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How and Why to Take “Gender Identity Disorder” Out of the DSM

Started by Shana A, August 13, 2009, 10:03:26 PM

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Shana A


How and Why to Take "Gender Identity Disorder" Out of the DSM
Human Bodies

Alice Dreger
06/22/2009

http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=3602

As a wizened gender rights advocate, I know better than to assume the activists making the most noise are actually representative of "the community" they insist they represent. So, while American transgender activists have lately been fairly unified and very vocal about the need to remove "Gender Identity Disorder" (GID) from the Diagnostic and Statistical Manual of Mental Disorders (DSM), I know that not all trans people agree.

Medicalization is, after all, a complex experience. Even while being labeled as "mentally disordered" can be a stigmatizing experience, it is also the case that the inclusion of GID in the DSM has functioned to provide financial and institutional support for medical, surgical, and psychological care for some transgender people.

This is not true in most of the United States, but is true in more progressive places around the world, like Canada and the Netherlands. Having GID in the DSM may also, to some extent, legitimize the transgender experience as a "real" one for people who think a transgender person should just "get over" the feeling that the gender label assigned to them was the wrong one.
"Be yourself; everyone else is already taken." Oscar Wilde


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Steph

Lemme see if I can do this without imploding...  For the most part I agree with your take on the essay Nichole.  Whew! that wasn't so hard  >:-)  It's one of the better one ones that I have read as well, however I didn't come away with your feelings on the "Double-edged sword" bit as much.

That nasty term "Mental Disorder"!  After all most, if not all of us would say that we are quite normal. :) I personally feel that "We" should be classified in the DSM for most of the reasons the author outlines and wonder if being classed under a term such as "Gender Disorder" be more palpable?

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sd

I agree it should be removed, however some should be left in regarding G.I.D.

Instead of G.I.D., maybe gender identity based depression. Treatment consists of working through personal issues to treat symptoms while the medical community corrects the cause of the problem.

QuoteAfter all most, if not all of us would say that we are quite normal.
Some of my friends say other than being born in the wrong body, I'm so normal it's scary.
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metal angel

Another thread i was in tangented into this and got kinda ugly.

I think the DSM needs some categories of normal variation maybe? Remove the stigma from being in the DSM and provide some useful notes on subcategories of the population that do not have a mental illness AS SUCH but who have personality or behaviour traits which might affect their treatment for other problems, or who's other conditions may cause mental distress. (Actually, if anyone can find a copy of the DSM see if there are entries for destress caused by other medical conditions?)

There is definatey something to gain by having a clear definition of your difficulties somewhere which is readily recognised: access to treatment free of charge in areas with a good public health system, protection from being told to "just get over it", protection form discrimination, you could get your treatment time off as sick leave from work rather than your holiday time etc.

Also i don't think you shold panick about whether your disorder is mental. There is a problem of stigma asociated with mental illness and eccentricity, but just vehamently claiming that your dificulties are not a mental illness doesn't really solve that. It's kind of an every-minority-for-themselves approach in which nobody wins.

There have been a lot of comparisons made to homosexuality which i don't think are valid. Homosexuals do not seek any medical intervention, and there is no evidence that they benifit from medical or psychological intervention. The issue with removing homosexuality from the DSM was about whether or not it was an illness at all, not about whether it was a mental illness.

Many, and possibly most, transexuals identify their dificulties as a medical condition, and seek medical treatment (surgery, hormones, etc.). So if you are happy to have it identified as a medical condition, then it is logical for it to be mentioned in comprehensive texts of conditions affecting all the systems it seffects. A comprehensive text book of genital surgery would describe SRS; a comprehensive text book of mental conditions (the DSM) should describe the mental destress caused by GID.

Post Merge: August 28, 2009, 01:26:40 PM

Can someone find a copy of the actual enrty in the DSM, i think i have access to it through my uni's library but i have forgotten how to get to it. I have had a bit of a dificult time mental-health wise recently (hence my passionate objection to you prepetuationg the stigma of mental illness), my issue was in  the DSM, but in every enrty i have read there is a note to the effect of "to a degree that causes the individual severe distress or loss of function" (not those words, but something like that), and if it doesn't pass that threashold it's an eccentricity or normal variation not a "mental disoorder". So this part of the article seems likely to be missleading:
QuoteOn top of that, keeping "GID" in the DSM marks all transgender people as mentally disordered, no matter how well they are functioning, no matter how sensible they are about dealing with the challenges of being transgender.

Also if i was making the descision on how to define it, i would include a note to the effect that some transgenderred individuals (e.g. crossdressers) can function perfecly normally without any medical intervention. If someone can find the actual entry, i suspect it probably does say something like that?

Post Merge: August 28, 2009, 02:38:28 PM

I like their idea of including it as something that can cause distress but is not actually a disorder as such.

QuoteRemove "GID" from the DSM as a "mental disorder." But add in the DSM transgender feelings as a known possible cause of depression, anxiety, sexual dysfunction, and so forth. (After all, sometimes being transgender – like being a gay youth or a grieving widower – can lead to depression, anxiety, and so forth.) And in those cases, where evidence supports it, allow the treatment for those particular forms of depression and anxiety to include hormone treatments and surgeries, if the patient so wishes to follow those paths. After all, we have lots of research that such treatments, almost without exception, result in positive outcomes.

Man, i think there should be something like this for asperger's syndrome... may cause stress if forced to interract with normal people ;)

Actually the more i read and think the more i get keen on my idea of the DSM including normal variation which may be relevant to disstress. Pathological or not, transexualismis unusual. It involves a way of thinking and an inner experience which is not typical of the rest of us/them.

thanks for the link, that was a really good article.
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Syne

OK, the biggest problem I see for taking this out of ye big book of you are nutzo is this: you are on page 43 and then turn that page totally expecting 44 and instead it is like 52. You cannot just go yanking pages out, gotta have something to replace 'em.

Oh and my friends and I say that my being TS is probably the most normal thing about me but then I have a rather interesting life. :)
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