Gender Expression Deprivation Anxiety Disorder (GEDAD)

[joannatsf]

I found this article by accident this morning while researching something else.  It's a bit long but the ideas it presents are consistent and in line with my own experience as a gender variant person.  It's also hopeful that our fender issued can be resolved.

The Gender Variant Phenomenon--A Developmental Review, Anne Vitale, PhD.


ABSTRACT

Living in conflict with one of the basic tenets of existence (Am I male or am I female?) is understandably anxiety provoking. This fact leads me to suggest that Gender Identity Disorder as this conflict is described in the DSM IV, is not an appropriate descriptor. I suggest here as I have elsewhere (Vitale, 1997, 2001) that instead the condition be termed Gender Expression Deprivation Anxiety Disorder (GEDAD). After explaining my thinking on gender expression deprivation anxiety, I will describe how this anxiety, if left untreated, is manifested in each of the five developmental stages of life: confusion and rebellion in childhood, false hopes and disappointment in adolescence, hesitant compliance in early adulthood, feelings of self induced entrapment in middle age, and if still untreated, depression and resignation in old age.

[Beyond]

I found this article by accident this morning while researching something else.  It's a bit long but the ideas it presents are consistent and in line with my own experience as a gender variant person.  It's also hopeful that our fender issued can be resolved.

The Gender Variant Phenomenon--A Developmental Review, Anne Vitale, PhD.


ABSTRACT

Living in conflict with one of the basic tenets of existence (Am I male or am I female?) is understandably anxiety provoking. This fact leads me to suggest that Gender Identity Disorder as this conflict is described in the DSM IV, is not an appropriate descriptor. I suggest here as I have elsewhere (Vitale, 1997, 2001) that instead the condition be termed Gender Expression Deprivation Anxiety Disorder (GEDAD). After explaining my thinking on gender expression deprivation anxiety, I will describe how this anxiety, if left untreated, is manifested in each of the five developmental stages of life: confusion and rebellion in childhood, false hopes and disappointment in adolescence, hesitant compliance in early adulthood, feelings of self induced entrapment in middle age, and if still untreated, depression and resignation in old age.

6 months ago I would have been really receptive to this concept.  And in a way I still am.  However, the twin devils of Zucker and Blanchard and their goal to keep us enslaved and pathologized has made me leary of remaining in the DSM at all.  I think the time has come to take off the shackles and reclaim our personhood and civil rights.  I am not "disordered" and I am not a lab animal.  I am a human being and I deserve respect.  I didn't choose to be born this way, I just was.  Instead of pathologizing me with their pet junk science theories, the medical community should be helping me achieve wholeness.  People have been medically transitioning for over 50 years in ever increasing numbers.  Transition is the ONLY proven treatment for transsexualism.  The problem is society and it's angst over matters of gender and sexuality (they confuse the two), not us.

We need to continue making noise.  We need to continue being ourselves.  Progress is being made, people are becoming educated.  Zucker and Blanchard will eventually be relegated to the dustbin of history, like Dr John Money previously.

We will triumph.

[Seshatneferw]

6 months ago I would have been really receptive to this concept.  And in a way I still am.  However, the twin devils of Zucker and Blanchard and their goal to keep us enslaved and pathologized has made me leary of remaining in the DSM at all.

Note, however, that what Vitale describes as a psychological disorder is not the same as the old GID. Instead, she's essentially saying that the Benjamin syndrome (no need for 'Harry' here, other syndromes use just the surname too), a physiological issue, often clashes with our society in a way that results in psychological problems. Also, Benjamin's is physiologically a benign condition (there's nothing wrong with either the brain or the rest of the body, they just don't match), so it needs no treatment unless it causes severe enough anxiety. Mostly it sounds good, although she kind of glosses over the anxiety that results directly from the mind/body mismatch and concentrates a bit too much on gender expression.

  Nfr

[Beyond]

Note, however, that what Vitale describes as a psychological disorder is not the same as the old GID. Instead, she's essentially saying that the Benjamin syndrome (no need for 'Harry' here, other syndromes use just the surname too), a physiological issue, often clashes with our society in a way that results in psychological problems. Also, Benjamin's is physiologically a benign condition (there's nothing wrong with either the brain or the rest of the body, they just don't match), so it needs no treatment unless it causes severe enough anxiety. Mostly it sounds good, although she kind of glosses over the anxiety that results directly from the mind/body mismatch and concentrates a bit too much on gender expression.

I understand all that.  However, how many times have you read somebody attacking us saying "It's a serious mental illness.  It's in the DSM!" ?   Second, we need to send a message to the greater psychiatric community that they can't turn a blind eye to what Zucker and Blanchard are doing.  That they are accomplices to the stigmatization we suffer and the reparative therapy (that they have denounced) being practiced on gender variant children.  The psychiatric community is violating their Hippocratic Oaths.  They continue to do us harm, by embracing Zucker and Blanchards junk science, and ignoring both the hard science being done in the last 20 years and the incredible success transition is for the great majority of us.  Riki Wilchins was right when she said that the APA has it's own disorder: "GenderPathoPhilia".  In her book "Transgender Emergence" Arlene Lev has a whole chapter called "Diagnosis and ->-bleeped-<-: The Creation of Pathology".  It makes for sobering reading.  And just so you know, this book was not written for rebellious purposes.  It was written by a therpist for therapists.  It's subtitle is: "Therapeutic Guidelines for Working with Gender-Variant People and Their Families".

