The Clarke Institute of Psychiatry: Canada’s shame (1998)

©1999, 2013 by Dallas Denny

Source: Denny, Dallas. (1998, 13 April). The Clarke Institute of Psychiatry: Canada’s shame. Transgender Forum.
 

 

 

 

 

The Clarke Institute of Psychiatry

Canada‘s Shame

By Dallas Denny

 

Most of Canada’s transsexuals have had dealings with the Clarke Institute of Psychiatry. That’s because The Clarke, as it is called, is the only institution able to authorize sex reassignment surgery under Canada’s public health system. Canada has other official gender programs, including an excellent clinic at VancouverGeneralHospital, but it’s The Clarke, down and dirty, for those who want surgery. Whether they live in Alberta or the Yukon or Newfoundland, the transsexuals of Canada have no recourse to The Clarke.

The problem with this is that The Clarke is a Jurassic Gender Clinic [1], an anachronism. It is a national embarrassment, a holdover from the dark ages of the early gender clinics, when transsexuals were treated with contempt and impunity—a place which should be censured rather than licensed as Canada’s ultimate experts on transsexualism—for, you see, despite its opinion to the contrary, The Clarke in fact knows very little about transsexuals or transsexualism, and most of what it does know is wrong.

The faculty of The Clarke has published widely on gender identity “disorder;” they are responsible for three textbooks and hundreds of journal articles, most of which are seriously screwed up. And not only has The Clarke succeeded in filling the literature with bad science—it has been successful in overriding the voices of less paleolithic professionals and bullying its views into the DSM and the Standards of Care of the Harry Benjamin International Gender Dysphoria Association.

Susan Bradley of The Clarke was Chair of the DSM-IV Subcommittee on Gender Identity disorders; Ray Blanchard and Ken Zucker of the Clarke were also on the Subcommittee. It’s because of their influence that the DSM continues to link gender identity with sexuality, requiring one’s sexuality be stated as part of the diagnosis. Any transsexual or transgenderist will tell you this is nonsense. The situation with the forthcoming Harry Benjamin Standards of Care is much the same. Maxine Petersen of the Clarke, who is a member of the SOC Committee, has steadfastly insisted that the SOC include one of The Clark’s hard-and-fast policies: mandatory real-life test before initiation of hormonal therapy. The politics of the SOC Committee have been such that her voice has prevailed, even though the majority of the Committee members are opposed. Consequently, the criteria for getting hormones will almost certainly be increased over previous versions of the SOC, requiring either RLT or extended psychotherapy in addition to the 90-day period currently in effect.

HBIGDA, knowing how controversial this is, has decided not to have the new SOC validated by vote of the membership, as with previous versions, but by approval of the HBIGDA Board of Directors.

If these Clarke-influenced Standards of Care are in fact approved, it will be a devastating blow for HBIGDA, for the SOC will not in fact be the consensual standards they have been until now, but an edict from The Clarke. Many and perhaps most counseling professionals in North America won’t follow the SOC procedure for hormones. The American Educational Gender Information Service, Inc., after consultation with its Board of Advisers, has taken the position that it is unethical to require a transsexual to cross-live in order to qualify for hormonal therapy. Wide distribution of the AEGIS position will make professionals aware of the ethical difficulties of abiding by the new SOC. This does not bode well for HBIGDA, an organization AEGIS and the rest of the transgender community has hitherto supported.

The folks at The Clarke consider there is something seriously wrong with us genderfolk. This assumption colors not only what they write about us, but everything they do regarding us. In particular, it has led to serious mistreatment of transsexuals. Pick a transsexual in Canada—almost any transsexual—and you’ll hear of such mistreatment. The Clarke is especially famous for bullying transsexuals into lifestyles and identities they would not choose for themselves. One woman was forced to resign her job as a mechanic for an airline— a job she really liked—and retrain in a traditional “female” occupation. She is now a nurse. Another woman was required to change her name—her first name was Lonnie, her middle name Dale—to one more traditionally “female”—LuAnn. Other women are forced into divorce. FTM transsexuals fare no better, having to be G.I. Joe to the MTFs’ Barbie. In its literature, The Clarke writes about “suggesting” lifestyle changes to transsexuals, but it’s not suggestion at all. It’s coercion, pure and simple, for those who refuse to abide by The Clarke’s “suggestions” are kicked out of the program—and there is no other authority in Canada which can authorize SRS under the health care system.

The literature The Clarke has produced is seriously hampered by its view of transsexuals as piteous creatures, full of psychopathology. Whether our mommies made us do it or whether its in our genes, the folks at The Clarke have no doubt that transsexualism is a mental disorder. They have never questioned the Benjamin model of transsexualism, which means only one thing—they have never taken the trouble to really get to know transsexuals—and of course they have no idea that for every transsexual there are a dozen or more transgenderists. The Clarke turns transgenderists away or forces them to pretend to want surgery in order to get hormonal treatment.

In an era in which the theoretical underpinnings of transsexualism are being re-examined, The Clarke continues to cling to old models. That makes them obsolete, Flat Earthers in the gender world, indeed a Jurassic Gender Clinic.

The Clarke represents neither the state of the art nor the majority opinion of professionals in Canada. It has a long history of abusing and manipulating transsexuals. It does all it can to humiliate, delay, and discourage those who seek sex reassignment, and forces those who endure to become sexual stereotypes. The Clarke is, in short, an embarrassment. It is even more embarrassing that Canadian authorities continue to empower the Clarke to make all of the country’s decisions about SRS. It is a national disgrace.

 

Note

 

[1] At a panel discussion at Southern Comfort—it might have been the one listed below in the references, but I believe it was three or four years earlier— several of the panel members were talking about the Clarke. Someone in the audience asked, “What is the Clarke?”

I looked at fellow panelists Anne Bolin and Jason Cromwell and took the lead. “It’s sort of a Jurassic gender clinic,” I said. A wave of shock and appreciation went around the room, and since then it’s been the Jurassic Clarke.

 

References

 

AEGIS. (1998, February). Mandatory real-life test before hormones: Unethical. Transgender Treatment Bulletin, 1(2).

Bolin, A., Denny, D., & Seven, M. (2007). Trans-modified: Society and bodies. Panel presentation at Southern Comfort Conference, 13-16 September, 2007, Atlanta, GA.

Bradley, S.J., Blanchard, R., Coates, S., Green, R., Levine, S.B., Meyer-Bahlburg, H.F.L., Pauly, I.B., & Zucker, K.J. (1991). Interim report of the DSM-IV subcommittee on gender identity disorders. Archives of Sexual Behavior, 20(4), 333-343.

Denny, D. (1992). The politics of diagnosis and a diagnosis of politics: The university-affiliated gender clinics, and how they failed to meet the needs of transsexual people. Chrysalis Quarterly, 1(3), 9-20.

Denny, D. (1997). Letter to SOC Revision Committee. AEGIS News, 1(13).

Levine, S., et al. (1997). Draft 8 of the Standards of Care Proposed Revisions. HBIGDA SOC Revision Committee.