Does Gendercare's Gender Variance Diagnosis and Evaluation
through the Web be reliable?
We may surely say
YES!
First Step: Starting it through an "anamnesis" consultation.
We always start diagnosis with an anamnesis consultation through emails.
Anamnesis is a medical term which signifies the way we have to know your life story. In presential face-to-face consultation,
the patient shows and tells to the therapist his/her problems and the therapists also observes the way the patient tells
the self situations and the self story.
We do the same through emails.
We will not see you, your manners, that is the weakest part to develop a Web-anamnesis, but we have the best part of it> when
someone writes the own story, the own life and remember all moments and situations, alwys that someone has the opportunity to
revive it. That is an aspect of the Web-anamnesis, that is extremely important, mainly for gender variance analyse. The patient,
most of times, opens the own heart, and remembers hided facts, live again old feelings.
The great French writer Marcel Proust, when he described the "magdalenes episode" inside his great work "A la Rechereche du Temps
Perdu" he shows us how some moments may trigger memories, when we almost live again old memories.
We seek to trigger the patient to write... to remember... to live again... to tell us... to live it again with us...
To develop a good anamnesis, face-to-face or Web-developed, the key words for us are... compassion and respect, always.
So through these emails we may know all your feelings, your
sufferings and your overall story... since your gestation, what you may know about your gestation... talking to your parents,
your grand-parents sometimes, and later about your first infancy... and so on, up until nowadays.
Are these emails secure?
Nothing in the Web is 100% secure. But the insecurity increases with money
subjects and email name exposure.
You never pay nothing to Gendercare through emails; you never show your account
numbers to us mainly
through emails and our clinical communications with you are developed through Gendercare email processors.
So our communication is sufficiently secure for what we intend to do.
Would not be better face-to-face interviewing?
Having some more "human contact"?
I would say yes and no; surely NO considering the most important factors!
Yes because it is always good to be near the other. To have among us two computers is not the best situation surely. Including, for
any Psy therapy, Web-therapy would be impossible - not due to legal perscriptions, that could be wrong - but due to the
impossibility to touch the other, using any technique as we like more, as Psychodrama for example.
But gender variances are special situations, really very particular situations.
The first important consideration to answer that important question, is personal interviewing gender variant people
could disturb you and your reality. All therapist, as all human being, has its own religious, ideological, social and
personal points of view! So, the contact, that is absolutely necessary for psychotherapy, is a problem for gender therapy.
Most patients with gender problems, most of the time live or acts as autists. They like to be alone, they prefer to
have not contact with "experts" or "therapists". Why?
The contact is difficult.
So, we have a rule number one: It is much more easy for someone with any gender problem, to open the heart to a strange, or
to a mirror, or to an inanimate, as a paper sheet, than to a therapist... that is an "outsider", that is a PhD and Emeritus
Professor, but who never suffered a gender problem.
At one meeting in Brazil, some years ago, a psychologist and antropologist was telling a lot of things surely people
with gender problems never would consider... and after she stoped I answered her... dear friend, how many times did you
live your home crossdressed as a man?
She answered me... never!
Yes... so you are not prepared to understand what it is to live that reality.
Someone could say: the good cancer expert need not to have a cancer. Yes, I agree.
Why?
Because a desiase, as a cancer is not you... it is something you HAVE... it is not someone you ARE.
Gender problems never are related to what you have but always to who you are. Transsex, CD, transgender, intersex,
intergender... these things are not things you have, but who you are.
So, medicine is not a good place to see any analogy, but ethnology for example.
You, as a "white American" you may not know really what it is TO BE a South American... as a South American may not easily
know what it is to be an Australian Aborigine... and also to an Australian Aborigine it is not easy to understand what
it is to me a British Gentleman... and for the British gentleman it would be very difficult to understand what it is to
be a Shivaite in India...
I have two extraordinary examples to show you here:
Alain Danielou, the great French musician and philosopher, to understand the Shivaism in India, he had only one way: to become
a Shivaite in India!
Another French, the ethnologist and artist Pierre Verger, who came to Brazil, to Bahia, to study Yoruba and Candomble culture.
The only way would be to become a candomble initiate, and later he went to Africa, Nigeria, and came back to Bahia... and until
today the Yoruba community respect Pierre Verger.
