The Disorder Nobody Wants To Talk About

Brazilian model Lea T.

Imagine, for a moment, a disease that affects 1 in 10,000 people. That is a fairly common disorder; about the same number of people that are affected by glaucoma or deafness, and three times more frequent than brain cancer. Add to that image a mortality rate of 41%. That’s a pretty serious disease, isn’t it?

Let’s add a bit to that picture. The treatment for this health problem is not terribly expensive, nor difficult. It requires some common, inexpensive drugs. It also requires some surgery, in the price range of $12,000. None of this treatment is particularly unmanageable or experimental, though as with any medical procedure, research would no doubt find room for improvement, and it does take a certain level of specialization.

What would you say if you found out that there is no insurance coverage for the treatment of this common, deadly disorder? And despite the fact that you may pay thousands of dollars per year for your insurance coverage, if you or a loved one had it, not a single dime will go toward the payment of life saving treatment.

That disorder exists. It’s called Gender Identity Disorder, and though we don’t know the cause of it, we do know how to help people with it. Through the use of hormones such as estrogen and testosterone, and surgery to help people’s bodies reflect their self-identity, we can not only vastly improve someone’s health and quality of life, we can also save their lives. Untreated gender identity disorder is associated with high suicide rates, and very high levels of substance abuse, as people try to self-medicate their pain.

All too often, GID (also known as gender dysphoria) is tossed off as a problem of morals, as if it were rectifiable by the application of religion, or as a manipulative version of homophobia. Even in the psychological community, there have been attempts made to reclassify gender dysphoria as an oddball variant of homosexuality.

In particular, there is the claim that male-to-female transsexuals are simply gay men who cannot admit their attraction for other men; or, alternatively, that this same group is  sexually aroused by the image of themselves as females, and thus turn to drugs and surgery to fulfill their autoeroticism. Not only do these half-baked theories fail to explain those seeking to transition from female to male, it also fails to take into account the full range of sexual expression, as transgender people may be gay, straight, bi or uninterested, just like everybody else.

The more likely explanation — and the one that has objective research supporting it — is that the vast majority of people who would prefer living as the opposite gender are simply responding to the way their brain is wired.

That’s right. The preponderance of the evidence these days points to the idea that for some people, during fetal development, their brain growth follows one gender track while their bodies follow another. The mismatch may be noted as early as mid-childhood, though for others the problem does not become evident until puberty, as the genders further differentiate, and as one transsexual person said, “it was all wrong!”

Even so, many people will continue to live with this precarious disconnect between their bodies and their brains because they feel they have no alternative. Afraid of the discrimination and out-and-out violence that is directed toward transgender people, even within the medical community, they suffer quietly. And their suffering takes its toll, in very high rates of depression and its end result, suicide; in drug abuse and alcoholism, as they try to manage their anguish by becoming oblivious; in unemployment and poverty, as their depression and anxiety makes it difficult to hold a job, or even worse, being fired after their condition becomes known to their employer.

The argument that transgenderism is “just” a boy who likes girls’ clothing or a tomboy gone too far is like calling a melanoma “just” a skin blemish. Gender identity disorder is serious, often deadly, and levies an awful toll on both the individual and society.

Which makes the denial of coverage for this disorder little short of heinous, particularly because the solutions we have at hand are relatively successful and not particularly experimental. Unfortunately, even for those people with health insurance, denial of coverage for surgical transition is the norm, via a “Transsexual Exclusion Clause” which excludes all medical procedures related to a person’s transgender status.

With the combination of hormones and surgery, medical doctors can create an internal and external state where one’s body more closely parallels one’s gender self-identity. No, it’s not a perfect answer; few medical responses to chronic conditions are perfect. Nor is surgery the right answer for all transgender people. But for many, the surgical answer is literally life-saving.

Enter the Jim Collins Foundation:

The mission of the Jim Collins Foundation is to provide financial
assistance to transgender people for gender-confirming surgeries. The
Jim Collins Foundation recognizes that not every transgender person
needs or wants surgery to achieve a healthy transition. But for those
who do, gender-confirming surgeries are an important step in their
transition to being their true selves.

