In Support of Removing GID from the DSM...

[Just Kate]

We can point to faulty genetics and physical abnormalities in the brain for various mental disorders - even things as "common cold" as major depression.  Should we de-classify those as mental disorders and and move them out of the DSM?

EDIT: The more I think about it, the more muddy it gets.  Ultimately everything has a physical component, so when do we draw the line between "mental" and "medical"?

[spacial]

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............


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.

At the risk of playing a devil advocate here, that sort of reasoning could equally lead to a label of Mental handicap / Learning difficulity.

It just seems that, attemting to rationalise our very real position, trying to apply vague notions of isolated malformations, to indicate that ours is some sort of inevitable need, will lead us down a blind alley.

[rejennyrated]

We can point to faulty genetics and physical abnormalities in the brain for various mental disorders - even things as "common cold" as major depression.  Should we de-classify those as mental disorders and and move them out of the DSM?

Interesting question.

I think what makes this different is that the "abnormality" is not one which renders the brain different from a normal section of society.

It doesn't make the brain into a damaged or malfunctioning brain. It merely makes it perform "normally" but in the same way as the opposite gender to that of the physical body in which it resides.

Which then gives rise to the almost philosophical question about what it is which makes us who we are? If you have a normal but mismatched brain and body then which part is to be taken as the defining artifact.

My answer is that it is for the individual to choose what they wish to be defined by. (in my case a bit of both) Therefore just because someone chooses to have their gender defined by their brain sex rather than their outward physical appearance it does NOT mean that they have a mental disorder. Therefore the condition still does not belong in DSM. QED!

[spacial]

Therefore just because someone chooses to have their gender defined by their brain sex rather than their outward physical appearance it does NOT mean that they have a mental disorder. Therefore the condition still does not belong in DSM. QED!

Think there are a few flaws in your reasoning Jenny.

The evidence for brain abnormalities is alegorical and very limited. As far as I'm aware, these findings have been made post-mortim.

Even if a live test could be perfected, it would limit the diagnosis to those that showed positive.

We know that there are many variations in transgender, from people who simply want to wear gender inappropriate clothing to people who absolutely detest every aspect of their, otherwise healthy bodies because of that body's gender

The claim that such a disorder, even when it can be demonstrated to be present, will justify surgery, for example, could equally lead to a prescription of gender specific hormones together with certain psychotrophic medications.

[Just Kate]

It doesn't make the brain into a damaged or malfunctioning brain. It merely makes it perform "normally" but in the same way as the opposite gender to that of the physical body in which it resides.

This is dang near impossible to prove.  I can no more say I know what it is like to have a normal male's brain much less claim a normal female's.  Ultimately an otherwise healthy male believes he is female or vice versa.  That screams damaged, malfunctioning, or disordered to me be it in the brain or body or wherever - something is definitely wrong.

Which then gives rise to the almost philosophical question about what it is which makes us who we are? If you have a normal but mismatched brain and body then which part is to be taken as the defining artifact.

My answer is that it is for the individual to choose what they wish to be defined by. (in my case a bit of both) Therefore just because someone chooses to have their gender defined by their brain sex rather than their outward physical appearance it does NOT mean that they have a mental disorder. Therefore the condition still does not belong in DSM. QED!

Not to get too philosophical, but could the existence of a desire to be defined by a gender not consistent with our anatomical features merely be an illusion created because there IS a problem elsewhere?

[rejennyrated]

Think there are a few flaws in your reasoning Jenny.

The evidence for brain abnormalities is alegorical and very limited. As far as I'm aware, these findings have been made post-mortim.

Even if a live test could be perfected, it would limit the diagnosis to those that showed positive.

Actually not so - as I understand it the study that I referred to used live subjects and brain imaging. It was studying activation patterns in response to stimulii and comparing them to gender norms. That is one of the things which makes this study so interesting.

This is dang near impossible to prove.  I can no more say I know what it is like to have a normal male's brain much less claim a normal female's.  Ultimately an otherwise healthy male believes he is female or vice versa.  That screams damaged, malfunctioning, or disordered to me be it in the brain or body or wherever - something is definitely wrong.

I think the point is that a diagnosis is a label, and the diagnosis of a mental disorder was originally intended for people whose condition made functioning normally in society impossible for them.

I reject absolutely the idea that it was impossible for me to function normally. It may have been uncomfortable, but I contend that it would have been perfectly possible. I just didn't see any good reason to choose to do so.

I chose my path, I was in no way compelled to it, and in the absence of any evidence that my choice presented a threat to others it is a dangerous precedent to start labelling my freewill choice as a form of madness or disorder simpy because you or anyone else may not understand or approve of it.

