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For the first time in almost 20 years, the American Psychiatric Association (APA) is rethinking how transgender people are diagnosed. And the discussion that’s currently taking place could put an end to terms that suggest being transgender is a disorder.
Up until now, a biological male who identifies as female or a biological female who identifies as a male (or even someone who is non-conforming) are considered to have “Gender Identity Disorder.” Advocates have long argued that the category creates stigma in an already stigmatized community, much the same way as when the establishment once deemed homosexuality to be a disease in 1973. After much protest and debate, it was eventually removed from the list of disorders in 1987.
The AP is reporting this week that because the association’s newest edition of the Diagnostic and Statistical Manual of Mental Disorders is set to be printed at the end of 2013, it creates an opportunity to make changes to current content that’s been in use since the latest edition was published in 1994. We all know attitudes have changed since then in regards to both gay issues and gender identity. A change in how people are classified could signal progress when it comes to not only recognizing gender differences at an earlier age, but providing counseling from childhood into adulthood and through the transition process at any age.
The APA says “Gender Identity Disorder,” as its known, could be renamed “Gender Dysphoria.” But as with any shift in culture, questions pervade about whether the new definition effectively describes the transgender experience as it relates to culture today, and what a new classification could mean both inside and outside the medical community.
The APA’s been fairly proactive in developing its own resolution on transgender, gender identity and gender expression nondiscrimination in recent years:
- Support of legal and social recognition of transgender individuals consistent with their gender identity and expression.
- Support the provision of adequate and medically necessary treatment for transgender and gender-variant people.
- Recognize the benefit and necessity of gender transition treatments for appropriately evaluated individuals.
- Call on public and private insurers to cover these treatments.
And the association has already voiced support in favor of same-sex marriage and other LGBT rights initiatives, saying that a lack of equality causes psychological distress among LGBT adults and their families.
A change in the way transgender people are diagnosed could have similarly important political ramifications, especially in the workplace and when it comes to issues related to the courts, marriage and parenting.
Consider what happens when a trans woman, who is fighting for custody of a child she fathered when she was a biological male, must prove she is a fit parent now that she lives her life as a woman. As it stands today, a judge could rule that she suffers from a chronic mental illness and she could lose custody of the child, but if the APA rethinks the definition, a new legal precedent could be set that wouldn’t necessarily discriminate against someone based on his or her gender identity.
On the other hand, a new definition could open the door for arguments that might jeopardize cases in which transgender individuals are discriminated against. The APA’s current definition has been used by many LGBT legal associations for not only defending transgender persons against discrimination and crimes, but also in prosecuting individuals who inflict harm.
But in the same way the gay and lesbian community have managed to grow awareness well beyond the idea that being gay was once considered a disease, why shouldn’t transgender individuals have the same opportunity?
“a biological male who identifies as female or a biological female who identifies as a male”
The brain, skeletal system and endocrine system are every bit as “biological” as the genitals. Like the APA itself, defining gender solely by genitals ignores two decades of solid findings in neurology, endocrinology and developmental biology.
In 1995 Zhou et all published a tiny, rough study. They not only found a sex-dimorphic structure in the brain, but also found that it matched trans people’s self-identified rather than assigned-at-birth sex. Since then, Zhou’s study has been duplicated and greatly expanded by others. Approximately 300 studies have identified 20 or so such sites including those that contain your sense of Self (damage it and you have trouble knowing you from other) and the brain’s map of the body (useful for movement, or scratching an itch without looking). It’s the latter that is likely responsible for surgery providing relief to trans people who need it, as the brain “expects” the gender opposite the genitals (which develop at a different time, from different signals). Researchers have also mapped out the complex gene expression dance responsible as well as the timing, enough to induce the condition in rats in 2003.
So, while I applaud the APA for grudgingly modernizing their diagnostic manual, far too many pet theories (such as those pushed by Zucker, Bailey, Blanchard, etc.) that depend upon ‘nurture’ as the cause have been rendered irrelevant and would be viewed as quaint if not for the harm they induce. The champions of those theories, however, are the “researchers” that make up half of the DSM GID rewrite working group. They and the APA completely ignore findings from outside their field, ensuring another decade of at best, mistreatment, and at worse, outright harm to trans people from attempts to “cure” them.
One problem I see with the changing of the Wording for G.I.D. still puts Gender non-conforming men and women under a mental illness. The truth is, the only necessary intervention of mental health care givers is to help with the transition process between male to female or female to male. I quote a passage from the movie Trans-America “Isn’t it strange that gender surgery can cure a mental illness?” That statement is very true. The transgender male or female aren’t mentally ill and as long as the APA continues placing them under a mental illness status, then insurances will continue leaving surgery for the transgender men and women as elective surgery. Transgender men and women aren’t mentally ill, they have a physical illness that usually gender surgery will correct.
This is really sickening. Why is it that anyone at any level of ignorance is free to make comments about transsexualism? Secondly, why is it that transgender people should have GID from the DSM IV-TR because the homosexual community had homosexuality “depathologized”? Is it that whatever is good for the homosexual community is also the way to go for the transsexual community? Who said transsexual people are stigmatized because of the DSM IV-TR classification? Bullshit
We should take a moment and celebrate what is a big moment in LGBT history. However, with rampant depression, homelessness, addiction and overall poor health prevalent in the transgender community, we cannot celebrate but so much.
http://www.blackwiththeblues.com/2012/08/moving-forward-transgender-is-no-longer.html
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