Last week, the Foundation awarded its first grant to Drew Lodi. “The Jim Collins Foundation for me is a miracle,” Drew said. “They helped me to stay motivated to live each day purposefully…I improved my life, mind, body, relationships, and faith. To know that people are out there who do NOT have to be helping–but are–makes me motivated to do everything I can…”

The Foundation awards grants based on a combination of financial need and preparedness. And it aims to be more than just deep pockets for people in need. The Foundation strives to empower people to find creative means of financing surgery for themselves, at least partially. Drew, for example, began funding his surgery by collecting bottles and cans for their deposits.

Having firsthand seen the results of the life-saving surgeries which the Jim Collins Foundation funds, I cannot think of a more worthy, or necessary organization deserving of your support and donations.

I know that money is tight for everyone, as this country slowly claws its way out of the Great Recession. But to the extent that you can consider a charity at all, I hope you will consider making a donation to the Jim Collins Foundation.

Gender dysphoria is the disorder that nobody wants to talk about, but that affects millions of Americans just the same.  The cost of treating every person who needs the life-transforming surgery amounts to 5 cents per American citizen. Do you think you could spare a dime to save a life?

Dr. Avery Jenkins is a chiropractic physician specializing in the treatment of people with chronic disorders. He can be reached at or by calling 860-567-5727.

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16 thoughts on “The Disorder Nobody Wants To Talk About

  1. I have read hundreds of blogs, and a handful of really excellent books on the subject, but I must say that Dr. Jenkins has written the most wonderfully apt description of GID/GD I’ve seen! Thank you for sharing this, and for the information about The Jim Collins Foundation – I will be sure to spread the word!

    –Stacey Adams (just another of the 1 in 10,000)

  2. Kudos! This is one of the MOST INFORMED articles I’ve seen on GID yet. (although the mortality numbers are closer to 50 percent as opposed to 41 as posted.)

  3. It is heart warming to read such a succinct piece from someone out-with the trans community. I was born six decades ago at a time when America woke to the nation wide news that an ex GI had returned to the US after having successfully undergone a surgical procedure to transform her into the woman nature failed to do. Still as you say even the medical fraternity can be stubborn enough to deny this fact and deny the simple help to those in need clearly in breach of their Hippocratic oaths.

    The shocking statistics for suicide and murder abuse are a cloud which hangs over our society. I was denighed help forty years ago and told by a doctor that there would be no help in my lifetime which I am only now able to prove wrong. What that doctor did was de-nigh me a real chance of life and the chance to contribute a lifetimes taxes to society, instead what would have been the working career of a high scoring student was spent as a depressed recluse.

    The treatment has long been proved to be one of the most successful procedures and the most cost effective of almost all surgeries yet countless thousands will never get the chance to get help in the richest country on earth.

    The cost to society of this policy is unimaginable!

  4. I’m glad to be a European transsexual. My insurance does cover the cost of the gender reasignment treatment, including hormones, psychological counseling and surgery.

  5. Great article, but it’s time to drop the whole “disorder” terminology. A cleft lip isn’t a disorder, it’s a birth condition. That’s what Transsexualism is, a birth condition. G.I.D. is an outdated term invented by the psychological community decades ago, when they actually believed this was a mental disorder. The science has changed our understanding, so the words must now follow, starting by removing them entirely from the DSM-V. Transsexual people aren’t mentally ill, so our condition has no business appearing in that publication. Gender DYSPHORIA is a real psychological pain – a symptom of Transsexualism, if you will – but not an indication of mental illness.

  6. Thanks for the kind words! I’m sorry for the delay in getting these approved and on the blog, but yesterday’s wild storms took my internet away for a day.

    @Fortes soli superant: I think the term “birth condition” is an excellent description. Thanks for the suggestion, I hope you don’t mind if I use it in the future.

  7. What an excellent idea comparing insurance coverages!

    Thank you for making such an eloquent statement.