A third example, a dearest example to me, personaly, because we were far relatives. The Villas-Boas brothers. They were the better
friends of Xingu indian nations in Brazil. I have tears in my eyes now, when I am writing it. Orlando Villas-Boas lived
a big part of his life among the Xingu indian nations in the center of Brazil. When Orlando died, the Xingu Nations performed
a Quarup - a special dearh ceremonial, to remember Orlando Villas-Boas, the white brother.They go to the forest and cut a big tree.
That tree they put in the middle of the "aldeia" where they live, and perform a lot of ceremonies, and later they took the
tree that signifies the dead friend, and put it in the river... a very beautiful ceremony, Brazilians saw last year.
All that i write to show you... what is important and what is not so important, in face-to-face anamnesis or Web-based anamnesis.
What is important is not the means we use, but the quality of the therapist. And we know the therapist not through the
number of PhD's and academic titles, but if the therapist lives, and knows "from the inside" and not
only "from the outside".
Also, as in ethnology, the therapist need to act sometimes not only as a doctor or as a psychologist, but with compassion, as
a priest.
Gender therapy, as good ethnology, we may live only as priests, as Alain Danielou was the Indian priest among
French people, and he worked also as a French priest among the Hindu people.
The same piesthood did Pierre Verger amond the Youruba, and Orlando Villas-Boas in the Xingu.
From the outside, all anamnesis is surely bad. Face-to-face or Web-based. From the inside, all therapy can surely be
good, when there is compassion and respect.
To treat a cancer, you need knowledge mainly. To treat THINGS PEOPLE HAVE you need knowledge and some talent.
To evaluate and treat gender problems is a question of life, so you need to live, to mediate life, and that mediation
is what I name priesthood... knowledge is absolutely necessary... but it is not sufficient!!!
Another aspect is
face-to-face therapy stimulates we act through our
own ideas and values, mainly some "old style" therapists
who always try to change or interfere on the patient, and not to know the patient...
We never intend to
interfere but
to know the way the patient feels and understands the self-reality.
The importance, for gender variance best evaluation, to
don't see the patient!
Why?
Because when the therapist sees the patient, what he/she sees arouse inner feelings
and values... unconsciously. For example, a someone that feels female, but is
very high, has a hairy body and beard... and some baldness, heavy and big as a truck driver...surely the uncouncious
of the therapist will press to say it is not a woman, but a man. But what need to be evaluated is
not hair, dresses, garments, skin... but identities! The therapist needs to learn
to evaluate brains and hearts, and not garments and manners, or baldness!
So, the best evaluation possible, is developped without seeing the image of the
patient!
The image of the petient helps nothing, but increase "information noise", decreasing the quality of the evaluation!
So, why not evaluate the anamnesis through the Web? The Web is the best place for it, considering all pros and cons!
After the diagnosis and evaluation,
if necessary, the patient may send us pictures/videos so we may know the
face, hair and body condition, to help transition (when needed and desired), hormonetherapy and surgeries.
For example see our TransPack instructions for gender dysphorics that need transition.
The Second Step: gender identity formation dynamics tests
Because through the Web, the patient feels alone and we may not suggest answers so we
may not disturb the test
with our presence, that is an ideal condition to perform a test!
At any moment, any question the patient may ask us, before or after the ending of the test ... and the patient in some special
situations may
repeat
the test, due to disturbing situations and even in some special situations when the patient feels insecure mainly about the time
schedule of our tests - as our tests intend to discover the dynamics of GI-gender identity formation, our questions
considers remembering facts and desires at childhood and early ages - sometimes patients may have difficulties relating
their own life development with the ages prescribed at the test. So some have difficulties not to answer the questions,
when the patient needs to remember situations, at past ages.
With the test answers, we may, with some software we developed, transform test scores and indices in time-series we call
"trajectories" in
Gender Space*g.
We consider gender identity formation a time invariant defining a gender phase space - using very simple time-delay
embedding techniques - and from that time-series and phase space / return plot portrait we may study its dynamic
characteristics.
We consider not etiology and causes, but only dynamic characteristics, and considering these characteristics
we may consider typical relations.
