is possible to have multiple anxiety attacks in a day, and each one weakens her resistance to the next. If the attack was severe, she might need a couple of days to fully recover.

When the physical effects of the attack have faded away, it may be a good time to encourage your friend to check on her stressors and triggers. Now is the time to find out if she has been facing a bad situation at work, or whether she is just at a bad point in her hormonal cycle. Dealing with the triggers ahead of time will prevent or at least lessen future attacks.

Be patient... anxiety disorders often require lifelong management, like diabetes or Crohn's, and it may be decades in the future (or longer!) before we can even identify the underlying problem, never mind finding a full-out cure. A person with an anxiety disorder can still lead a perfectly fine, happy, fun, fulfilling life, as long as her family and friends can patiently deal with the attacks and move on to the good stuff.