Gender

[GrandizerII]

It's been my understanding that no test is diagnostic for clinical depression and that as a result, self-reporting is the primary tool.

As far as I know there's no definitive test. Most diagnosing takes place through interviews, as I said. 

The fMRI differences are detected in patients who have already been diagnosed, but in practice this is far more than self-reported feelings. Severe cases exhibit certain kinds of behavior which can be observed independent of self-reporting. 

The kind of severe withdrawal and anhedonia one sees don't seem like choices that one would make. They do allow experienced diagnosticians to say that a person self-reporting as severely depressed does not show the indications of depression, and the doctors should consider treatment accordingly. It would be bad to misdiagnose something and give it the wrong treatment. 

There's evidence that there are objective markers for gender and while we don't currently have the ability to determine gender scientifically, that doesn't mean that it isn't objective; that would be an appeal to ignorance.

It will be interesting to see what gets discovered in the future. I remember when they started mapping the genome a lot of people were talking about a "gay gene," and of course things turned out to be not so simple. 

Maybe there will be objective tests which will allow doctors in the future to tell self-reporting individuals "no you're wrong." I wonder what people who are confident in their self-report will do when the objective test tells them that their gender identification is incorrect. Will we continue to support their choices? Or will we tell them that they will not be allowed to transition based on these tests?

Not sure how this would work if it seems like gender is partly determined by how one identifies themselves as in relation to the society that they're in. Both science and observation have ruled out genitals or sex chromosomes as being the absolute definitive markers for gender. Clearly, there is something else beyond genitals or sex chromosomes, even if we don't know definitively what the exact criteria for being a man or woman are.

Also, since I see depression is being brought up here, this brings me to a very pertinent point here. There is very often no one sole combination of criteria that dictates whether one warrants a diagnosis of a particular psychiatric disorder. Often times, you only need to meet a minimum number of symptoms listed in the DSM (or whatever other official source of diagnoses being used) to then be diagnosed with that disorder. And this means two different individuals could meet different criteria for a depressive disorder and still both be rightly diagnosed with the same thing.

I suspect it's like that with gender as well. Someone who identifies as a man might not have a penis, but if they meet enough of the other criteria for being a man (whatever these criteria may be), then they shouldn't be precluded from being considered by society as a man.