 Acupuncture
in the Public Health Setting
Beth Sommers, MPH, LAc and Kristen Porter, MAc, LAc
The Dance of Yin and Yang: Transgender Health, Part
One
"Please bear in mind, however, that the concept of
yin and yang is relative and that it defines no clear-cut
antithesis understood to be absolutely active and positive
or absolutely passive and negative. Yin can exist within
yang, and yang within yin. The active and passive
principles are not merely an arbitrary division of energy,
but they are the actual interplay between the elements.
All, let it be remembered, is relative." - Mme. Dr. M.
Hashimoto1
In our work with Asian medicine, we develop a
professional understanding and respect for the ancient
concepts of yin and yang. Originally used to describe the
relation of light and shadow, as in the sun's course
through the heavens in the daily cycle, yin often
represents shade, the moon and the feminine principle;
yang is frequently interpreted as bright, the sun and the
masculine principle.
Just as the light of the sun shifts throughout the
course of the day, yin and yang are continually changing
and transforming into each other. The morning's sunny
slope becomes the shaded area of the afternoon; there is a
perpetual polarity of metamorphosis, a dialectic of
contradictions and solutions that results in the
unification of opposites. At the point of most extreme
night (viz. midnight), morning begins. At the moment the
tide is at its lowest ebb, the swell of resurgence
commences.
These concepts are rooted in the forces of nature,
which are ever-changing. Human beings, as part of the
natural world, also reflect the unending cycle of
antithesis and synthesis. Charlotte Furth2
writes about the "multi-valence" of yin and yang, which
provides a view of nature suffused with gendered
attributes that do not depend on the body for their point
of reference.
In this context, we are privileged to work with clients
who reflect the rainbow of gender identity. One of the
primary principles of public health is providing
accessible care to all people regardless of age, ethnicity
or gender. On a daily basis, gender is often associated
with a binary male or female system, such as bathroom
delineations; driver's license categories; and male or
female check-off boxes on survey forms. However, many
gender identities and presentations do not conform to this
limited categorization. Activists and advocates have
challenged this binary social construct of sex. The
resulting response has become a progressive social and
political movement. As this article is completed for
print, even the national publication People
magazine highlights its first mainstream article about
transgenderism.
"Transgender" is an umbrella term to describe a person
who cannot or chooses not to conform to societal gender
norms associated with their physical sex.3
Transgender persons live their lives to varying degrees as
their chosen gender and may self-identify as female; male;
trans-women or trans-men; nonoperative transsexuals;
preoperative transsexuals; transsexuals who have completed
surgical sex reassignment; transvestites or
cross-dressers; and drag queens or kings, among others. A
person's sexual identity is not relevant to this issue.
Intersexuality (formerly called hermaphroditism)
involves a set of medical conditions that feature
congenital variations of the reproductive and sexual
systems. Intersex people are born with "sex chromosomes,"
external genitalia, or internal reproductive systems not
considered "standard" for either male or female. The mere
biological existence of intersexuals has challenged the
social construct the binary gender system has
traditionally reinforced.
A transsexual is a person with an apparently normal
somatic sexual differentiation who has the conviction he
or she is actually a member of the opposite sex.4
The ICD-10 (International Code of Diagnoses) cites three
criteria for this diagnosis: the desire to live and be
accepted as a member of the opposite sex, usually
accompanied by the wish to make his or her body as
congruent as possible with the preferred sex through
surgery and hormone treatment. This identity has been
present persistently for at least two years, and is not a
symptom of a mental disorder or a chromosomal abnormality.
A transvestite is defined by the ICD-10 as an
individual who wears clothing of the opposite sex to
experience temporary membership in the opposite sex. There
is no sexual motivation for the cross-dressing, and the
individual has no desire for a permanent change to the
opposite sex.
The second part of this series will be published in the
July 2003 issue.
A concluding announcement: We hope readers will
join us in Boston November 15-16 for the 10th annual
meeting of the Society for Acupuncture Research (SAR).
Acupuncture professionals from around the country will
provide presentations on clinical and physiological
research and evaluation, as well for discussions on
emerging trends in our profession. Abstracts are due June
30, 2003. Please check SAR's Web site (www.acupunctureresearch.org)
for further details.
References
1. Mme. Dr. M. Hashimoto (ed.) Japanese Acupuncture.
Dr. P.M. Chancellor. New York: Liveright Press, 1966.
2. Furth C. A Flourishing Yin: Gender in China's
Medical History 960-1665. Berkeley: University of
California Press, 1999.
3. Gender Education and Advocacy. Gender Variance: A
Primer. 2001.
www.gender.org.
4. Gooren L. An appraisal of endocrine theories of
homosexuality and gender dysphoria. In: Sitsen JMA (ed.)
Handbook of Sexology, vol 6. Amsterdam: Elsevier
Science Publishers, 1988, pp 410-424.
Beth Sommers, MPH, LAc and Kristen Porter, MAc, LAc
Boston, Massachusetts
bsommers@pathwaystcm.org
kporter@pathwaystcm.org
www.pathwaystcm.org
Editor's note: If you would like to comment on
this article, please contact Acupuncture Today by
fax (714-899-4273) or e-mail (Editorial@AcupunctureToday.com).
You are also encouraged to discuss Ms. Porter and Ms.
Sommers' article on their "Talk Back" forum at
www.AcupunctureToday.com/columnists/portersommers.
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