In Support of Removing GID from the DSM...

[Julie Marie]

The recent decision in the United States Tax Court where it was overwhelmingly ruled (O'Donnabhain v. Commissioner of Internal Revenue) that a transgender woman's medical expenses for hormone therapy and sex reassignment surgery were medically necessary and therefore tax-deductible under Federal law, gave further indication that GID being in the DSM will prevent gender identity from being considered a medical condition.

The argument given by the defendant states "Petitioner's male body was healthy, and his mind was disordered in its female self-perception. GID is in the jurisdiction of the psychiatric profession--the doctors of the mind--and is listed in that profession's definitive catalog of "Mental Disorders". See DSM-IV-TR at 576-582. When a patient presents with a healthy male body and a professed subjective sense of being female, the medical profession does not treat his body as an anomaly, as if it were infected by the disease of an alien maleness. Rather, his male body is taken as a given, and the patient becomes a psychiatric patient because of his disordered feeling that he is female."

This is the argument usually given by insurance companies and the IRS had no problem using it.  The entire concept of it being a psychological condition was the crux of the IRS defense. 

While I realize the courts ruled GID to be a disease and that medical intervention treated this disease, I think it's important to remember that the mental disorder aspect of this trial was the focal point in denying the deduction.  There are plenty of medical conditions that are allowed as tax deductions and we need to ensure this becomes one of them.

GID needs to be removed from the DSM and placed in the medical books as a medical condition. As long as people think we're nuts, they will treat us that way.

[rejennyrated]

I have said it many many times.

GID should not be in DSM and should never have BEEN in DSM in the first place.

It is every bit as offensive to have GID in there as it was for homosexuality to be included until the 1970's. Particularly given the genetic and physiological evidence which is now at last gradually emerging which supports physical causes at least in some cases.

[Asfsd4214]

I have said it many many times.

GID should not be in DSM and should never have BEEN in DSM in the first place.

It is every bit as offensive to have GID in there as it was for homosexuality to be included until the 1970's. Particularly given the genetic and physiological evidence which is now at last gradually emerging which supports physical causes at least in some cases.

For some reason there's a reasonably large group of people even here on susans that hate the idea of a physical cause even aside from DSM/Insurance issues.

I'm not one of them though and I don't like GID being in the DSM either.

[Janet_Girl]

The AMA has already stated int resolution 122 that;

Gender Identity Disorder (GID) is a serious medical condition recognized as such in both the Diagnostic and Statistical Manual of Mental Disorders (4th Ed., Text Revision) (DSM-IV-TR) and the International Classification of Diseases (10th Revision)

It also states that;

An established body of medical research demonstrates the effectiveness and medical necessity of mental health care, hormone therapy and sex reassignment surgery as forms of therapeutic treatment for many people diagnosed with GID

And further states:

Whereas, Health experts in GID, including WPATH, have rejected the myth that such treatments are "cosmetic" or "experimental" and have recognized that these treatments can provide safe and effective treatment for a serious health condition

While it is not a mandate to the insurance companies that AMA states that:

The denial of these otherwise covered benefits for patients suffering from GID represents discrimination based solely on a patient's gender identity

Maybe with this resolution and now the court ruling, we might just see some action regarding coverage by the insurance companies.

[gennee]

I wonder why they called GID a disease in the first place.

Gennee

[Asfsd4214]

I wonder why they called GID a disease in the first place.

Gennee

From wikipedia

In human beings, "disease" is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, and/or death to the person afflicted

In that sense, speaking for myself its definitely given me 4 out of 5 and brought me pretty close to all 5.

[tekla]

What guarantee do you have (I'm guessing less than zero) that if you get it pulled that the medical community is going to be so hog wild on picking it up.  I'm down with it being out, but being out means no insurance coverage (or tax write off).  That's rollin' them laughing bones for a lot of people.

[V M]

*Resisting the urge to say something rather naughty about getting a bone and laughing* 

But seriously, It should not be seen a mental disorder. Sure, someone with GID does experience anxiety and depression. But it is attached to how they feel about themselves both mentally and physically

The mental part being triggered by the physical part

Not the physical part being triggered by the mental part

Does that make any sense?

[tekla]

It's an old school term for dice.

[V M]

Yeah, I know..... I'm just feeling a bit playful and thinking about serious stuff at the same time

I get frustrated by the medical "profession". They so often get things backwards or just don't really want to bother. It's like they're playing guessing games and get paid allot to do so because they went to school and have a permit

Most of the time it just boils down to their own personal opinion anyway

[rejennyrated]

But seriously, It should not be seen a mental disorder.

Exactly! No one is saying that it should not be considered as a disorder. Simply that it should not be classed as a MENTAL disorder, which is of course what the DSM is. It's a psychiatric manual of mental disorders. You won't find a boken arm in the DSM, because it is recognised as medical.

Which means by extension that if your disorder is included in DSM then you are to some extent automatically a fruit loop and therefore fair game for every Tom Dick and Harriet who wants to ignore you or discriminate against you because you are an irrelevant deluded little nutcase!

Only personally I don't think any of us are... and I'm certainly not. Afle barfle gloop - ning nong didle po! It's time for the nice men in white coats to take me back to bed unk unk!

