I wrote about the diagnosis
of transgenderism in a previous post, a diagnosis which, premised as it
is on being born in the wrong body, is incorrect. Now I want to
discuss the process of making a diagnosis.
Being a physician is a lot like being a detective: you are called to the scene of a problem (though detectives seem often to be on a luxurious vacation at a rich person's estate when their relaxation is rudely albeit conveniently interrupted by a murder, while physicians are merely at their office); you are told the story of the problem (dead body/illness) by the person who has discovered it (maid/patient); you gather clues and arrive at a hypothesis (red herring suspect/diagnosis); you test your hypothesis (elabourate ruse/examination and investigations); then, in the last chapter, you confirm or revise your hypothesis and come to a final conclusion or diagnosis.
Usually, at least for physicians, the initial hypothesis (diagnosis) is correct. We are taught several aphorisms for this: "common things are common"; "if you hear hoof beats, think horses, not zebras."
Making a diagnosis is the work and responsibility of the professional, whether physician or detective. This is not patronizing; this is about the years of education, training, and experience the professional has acquired which has created expertise.
We all know the sometimes hilarious results of someone without medical training Googling their symptoms and convincing themselves they have the least likely and most dire condition.
This isn't to say the input of patients is not important. The story our patients tell us is vital. Another aphorism from medical school: "the diagnosis is 90% history and 10% physical examination," meaning what a patient tells us often contains all the information we need to make the diagnosis; the rest of what we do merely serves to confirm our hypothesis.
The real point I am getting at here is this: transgenderism, or gender dysphoria, is the only "diagnosis" that I can think of which is made and confirmed by the patient rather than the physician. This suggests many notions to me, such as: transgenderism is not a medical condition; the diagnosis is wrong; physicians, in this situation, are being lazy.
A diagnosis is the result of an evaluative process. It is not a statement of identity. By all means, we all ought to be free to choose how to express our sense of identity, but we must stop medicalizing that.
A diagnosis is not an identity and an identity is not a diagnosis.
Being a physician is a lot like being a detective: you are called to the scene of a problem (though detectives seem often to be on a luxurious vacation at a rich person's estate when their relaxation is rudely albeit conveniently interrupted by a murder, while physicians are merely at their office); you are told the story of the problem (dead body/illness) by the person who has discovered it (maid/patient); you gather clues and arrive at a hypothesis (red herring suspect/diagnosis); you test your hypothesis (elabourate ruse/examination and investigations); then, in the last chapter, you confirm or revise your hypothesis and come to a final conclusion or diagnosis.
Usually, at least for physicians, the initial hypothesis (diagnosis) is correct. We are taught several aphorisms for this: "common things are common"; "if you hear hoof beats, think horses, not zebras."
Making a diagnosis is the work and responsibility of the professional, whether physician or detective. This is not patronizing; this is about the years of education, training, and experience the professional has acquired which has created expertise.
We all know the sometimes hilarious results of someone without medical training Googling their symptoms and convincing themselves they have the least likely and most dire condition.
This isn't to say the input of patients is not important. The story our patients tell us is vital. Another aphorism from medical school: "the diagnosis is 90% history and 10% physical examination," meaning what a patient tells us often contains all the information we need to make the diagnosis; the rest of what we do merely serves to confirm our hypothesis.
The real point I am getting at here is this: transgenderism, or gender dysphoria, is the only "diagnosis" that I can think of which is made and confirmed by the patient rather than the physician. This suggests many notions to me, such as: transgenderism is not a medical condition; the diagnosis is wrong; physicians, in this situation, are being lazy.
A diagnosis is the result of an evaluative process. It is not a statement of identity. By all means, we all ought to be free to choose how to express our sense of identity, but we must stop medicalizing that.
A diagnosis is not an identity and an identity is not a diagnosis.
No comments:
Post a Comment