As it happens, I personally may not have been an otherwise healthy male, but that is actually fairly irrelevant in my opinion. The hegenomy that wishes to label the actions of others whom they do not understand as madness is insidious and dangerous - that way lies the thought police and repression and it should be strenuously resisted.

I may think that those who believe in God show evidence of a disorder. I don't start arguing for that to be included in DSM but personally I think the evidence in support of that position is every bit as strong as that for including someones choice to believe in their belonging to a different gender. After all to borrow your own phrase is it also "Dang near impossible to prove" the existance of God. But I don't think many people would be that impressed to find religiousphila included in DSM V!

In the end what it boils down to is numbers. Religious belief with no evidence is acceptable and normal because somewhere between 30% to 50% of humans may have it, whereas gender belief without evidence is a disorder because less than 1% have it. That to me is a democratic tyrany of the worst kind and it is also hypocritical because people are trying to have things both ways.

[spacial]

Actually not so - as I understand it the study that I referred to used live subjects and brain imaging. It was studying activation patterns in response to stimulii and comparing them to gender norms. That is one of the things which makes this study so interesting.I think the point is that a diagnosis is a label, and the diagnosis of a mental disorder was originally intended for people whose condition made functioning normally in society impossible for them.

Possibly, but all I've seen so far are animations.

However, the possibility remains that the consequence will be chemical treatment.

This route puts us into the hands of an exclusive group. It leaves us relying upon their benevolance to proceed as we would choose.

[Just Kate]

As it happens, I personally may not have been an otherwise healthy male, but that is actually fairly irrelevant in my opinion. The hegenomy that wishes to label the actions of others whom they do not understand as madness is insidious and dangerous - that way lies the thought police and repression and it should be strenuously resisted.

But that is just it, the diagnosis of mental illness is based on the idea that something isn't normal which makes it VERY relevant when considering whether or not to include it in the DSM.  More specifically, when someone's behavioral patterns or cognitive processes are outside of what is considered normal AND cause distress to the individual, then it has the makings of what we would term a mental disorder.

GID fits both those characteristics.  It might have an undesirable social stigma, but believing oneself to be a gender other than one that matches one's own anatomical sex is not normal, and the fact that the disconnect causes distress and is detrimental to the affected fulfills the second requirement.

There are more detailed requirements than these so I apologize for a lack of thoroughness.  But as far as I can see, GID still meets all the necessary criteria for a mental disorder based on the definition of a mental disorder.  Now whether or not it should be termed a paraphilia as some would wish to define it is up in the air, but that only concerns itself with where in the DSM it gets included not IF it is included.

[rejennyrated]

I was referring to the fact that I personally may have had other physical abnormalities...

However my point is that I don't know that I did "believe myself to be of a different sex to that which my anatomy suggested" anyway. It was probably more accurate to say that I chose to adopt a sex which was different to that which my anatomy may have suggested.

Now you may argue that such a choice is not normal - but I return to my point that whatever choices others make, which we do not understand or sympathise with, will seem to some extent abnormal to us - because we would have chosen differently.

My partner chooses a big car - it causes her distress when she can not have a big car - I do not call her disordered because of that choice although I secretly think she is "mad" (oops - now I've admitted that) in her choice because to me small is beautiful! Should I therefore get her condition classified in some section of DSM?

Has my choice or condition in relation to gender caused me suffering and distress? - Actually probably not. For me it has been more of a big adventure to be honest. One which I have thoroughly enjoyed!

Although many who do undoubtedly suffer through this would probably see that fact as the ulimate proof that I really am crazy.

[Julie Marie]

Engaging in discussions about the why and how is all well and good but the real problem we face is social rejection.  We would not be here discussing this is the world accepted the transgender condition the same as say, red hair.

Basic ignorance is primary to the stigma we face.  And those who don't want to open their minds can simply say this is a mental disorder and hold up the DSM and say "here's proof".  The fact that gender identity DISORDER is in the DSM hurts our chances of getting people to listen to discussions like the one above.  They don't care what some studies say.  They have all the evidence they need to ignore those studies and any supporting evidence.

What we have now is sufficient proof that this is a medical condition because the treatment that works is medically based and treats the body, not the mind.  The fact that we have to begin with therapy before we receive any medical attention is in place only because society in general can't fathom the concept of not being happy with what's between your legs at birth.  And any doctor who performs GRS without a some proof you have been diagnosed transgender, AND found to be sane, risks losing a lawsuit in court if the patient later regrets having the surgery.

As we debate the whys and hows, we can't lose focus on the importance of removing GID from the DSM.  If we don't, the whys and hows will fall on deaf ears.

[rejennyrated]

Engaging in discussions about the why and how is all well and good but the real problem we face is social rejection.  We would not be here discussing this is the world accepted the transgender condition the same as say, red hair.

