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50 Signs of Mental IllnessA Beautiful MindA Beautiful MindA Bright Red ScreamA Casebook of Ethical Challenges in NeuropsychologyA Corner Of The UniverseA Lethal InheritanceA Mood ApartA Research Agenda for DSM-VA Slant of SunA War of NervesAbnormal Psychology in ContextADD-Friendly Ways to Organize Your LifeAddiction Recovery ToolsAdvance Directives in Mental HealthAggression and Antisocial Behavior in Children and AdolescentsAl-JununAlmost a PsychopathAlterations of ConsciousnessAm I Okay?American ManiaAmerican Psychiatric Publishing Textbook of Neuropsychiatry and Clinical NeurosciencesAn American ObsessionAngelheadAnger, Madness, and the DaimonicAnthology of a Crazy LadyApproaching NeverlandAs Nature Made HimAsylumAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderBeing Mentally Ill: A Sociological Theory Betrayal TraumaBetrayed as BoysBetter Than ProzacBetter Than WellBeyond AppearanceBeyond ReasonBinge No MoreBiological UnhappinessBipolar 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ChildrenEmotions and LifeEmpowering People with Severe Mental IllnessEssential PsychopharmacologyEssentials of Cas AssessmentEssentials of Wais-III AssessmentEthics and Values in PsychotherapyEthics in Mental Health ResearchEthics in Psychiatric ResearchEthics, Culture, and PsychiatryEverything In Its PlaceFamily Experiences With Mental IllnessFatigue as a Window to the BrainFear of IntimacyFinding Iris ChangFinding Meaning in the Experience of DementiaFlorid StatesFolie a DeuxFor the Love of ItForensic Nursing and Multidisciplinary Care of the Mentally Disordered OffenderFountain HouseFrom Madness to Mental HealthFrom Trauma to TransformationGandhi's WayGender and Its Effects on PsychopathologyGender and Mental HealthGenes, Environment, and PsychopathologyGetting Your Life BackGracefully InsaneGrieving Mental IllnessHandbook of AttachmentHandbook of DepressionHandbook of Self and IdentityHealing the SplitHerbs for the MindHidden SelvesHigh RiskHope and DespairHow Clients Make Therapy WorkHow People ChangeHow to Become a SchizophrenicHow We Think About DementiaHughes' Outline of Modern PsychiatryHumanizing MadnessHysterical MenHystoriesI Hate You-Don't Leave MeI Never Promised You a Rose GardenI Thought I Could FlyI'm CrazyImagining RobertImpulse Control DisordersIn Others' EyesIn Two MindsInsanityIntegrated Behavioral Health CareIntegrative MedicineIntegrative Mental Health CareIntuitionJust CheckingKarl JaspersKissing DoorknobsKundalini Yoga Meditation for Complex Psychiatric DisordersLaw and the BrainLaw, Liberty, and PsychiatryLegal and Ethical Aspects of HealthcareLiberatory PsychiatryLife at the BottomLife at the Texas State Lunatic Asylum, 1857-1997Life Is Not a Game of PerfectLithium for MedeaLiving Outside Mental IllnessLiving with AnxietyLiving With SchizophreniaLiving with SchizophreniaLiving Without Depression and Manic DepressionLost in the MirrorLove's ExecutionerLoving Someone With Bipolar DisorderMad in AmericaMad TravelersMad, Bad and 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Related Topics
NormalReview - Normal
Transsexual CEOs, Crossdressing Cops, and Hermaphrodites with Attitude
by Amy Bloom
Vintage, 2002
Review by Christian Perring, Ph.D.
Apr 21st 2003 (Volume 7, Issue 17)

In Normal, Amy Bloom investigates the lives of transsexuals, cross-dressers, and hermaphrodites and discusses the social and ethical concerns arising from medical treatment of people identified as being in these groups.  It's a short book with just three chapters and an afterword, and two of those chapters have appeared in magazines previously.  Bloom is an eloquent and charming writer, with occasional phrases and sentences that stand out with their casual yet telling images.  These and her liberal quotations from her interviewees put the reader at ease reading abut matters that many will find unsettling.  Often she uses humor to great effect.

