Mental Health Of The Nation: Our Evolving Understanding Of Issues Of Gender


Dr Mike Neville


"Gender equality is not a woman's issue, it is a human issue, it affects us all." - Unknown.

"WHAT gender am I?" Most of us have not had to ask this question, but many have. The simplistic answer that there are two sexes and that is it, no longer sits well with our current knowledge.

It is not really a mental health issue, though we do help with people, mainly adolescents, with gender dysphoria. This is not really a mental illness, but the anxiety and depression that accompany the strong feeling that they are not the gender they appear to be, does need psychological help. This condition must not be confused with homosexuality and the medieval attempts to "cure it."

The Church of England has recently called on the British government to ban "conversion therapy" and condemned the practice, which aims to change sexual orientation, as unethical and potentially harmful. It is now about 50 years since the laws on homosexuality began to change in England with the acceptance that sexual acts, between consenting adults, in private that did no physical harm should be legal. The International Psychiatric Association also accepted that homosexuality was a normal variant and should not be seen as needing treatment. The laws and opinions are constantly changing, they have followed developing science and the scientific community now accepts that there is a strong biological part to sexual orientation which is influenced by genetic, environmental and hormonal factors. This means that our sexual feelings be they heterosexual, homosexual or otherwise are not a simple freewill choice.

It may be of interest to some that there is an exhibit at a British museum which traces historical writings and artifacts which clearly show that gender variance and same sex desire has always existed in all places and at all times. Many cultures have always accepted a third gender, for example Native Americans had a word in the Dakota language "Winkte" which means "wants to be a woman." This area has created enormous difficulties for the Olympic committee where gender equality is enshrined in the Olympic charter, which compels the IOC to encourage and support the promotion of women in sports at all levels. This seemed easy enough when science discovered chromosome testing, females had XX chromosomes and males had XY chromosomes. Then it was realised that there could be more combinations of chromosomes and even more difficult; people could be born with both male and female sex organs. This has really complicated things if you looked externally like a female but have testes in your abdomen which produce male levels of testosterone.

Are you cheating?

If it makes you feel any better the Olympic association keeps reversing itself and does not seem to know what to do either.

This brings us back to equality; which simply means the equal ease of access to resources and opportunities regardless of gender. I am still puzzled that the Bahamas has twice rejected by referendum the concept that men and women are equal. I am sure political shenanigans played its role, but it seems such a simple human right that we should all have equal opportunities regardless of race, gender and other supposed differences.

• Dr Mike Neville is a forensic psychiatrist who has practised for more than 40 years in The Bahamas, working at Sandilands, the prison and in private practice. Comments and responses to mneville@tribunemedia.net


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