Can someone fake the test? Surely yes, even Nasa may be faked, and Fort Knox. But... to mislead a face-to-face therapist
with
maneurisms surely is much easier than to fake a phase space structure.
Surely also, as the patient pays the test - that is important, to pay the test to be something that costs money - the
patient will not misuse it, spending money for nothing.
Our tests are very useful in thousands of situations... for a lot of
clients from
different countries and languages, from different cultures.
Our free pre-evaluation MF9 and FM1 tests up until today were answered by more than a
dozen
thousand visitors - Brazilian and foreigners -, and the clinical ones (the only dynamic ones) were answered by some
cents of clients - also Brazilians and foreigners from USA, United Kingdom, Ireland, Italy, Chile, Mexico... Japan, Singapore...
Phillipines, South Africa... including Arabian countries, among much others.
(Those tests were scientifically validated through more than one thousand
answered tests through the web by Brazilians, in 2001/02.) - but now we have a special opportunity to show better
mainly HBIGDA members and other "experts" its quality.
I would be very interested in taking a Pilot research project, inclunding a control group of non-trans patients
and a comparator group of trans patients and running these volunteers through your various analytical tests.
It would not be a study I could obtain monry for in the early stages - I would need to do a pilot study with 12 to
20 indiiduals completing your early daignostic forms. I would like to test patients on your 'First Anamnesis test',
the Female Identity (2011), Male Identity (2012), PdQ4 Questions (3013), PTSD evaluation (3015), MMPI Questions (3011),
and PdQ4 Conclusion (3014).
I would suggest that if your practices wish to obtain recognition, the project must involve using 2 blind control
groups; a control group and a group of people starting the process of assessment and treatment. The control group
would be reached through the non-crossdressing trans populaton, and the others through a clinical team either here
in the UK, or based in Europe and attending European clinics.
Throughout the various stages the results of the tests, comparisons would be made with the groups to see to what
extent the test results represent their life choices.
This could only be an unfunded pilot project, but it might enable a larger funded project to be developed. It would require complete co-operation from your team in either analysing and reporting back from the tests, or by
teaching us how to do that analysis.
It may take 3 to 4 years to complete such a project, and of course we would not be in a position to pay for the
tests or their analysis. Would you be willing to put your theory and practice through such outside scrutiny?
Stephen
Obviously our answer was YES, and we are prepared for all HONEST evaluation of our methods, since we may work on the
results actively, and also considering the necessity to publish these results in an European journal, after we discuss
and jointly conclude and agree about the conclusions of the proposed - and immediately accepted - Pilot research.
What do the MFX and FMX Gendercare tests
evaluate?
The patient's Gender Identity development.
Gender is a typical non-linear dynamical process, as almost all genetic-triggered processes are. From the human egg
starts a huge diversity. Each human being is one human being as the result of that potential - real and experimental -
reality.
From the human egg, since the start there may be small genetic differences that surely will develop systems diversity -
deterministic and not stochastic diversity - a diversity determined by the start structure. XX or XY... or chimeras,
or mosaicisms, or...
a lot of possible diversity!
But let's suppose we consider only male eggs... XY, XXY, XYY... etc... even with these big restrictions we have also
a big diversity!
But suppose now we have only XY, very stable XY eggs! Much more restriction at the start! Due to AIS-androgen
insensitivity syndromes we may have ... from XY eggs... CAIS women... and other possibilities!
and the diversity continues!
But let's suppose all eggs are XY with no Androgen Receptor sensitivity problems! All them follow a Typical Sexual
Development-TSD... but in kindergarten
some will show and also will say they feel girls and would like to be girls and not boys! So... XY with TSD means
almost nothing about gender development!
That is a real complex system! but as it is very sensible to the initial conditions, by definition that system surely
is a non-linear deterministic system, or in other words, what we define a "Chaotic System".
Our conclusion? If we define a Gender Space, between two limits we call M and F, all gender identity will be necessarily
inside that space
and will show always a potential development diversity but always following an underline pattern - or a "fractal"
dimension.
We developed our tests to research that pattern of development for each human being that answer our 100 questions.
To start evaluation GI inside gender space, we need a reference point. M or F.