[joannatsf]

Anne itale is very supportive of gender variant people.  She makes that case much better than I can so here's what she says.  I can fully support her conclusions in the final paragraph.

I am a Licensed Psychologist (California #PSY15764) specializing in working with individuals with crossdressing and other gender identity concerns. I am a long standing member of the World Professional Association for Transgender Health (WAPTH) (formerly known as Harry Benjamin International Gender Dysphoria Association (HBIGDA)) and a founding member of the Bay Area Gender Associates, a peer supervision and consultation group.

My therapeutic orientation is Existential-Humanist. Essentially that means I place great emphasis on the current conditions of the client's life. It is impossible to fix the past. Only the present can be modified and made workable. Further, as an Existential-Humanist, I expect my clients to take full responsibility for their lives. This is especially important when one is discussing the possibility of changing one's sex. I am firmly committed to working within the limits of flexibility described in the WPATH/HBIGDA Standards of Care. My experience in the area of gender issues is extensive, dating back to my graduate studies in 1978. I estimate that I have worked with over 450 individuals since then.

Although I am qualified to work with a wide range of psycho therapeutic issues, I have come to understand that when working with my gender clients, my function is often simply that of being a knowledgeable guide. Ultimately, only the client can know the rightness or wrongness of gender transition. In my experience, most people who present with gender issues are responsible, capable and intelligent people. I see no reason not to take advantage of those abilities when helping my clients resolve their gender issues.

[Beyond]

Anne Vitale is very supportive of gender variant people.  She makes that case much better than I can so here's what she says.  I can fully support her conclusions in the final paragraph.

I know about Anne Vitale, I read some of her stuff while transitioning.  The problem is she isn't a member of the DSM working group, Zucker and Blanchard are.  And the fact they were chosen at all shows you how much the psychiatric community as a whole (dis)respects us.

[Kate]

I'm just not thrilled with the "expression" part of "Gender Expression Deprivation Anxiety Disorder."

I was never all that deprived of expression; rather, I was deprived of being a female, and of people seeing me as a *literal* female (I sorta had the social aspect of it in may ways already).

"Expression" makes it sound like my anxiety was about not being able to dress up, wear makeup, and do "girly" things. That old distinction again about how my drive was to be *female*, with being "feminine" as a consequence of that, and not a driving goal or need.

~Kate~

[NicholeW.]

I think the thing we all are going to have trouble recognizing here is that Anne Vitale, Arlene Lev, Randi Ettner and other positive professionals do not/have not seen us from 'the inside out.' They hear what we experience, but I'm still convinced that only when numbers of people realize that their bodies and brains are congruent and their 'gender-identity' is so natural they simply have never thought they had one that they will have a dawning of understanding about us.

They mean well. AFAIC(oncerned) they are on the side of the angels. That we parse their words and find places we disagree with this and that is natural as well. Our experience and what we know comes from a different place than do theirs.

I think we have an obligation at some point to help refine and clarify some of their theories if they are willing to allow us to do so. The medical-model is a hard thing in that regard, however. It places the professional in the authoritative position, even an Existential-Humanist one like Vitale. When added to always living with brain and body congruent it makes it more difficult for them to completely feel and understand where most of us come from.

I think we need to praise and encourage such people though because they do support us. I think their theories often go wrong at certain points. But the stickling that they totally understand where we each, or the whole group, are in relation to their writings shouldn't be used by us to undermine their attempts. Those are worthy and positive.

If they don't get me 'down pat' then they don't. At the least they are making good attempts and that, for me, is an aspect of these writings that we have to keep to the fore for ourselves. We need to soften some of our critiques with the knowledge that there are many good psychologists and psychiatrists of good will who truly wish to affirm us.

Nichole

 

[joannatsf]

I believe that GID is not a disorder and as Dr. Vitale states, "Ultimately, only the client can know the rightness or wrongness of gender transition. In my experience, most people who present with gender issues are responsible, capable and intelligent people."

Unfortunately, we live in a society that does not offer universal health coverage and in a socio-political environment that is hostile to transgender people and their needs.  Those of us that are higher up the socio-economic ladder have access to the resources necessary to transition.  Those who are not so privileged will require coverage from increasingly pliable health insurance providers.  In order to get the needed coverage the providers need to believe there is pathology associated with our condition.  GEDAD as an anxiety disorder has far less stigma attached to it than than a psycho-sexual disorder.

Is ->-bleeped-<- a disease?  Nick Gorton, MD, a transman, makes a compelling argument for it in his paper Toward a Resolution of GID, the Model of Disease, and the Transgender Community

The question whether ->-bleeped-<- is a disease is hotly debated in both the medical and transgender community. This paper seeks to reconcile this question by defining disease, examining the moral meanings of classification as a disease, and with this model clarifying both what is meant by treatment and whether the state of being transgender is in fact a disease.

Disease: A clinically significant adverse effect or experience for an organism due to an interaction between one or more biological traits of that organism and the environment in which it resides.

This definition recognizes the fact that abstracted from its environment, whether a given genotype or phenotype is a disease cannot be accurately determined.

read on...

[mickie88]

ok, i read the whole thing, where is Blanchard mentioned? all i see is Susan  Bradley


Warrior Princess Mickie