[placeholdername]

The whole situation is dicey.  The concept of mental disorder implies that there is some sort of normal mental order baseline to compare to, when in fact we're all sane and crazy at various times.  Psychiatric classifications of mental disorder should be a social tool for identifying who needs extra help, but instead becomes about singling out who is 'abnormal'.  From my point of view, I don't have a mental disorder, I'm just me.  If classifying my situation as a mental disorder ends up helping me, then I'm all for that, and if it doesn't, then I'm probably against it.  But the reality is that most of this is about politics and not so much about the well-being of those affected, no matter what words we use to describe them/us.

[spacial]

The problem with calssifying GID as a mental disorder is, as Jenny says, the association with 'fruitloop.

The psychiatric comminity and the medical/social community in general have, for many years, been attempting to alter public perceptions of mental illness to something as acceptable as a common cold.

Mental illnesses, depending on what you define them as, are certanly very common. But the essential problem with mental illness is the loss of liberty. This leads many people who might otherwise suffer some loss of function to abandon many others, becoming increasingly dependant.

Sadly, the medical community has been reluctant, to say the least, to abandon its authority over and especially power over people with mental health problems.

In a city here in the UK, a few years ago, during a reorganisation of medical services, the assessment and treatment of Multipul Sclorosis was transfered to a building that had formally been the admissions unit for mental health services. The mental health admision being transfered to a new building opposite.

From a medical point of view, this made good sense.

The reaction from people suffering from MS, their families, the press and the public was outrage.

The mental health services cried their usual self pity of being misunderstood by ignorant ordinary people. The reality was and is, the mental health workers so addicted to the power they weald, they are incapable of seeing that the biggest problem for people with mental health problems is the cure itself.

[Robyn]

What guarantee do you have (I'm guessing less than zero) that if you get it pulled that the medical community is going to be so hog wild on picking it up.  I'm down with it being out, but being out means no insurance coverage (or tax write off).  That's rollin' them laughing bones for a lot of people.

Yes, it would have to be a coordinated effort: roll it out of DSM into whatever the medical equivalent is. (What is the medical equivalent?)

With Zucker in charge of the GID portion of DSM V, we are likely to be portrayed as having a philia on a par with pedophilia or other philias including amputaion of limbs to become disabled or whatever Anne Lawrence dreams up next.

Robyn

[placeholdername]

Yes, it would have to be a coordinated effort: roll it out of DSM into whatever the medical equivalent is. (What is the medical equivalent?)

With Zucker in charge of the GID portion of DSM V, we are likely to be portrayed as having a philia on a par with pedophilia or other philias including amputaion of limbs to become disabled or whatever Anne Lawrence dreams up next.

Robyn

Actually, it's already in the equivalent, the ICD (which is what my LGBT clinic uses for diagnoses):

http://en.wikipedia.org/wiki/ICD

It doesn't matter how they classify it, if the insurance companies don't want to pay for it, they can make up a reason.

[Julie Marie]

Don't know what happened to my post from yesterday but...

No matter how you slice it, if it's in the DSM, it's all in your head and that's what they will treat.  If it's a physical condition, they will treat your body.  And everyone who is trans-phobic will use the mental disorder defense as long as they have proof it is.

For me, I'll roll the dice.  It's already rolling in our favor.  The AMA recognizes it.  Many companies recognize it.  And now the IRS recognizes it.  That's some pretty good clout.  Throw the discrimination card in the face of the rest of the companies who don't recognize it and eventually their defense will crumble.

All we have to do is not give up.

[spacial]

Key points

·          Transgender people have a recognised medical condition

·          Transgender is not a mental illness although transgendered people may experience mental or physical ill health in the same way as everyone else

·          Transgender is a condition of gender identity or gender expression, not sexual orientation

·          Transgendered people have a right to, and may wish to, keep their transgendered status private
http://www.nhsemployers.org/EmploymentPolicyAndPractice/EqualityAndDiversity/the-eight-strands-of-equality/Gender/Pages/Transgender-Homepage.aspx

This is the perspective of the UK health service as an employer. Not a lot of immediate help to people in the US, but as a reference.

[Julie Marie]

All good points but it depends on who is listening.  There are plenty of very vocal groups, including some governmental ones, that will dispute your key points.

There's a saying, "The foolish reject what they see, not what they think.  The wise reject what they think, not what they see."

Most all of the people who campaign against positive change fall into the former category.  Their phobias will not allow them to open their minds.  And phobia is an element of thinking, not seeing.

[Just Kate]

What is the abnormal physicality (physical symptoms/markers) of GID that would classify it as a "medical disorder"?

[rejennyrated]

What is the abnormal physicality of GID that would classify it as a "medical disorder"?

Evidence which has been published in the last two years of tiny irregularities in the androgen receptor. It's a minute gene fault which does not constitue androgen insensitivity but results in under masculinisation of the brain.

The gene resides on a non sex chromasome and is recessive, so you have to inherrit two copies to be affected.

Professor Andrew Sinclair and Dr Harley Vincent at Melbourne University performed the research. They also found a matching varient which could cause the reverse effect, over masculinising the brains in females.

That is a physical effect, not a mental one, even though the organ affected is the brain, because it takes place before the mind begins to form.

Then there are the chemicals like DES, to which I was exposed in the womb. These are stable synthetic estrogenic chemicals which can disrupt development. Some Pthalates, which are in many flexible plastics, have the same chemical properties. In high doses they cause external physical abnormalities. In lower doses they disrupt the development of the nervous and endocrine systems alone.

Any of these things can disrupt the development of the physical wiring of the brain - and if your brain is PHYSICALLY damaged then that is a physical (medical) defect and not something of the mind or psyche.