We use M as the reference point for:
Men (heterosexual, homosexual, bisexual, asexual or pansexual);
MtF crossdressers (CD's) and transgenders/GIDNOS (TG's);
MtF transsexual women;
Men assigned intersexuals (even if they are not satisfied with the initial classification "from the outside").
Vice versa for F, women (heterosexuals, homosexuals...), FtM men and F assigned intersex.
We considers
4 main scales:
Unexpected gender development scale, when we may see your male or
female inner tendencies,
since first childhood;
Gender Dysphoria scale (differential diagnosis between transsexualism,
transgenderism and crossdressing), from where we may discover the deepness of the
unexpected femininity or masculinity, and how it developed; that scale result need always to be considered in relation to
the fist scale. For example let's say that for age 3 someone shows 80% tendency to transsexualism... but also for that
age only 30% femininity... so that result means not necessarily a tendence to transsexualism, because the femininity
baseline was very low.
Sexual Orientation scale, where we discover what kind of people
you love more, and how
that tendency developed inside your "tastes";
Sexual Action scale , where we consider what sexual action you prefer in bed:
to play the active partner, the passive,
both or neither? that way we try to understand your sexual action tendencies.
We study these 4 scales, in a progressive way, following your age and life development, generating for each scale a
"trajectory" as a time-series.
The only scale we study in depth the development dynamics is the first scale, when we develop the time-series as the
"trajectory", and also the Phase Space portrait and the return-plot portrait, comparing the result with typical results.
As you may see, with those tests we may discover your Gender Identity, and how it
developed, but we discover almost nothing about
why you may have a discord gender identity!
How could we discover why you are a
Gender Variant?
To answer that question, we will need to answer first two other questions:
1st:Have you a gender dysphoria? Or even with an Intergender or Gender Variance are you happy
with your body condition?
2nd:Perhaps, could you have some mental problems?
May your Gender Dysphoria & Gender Variance be caused by any kind of mental problem?
How may we be sure you have a real GID- gender identity disorder
or a GIDNOS - gender identity disorder not otherwise specified - a GID plus something more? (it is so common,
GID people develop an OCD or other derived
problems as depressions, etc.!). May your GID be caused by any kind of mental
problem?
3rd and Final step: Psy Screening
We use 2 main online very considered Psy Screening tests: the original version of the MMPI inventory (original 566 questions)
and
the PdQ4 test (the PdQ4 adapted by us
for GID's - instead of the original 100 questions, we consider 200 questions).
Do they work well?
Surely YES!, they are, mainly the MMPI, very recognized standard screening tests.
The MMPI is the most recognized personality inventory for almost 70 years, and the PdQ4
test
is a good psy screening standard interview, based on DSM-IV, recognized for more than 20 years.
If you have not important mental problems,
why did you have a GID/GIDNOS?
If our MFX or FMX tests show you are a transsexual
GID, and you have no mental problems,
you PROBABLY have what Dr.Waleria Torres, MS, PhD defined in 1998,
with Dr.Dorina Epps Quaglia, MD, PhD; Dr.Jalma Jurado, MD, PhD and Dr. Julio Cezar Meirelles Gomes, MD as a
gender neurodiscord
when your neural basal brain
organization and your genitals are in gender discord ... that may happen during the
final stages of your gestation. We can't change your brain, but we may respect how
your
brain was differentiated, and change your genitals and other body aspects, to be in
harmony with your brain and inner feelings that define your self-perception.
If our tests show you are a transgender GIDNOS,
and you have no mental problems, probably
you suffered, during first childhood, very strong traumas, mainly from mother rejection & relations.
We will investigate deeply your story, to try to discover that trauma root. But that kind
of traumas are so deep, we could not change the consequences of it, and what we
may do to help you, is help to adapt your body for your inner reality, and to
survive happily to that trauma.
If our tests show you are a CD-crossdressing
GID, and you have no mental problems, the origin probably may be
another kind of trauma... not so deep, not so early in your life...possibly a
sexual abuse, or father's problems... we will investigate and help you, and show you
your limits... your possible obsessions and compulsions... and sometimes we may help you to be
delivered
from all old traumas,
and live in a more happy way, only if you ask us to
try to do so. Each CD
situation is personal, and very
different from the others.