  8. Funny that I find this article when I did. I’m a transgendered woman in my 20s trying eek out an existence as best I can living in the deep south and being poor. It’s not an easy task trying to find work and be myself knowing more than half the population would gleefully execute me if there weren’t laws preventing it. Add on top of that a deep depression and accompanying self-loathing regarding the way I look, and it’s not surprising I thought about suicide no less than 4 times today. The only solution is surgeries I can’t afford. So I just get to be a freak everyone hates day after day.

    My situation isn’t even unique. I’m friends with tons of other mtfs in the exact same boat. Some of us will make it and come out on top. Some of us will die trying. The tragedy of it all is that these deaths would be entirely preventable if we weren’t ostracized by the medical community and society as a whole. The so-called ‘standards of care’ psychologists make transgendered people follow is an absolute joke meant to destroy what little self-confidence any of us have, leading the problem to ‘fix itself’ either by forcing us to give up or kill ourselves from shame.

  9. GID is recognized by the American Medical Association, the American Psychiatric Association and Federal Aviation Administration. The last item is particularly interesting. If your GID is severe enough, you don’t fly.

  10. I hate to take issue with much in this article, which is really excellent. But the mortality rate needs some adjusting. I believe the 41% mortality rate comes from the NCTE/NGLTF report (“Injustice at every turn”) on the rate of suicide among the trans population. If that is true, the statement needs modification. Suicide attempts, while horrible in themselves, are not mortality. There are estimates that in the USA, the ratio of suicide attempts to fatalities is 3:1 among older people, 10:1 among younger. That would mean fatalities would be between 4% and 13%, still a horrific rate for GID/GD. If we mistate data, the haters can use it to undermine the message. An even more horrific interpretation, since those who lost their lives to suicide were not available to participate in the NCTE/NGLTF survey, about half of trans people try to erase themselves from existence (45% to 54%, depending on the ratio of attempts to fatalities).

    Thank you for a brilliant article

  11. Having only just attended a conference (mainly) about legislation affecting trans people, I heard about the Injustice at Every Turn report, so I’m about to have a read of it myself. Dr Jenkins is obviously pretty clued up on the subject.

    The mortality rate is ridiculously high. Coupled with the number of people who successfully transition and disappear into the woodwork, forever mindful of their past but purposefully invisible to all, it’s perhaps little wonder that our community struggles as much as it does. But neither can we all be like meerkats, constantly watching and calling out. How awkward a condition it is, in which the best indicator of success is ultimately the return of zero patient feedback, and which some medical bodies twist into being the best indicator of the unproven value of treatment.

  12. My insurance covers it. I’m too scared to go through with it. It’s terrible. Thank you for writing this; it matters.

  13. This is a fabulous entry on GID/GD and I must say that it emphasises, quite well, the danger that this disorder can bring to an individual.

  14. First, I honor the idea of this foundation. I have been trying for 15 years to do something similar. If every Trans* person would donate just $10/month, think of how many we could help. Seems that those who would most benefit, are least willing to participate.

    Second, where do you come up with at $12,000 price tag? With HRT, therapy, electrolysis, etc.; costs for transition are closer to $30,000-$50,000. Just top surgery for FTM’s or MTF’s is $5,000-$10,000. Bottom surgery approaches $20,000 at the lower end of the spectrum if one has Gender Confirmation Surgery in North America.

    Next, I agree with what Jill said above.

    Lastly, it really sucks that we have to pathologize our lives. Trans* people have existed throughout time and all over the world. As for causality, my research shows that endocrine interrupters, found in our food supplies, our air, and our water, affect how a fetus develops in-utero. There IS a cause and affect. We may not know exactly how and where it actually begins, but we are relatively sure of the cause and effect.

    What I fear of utilizing only the pathological approach, is that our naysayers will want to find a “Christian acceptable cure” .. meaning fix it to “make us the way God made us”. In other words, they won’t want to allow us to transition and have GCS.

    I wish your foundation all the best.

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