The Breast Binding to Mastectomy Pipeline
And how Rapid Onset Gender Dysphoria looks an awful lot like Obsessive-Compulsive Disorder
Today’s blog post started off on X. Find & share it here.
To better understand what Stella O’Malley and Alasdair Gunn point out here about the harms of breast-binding, we need to understand the link between thoughts, feelings, & actions — and why modern gender dysphoria is a whole lot like Obsessive-Compulsive Disorder.
Every day we each experience thousands of thoughts, feelings, & actions. Cumulatively, these can move us toward or away from mental & physical wellness, or any particular goals we may have.
Thoughts/Feelings/Actions can all influence each other in any direction. We may Feel angry or anxious, & have a lot of accompanying Thoughts to back up why a given situation warrants that emotion; but we can also choose to indulge those interpretations, or challenge them;
And we can choose Actions that give in to unhelpful patterns of thinking & feeling, or Actions that move us in a healthier direction.
Example from my daily life:
I Feel anxious when I check email, because sometimes I receive stressful messages; I've learned to anticipate them.
I can choose to give into Thoughts about worst-case scenarios & unfavorable interpretations of words lacking in social context & nonverbal cues, or I can deliberately contradict that tendency with grounding principles such as: make no assumptions, take nothing personally, etc.
Perhaps more importantly, I can choose my Actions. Were I acting purely on emotion, I might avoid dealing with email, or react presumptively, doing more harm than good. What ultimately matters in the long run is: do I check my email & respond to important messages appropriately?
By checking my email & responding to important messages appropriately, rather than reactively, I take deliberate action that moves me forward in business & relationships. I do not let my Feelings or automatic negative Thoughts control me or guide the outcomes of my future.
Dialectical Behavioral Therapy (DBT) offers the principle of Opposite Action. Sometimes, we need to learn to do the opposite of what our emotions would compel us to do.
Tempted to yell at someone? Take a walk & cool off instead.
Tempted to avoid Doing The Thing? Do The Thing.
Tempted to self-soothe with ice cream or alcohol? Do burpees & crunches instead.
Tempted to self-sabotage with self-destructive behaviors such as cutting or acting out sexually? Instead practice restraint, gratitude, meditation, artistic expression or goal-directed activity.
A healthy life doesn't require us to exist in a perfect state of Zen at all times. It simply asks that we choose meaningful Actions congruent with our values, most of the time, regardless of how we feel.
Over time, these Actions in turn shape how we feel, think, & see ourselves.
Virtue begets virtue. By acting generously, we become generous. As we practice patience, forgiveness, restraint, humility, charity, levity, temperance, & so on, our virtuous actions help mold us into more virtuous characters. It doesn't have to begin with "feeling like it."
So, what does all this have to do with breast-binding, gender dysphoria, or Obsessive-Compulsive Disorder? I'm getting there.
Almost all self-destructive cycles, such as addictions, compulsions, & fixations, begin with an uncomfortable Feeling, accompanied by a belief that one is helpless to control or tolerate that Feeling unless they give into such-and-such way of Thinking & Acting.
This is how OCD develops. Uncomfortable Feeling (such as anxiety, anger, or uncertainty), combined with an underlying belief that one cannot tolerate or cope with this feeling in any other way but to give into the compulsion to take Action X to mitigate that Feeling.
Someone with normal human anxiety, but not OCD, may occasionally worry that they left the stove on or touched something gross, but can usually mitigate this with a simple, "no, I'm pretty sure I turned it off," or "I washed my hands once already; that's enough."
Someone with OCD, on the other hand, allows that anxiety to spiral out of control, as well as the Thoughts accompanying the feeling, & they cave into the compulsive Actions they're tempted to take to mitigate the distress. This cycle repeats 1000's of times over, forming habits.
It is well established that OCD is especially prevalent in those on the Autism spectrum. So is gender dysphoria. 🤔
Now let's examine the links.
It's normal to have distress about one's developing body during puberty, especially if one has been subjected to sexual harassment or assault; mockery or body-shaming; exposure to pornography; or unrealistic beauty standards.
Unfortunately, this kind of distress is nothing new.
What's new, however, is how youth are dealing with that Feeling: the Thoughts & Actions they've been introduced to as ways of coping, by their peers, social media, the culture at large, & worst of all — by adults who are supposed to protect & nurture them.
This generation has been taught to mentally fixate their Thoughts on the idea that they're in the wrong body, or have a separate gender identity for their sex, or would be better off as the opposite sex... or that any of this is even possible & worth ruminating over.
And they've been taught that there are Actions one can & should take in an attempt to indulge these ruminative Thoughts & mitigate these distressing Feelings. The Actions are never-ending:
-everything pertaining to pronouns
-breast-binding
-tucking
-pursuing medical interventions
So rather than Feeling embarrassed, Thinking "ugh, these new breasts are so weird," leaving it at that, & then doing some unrelated Action to get her mind off of it — like playing a game, or instrument, or practicing her French, or going out with a friend, or climbing a tree...
...Today's young woman can ruminate endlessly with a variety of obsessive Thoughts introduced to her by peers/media/influence, & become fixated on the idea that only a certain set of Actions, pertaining to "transitioning," will alleviate her distress.
So she wants a binder. She Thinks THIS is what's going to make her Feel better.
And every time she chooses to fixate mentally, & bind her breasts as the Action corresponding to the Feeling of awkwardness, she reinforces the cycle, forming habits — just like with OCD.
Thoughts of being "trans" become a mental obsession. Breast-binding, or whatever the trans-related Action du jour may be, becomes the compulsion.
The ability to differentiate between Thoughts, Feelings, & Actions, or to see other options for how to cope, becomes diminished.
But of course, breast-binding does NOT alleviate distress as promised. Binding creates a literal feeling of pressure in the chest, which is almost indistinguishable from anxiety.
So binding reinforces the OCD-like pattern in multiple ways:
-It reinforces the sense that one must take this particular compulsive Action in response to various Thoughts & Feelings.
-It re-creates the physical sensations associated with anxiety, worsening the distress.
Binding also makes breasts look deformed over time, worsening a girl's discomfort with her appearance. She doesn't look any closer to male, but she's also looking like a less ideal female. Overall distress becomes heightened; the obsessive Thoughts & compulsive Actions worsen.
As this cycle becomes more distressing, & she's dealing with the daily discomfort of physical pressure in the chest (=anxiety), because she's already established a pattern of giving into a particular set of Thoughts & Actions related to "being trans" as a way of coping...
...naturally the next step is clear: dig her heels in deeper, make the commitment, take the plunge: radical elective double mastectomy.