If you are an intersex living some intergender reality, and want to do body changes to achieve perfect
harmony, we may try to help you. If you are satisfied with your body, after our identity tests we have nothing
more to help you.
Is Gendercare diagnosis expensive?
Surely it is much
less expensive than months or years of face-to-face therapy. Our method is straight... we
soon discover who you are, and why you are who you are!
And after diagnosis, what we may do for you?
If necessary, for transsexuals and transgenders, after the evaluation we may start a
transition and hormone therapy... see our TransPack.
That hormonetherapy is always based also in your local health and medical support,
for clinic analysis, some
prescriptions and overall health care.
If you had a strong trauma (crossdressers), we will help you and suggest you local ways
for
support, as art therapy experts, occupational therapy, allways based in your culture,
country
and local
resources.
Do you need necessarily 2 years of hormonetherapy
and transition before a MtF or FtM
SRS reassignment surgery?
As HBIGDA members we may say you:
Not necessarily
....that depends on your body, your age, your particular condition.
If you are a transsexual, MtF or FtM....we will help you suggesting surgeries,
technologies, experts in different countries. That will
depend on your age, your existential and social needings and your overall
possibilities.
For MtF SRS we may refer you through our referral letters
to Dr.Suporn in Thailand; Dr.Preecha, Dr.Kamol or Dr.Kunaporn also (those Thai surgeons have,
mainly Dr.Suporn, in
our point of view, the best MtF SRS technologies for young and middle aged
people, and are not so expensive as USA and Europe surgeons)....that depends on you
and what
you expect from the reassignment.
Important NOTE:
Dr.Suporn's MtF SRS is almost perfect. The neoclitoris is fully sensible and
orgasmic... the channel is deep and operational... all is fully operational... the only
problem is the needing of forever dilate the channel, because of possible stenosis
(the channel closure). For young and midle aged patients, dilation forever may be a
pleasure and not a problem.
Brazilian surgeons, as
Dr.Jurado
(he developped in our point of view, the best MtF SRS surgeries
for mature people... his technique is not well knew in USA, Europe and Thailand up until now)
have sometimes also special habilities and solutions.
Important NOTE:
Dr.Jurado's MtF SRS is not so perfect... it remains not an orgasmic and sensible
clitoris, but the sensibility and orgasm possibilities are preserved in the botton
of the vagina (the glans penis with all nerves and vessels are preserved inside the
vagina, at the botton).
For a young and middle aged woman, the perfect esthectics of Suporn's, and the
functionality is so important... but Jurado's surgery doesn't colapse, there is
no stenosis, and no necessity of forever dilation, after 3 months of good dilation after the surgery!
That is very good for mature women! You may live as any other mature women...
with no special need of dilation, relations, etc..
Jurado has presented his surgery now, at Ghent during the HBIGDA Biennial Symposium in Belgium... and I hope
talented
surgeons could understand his technique, because his English is not so good...
and his technique needs a talented surgeon (during an 1999 meeting in Brazil, about
intersex and gender dysphorias, Jurado presented
his technique in Brazil, and Dr.Dalrympole from London, UK was there, and also myself,
and he told me he thought it would be impossible to do what Jurado does... but he does,
and it
work fine... but needs a talented surgeon).
For FtM transsexuals, we may suggest mastectomy through peri-areolar, lipoaspiration, T
incision or double side incision... ovariectomy and hysterectomy ... and later a vaginectomy and SRS through a
metaidoiplasty
(the relocation of the corpora of the inside clitoris, more to the outside,
and complementations for a small neophallus creation --- an erectile, orgasmic and fully
sensible
micropenis --- Dr.Meltzer in USA and Menard/Brassard in Canada have great results)
or another kind of neophallus creation (bigger but not so functional)... etc..
We may refer surgeries
all around
the world, for any desired chosen surgeon.
Decide NOW! Start your diagnose and treatment!
In a couple of months you may be surely diagnosed, about any kind of gender dysphoria.
Don't loose more time! Start it now! See our PRICES HERE.... we accept all credit
cards, thru Clickbank & Paypal. We accept also cash through Western Union. Our prices are determined in US$, and you
may pay through your
local currency ... Clickbank calculates the exchange rate for you, so you pay in your
currency and we receive in US$.