Bloom's perspective is consistently humanistic and liberal, and she always prioritizes the experience of the people she interviews and she allows them to voice their opinions.  For transsexuals and hermaphrodites, the proper stance to take is clear enough: if people really feel they need to get gender-reassignment surgery, they should be allowed to do so, and we should not judge them.  Her focus in her first chapter is not on the more familiar case of male-to-female changes, but rather on the desire of some women for female-to-male surgery.  She discusses the details of the different surgical options available and the opinions of different experts on which option is best.  She also provides some historical background to past practices concerning transsexuals.  What is especially valuable about Bloom's account is her ability to convey the complexities of thoughts of emotions of people who are contemplating or have had the surgery.  As is nearly always the case, the stories of individuals command the most interest—people talking about their feelings, families, and of course, sex. 

The second chapter on crossdressers is in some ways the most surprising of the book, because it is in this chapter that Bloom's own sympathy with a stigmatized group is most tested.  In the other chapters, she sets out graphic details of surgical procedures of modifications to genitalia with no sense of revulsion or distaste.  However, in this chapter, she finds it hard to empathize with her subjects.  Her observation is that heterosexual crossdressers seem to be conservative and even sexist in their attitudes – their view of femininity is stereotyped and old-fashioned, and may even be tied to their need to cross-dress.  Bloom expresses more sympathy with the long-suffering wives of these men, whose disappointment with their lot is palpable.  Her description of a group of crossdressers on a ship cruise with their wives is sad yet funny.  She is clear that crossdressing is a compulsion yet "somehow not a sickness."  She says of the crossdressers she encounters that they have no grasp of female friendship, and she quotes one wife," For twenty years he couldn't help with the dishes because he was watching football.  Now he can't help because he's doing his nails.  Is that different?"

The third chapter provides Bloom much more solid ground for moral indignation at society's intolerance towards people who do not fit in with conventional categories.  Doctors regularly put pressure on new parents to consent to surgery on their newborn baby if the baby has ambiguous genitalia.  There is no clear medical need to perform this surgery, and there is no evidence that it improves quality of life.  It seems the only reason for the surgery is to alleviate the discomfort of parents and medical professionals alarmed at existence of a child whose sex does not fit easily into categories of male or female.  Estimates of the frequency of intersexuality put it at about one in 2000.  The cause of the intersexed was recently advanced greatly by the publication of As Nature Made Him by John Colapinto, the unhappy story of the boy raised as a girl under the supervision of psychologist John Money.  Money theorized that gender is purely created by nurture, and so any child raised as a girl would identify as a girl.  The child who was called Joan and raised as a girl never settled into a female identity and later came to identify strongly as a male, thus apparently disproving Money's theories.  Bloom mentions this case, but spends more time describing her meetings with Cheryl Chase, founder of the Intersex Society of North America.  Chase is a charismatic leader, and advocates powerfully against unnecessary surgery.  Bloom is clearly impressed and convinced by Chase, and presents a strong case for the rightness of Chase's views. 

Despite its sensationalist subtitle. Normal is a compassionate and thoughtful look at people whose bodies, behavior and desires don't conform with societal expectations even in a time of greater tolerance of gay and lesbian people.  Bloom summarizes some of the latest research on what is helpful and what is not, and she provides a short bibliography, which may be useful for readers wanting to do more reading on the topic.  Her reports of meetings and interviews with a wide variety of people add a personal dimension that makes the book especially approachable.  Recommended.

 

© 2003 Christian Perring. All rights reserved.

Christian Perring, Ph.D., is Chair of the Philosophy Department at Dowling College, Long Island, and editor of Metapsychology Online Review. His main research is on philosophical issues in medicine, psychiatry and psychology.


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