Basic ignorance is primary to the stigma we face.  And those who don't want to open their minds can simply say this is a mental disorder and hold up the DSM and say "here's proof".  The fact that gender identity DISORDER is in the DSM hurts our chances of getting people to listen to discussions like the one above.  They don't care what some studies say.  They have all the evidence they need to ignore those studies and any supporting evidence.

What we have now is sufficient proof that this is a medical condition because the treatment that works is medically based and treats the body, not the mind.  The fact that we have to begin with therapy before we receive any medical attention is in place only because society in general can't fathom the concept of not being happy with what's between your legs at birth.  And any doctor who performs GRS without a some proof you have been diagnosed transgender, AND found to be sane, risks losing a lawsuit in court if the patient later regrets having the surgery.

As we debate the whys and hows, we can't lose focus on the importance of removing GID from the DSM.  If we don't, the whys and hows will fall on deaf ears.

Well said - pretty much what I was trying to drive at - only rather better put!

[spacial]

As a Briton, I can sympathise with Americans and others affected by DSM. Equally, it is obvious that the long term consequences can easily turn quite unpleasent.

However, I wonder if this is really a workable or even a correct approach.

Individual rights to be who we choose. Individualism.

The basis of modern civilisation, where each of us can live according to our aspirations without dusrupting the lives of others.

This is the rationale behind the increasing acceptance of gay people.

We might be able to make more headway here by being more united in our attitudes.

[eshaver]

Old habbits , Old ideas , old traditions , Old money , old arguments , old hatred , old ordeals die hard here in The old Dominion - Virginia . And oh yess, the ole S O B's are currently spewing their retoric up on Comunist hill as I write this ............. Ah , I jus luv Ole Government heroes ........ Ellen

[Cindy Stephens]

As far as brain imaging, isn't the causal effect in question?  I believe that some have asked whether or not being transgendered causes the brain changes or vice verse.   To prove one way or another, you would have to examine a large population, at an early age, identify those whose function differs, then follow all to see if that does in fact identify a transgendered individual.  I don't believe that that has been done yet.  So the results remain interesting, but not compelling one way or the other.

Now, as for being in the DSM I have mixed feeling.  I understand not wanting the "you're wacko crazy as sh**" argument.  It is unfortunate that all mental conditions have such a negative connotation.  Over the last 20 years drugs have been discovered that actually treat the underlying causes of many mental illnesses and treat the problem rather than just control the patient like the old ones did.  Does that make it a Medical problem?  The argument is being made, by some today, that all mental illnesses are physical at the most basic level.  It is just that some Doctors have been given further education useful in treating that grouping of conditions that have a certain aspect.  The DSM is a TOOL used by those doctors to help identify and treat those conditions.  In our current society, most transgendered people have concomitant socialization problems.  I have in the past suffered clinical depression, SAD, GAD as well as GID.  Therapy, for me, involved treating All of these in a holistic way.  By a shrink.  I doubt if a medical doctor would have taken the time to treat that way.  Don't they have a 10 minute rule?  Hopefully, younger people will have better integration with society and fewer adverse responses to the horrible social stigma we older girls faced.  That day, it won't need to be in the DSM and you'll just see your endocrinologist once a year, they will be primary and not an adjunct to your therapist.  But for now, I personally believe that for most of us, it is listed in the proper manual and is being treated by the most appropriate medical professionals.  Of course, I may be wrong.

[LynnER]

Theres even more hope now.  Doctors, surgeons are performing orchis for MtF's with out psychological referral letters.  GP's are prescribing HRT with out requesting psychological letters. Things are getting easier for us. My doctors are using what they called "informed consent" I'm obviously TS, why do I or they need letters from a shrink to tell them that these things need to be done for me to be a functional person?

[Asfsd4214]

As far as brain imaging, isn't the causal effect in question?  I believe that some have asked whether or not being transgendered causes the brain changes or vice verse.   To prove one way or another, you would have to examine a large population, at an early age, identify those whose function differs, then follow all to see if that does in fact identify a transgendered individual.  I don't believe that that has been done yet.  So the results remain interesting, but not compelling one way or the other.

There is no evidence that TS is a purely mental disorder, and ample evidence indicating that it's not.

There is no "proof" in either case, but assuming it to be a mental disorder at this point is just ignorant.

[spacial]

I sure Ashley didn't intend any direct offense.

As I read it, she was calling the assumption ignorant, not you.

This is a controversial topic, because it is the single topic that affects each and every one of us.

That we all care so passionately about it indicates the passion we each have for what we are doing.

But we will disagree. I have to say I disagree with everyone, including myself. Hopefully we can remember that, what unites each of us here is greater than what divides us.

[juliekins]

Theres even more hope now.  Doctors, surgeons are performing orchis for MtF's with out psychological referral letters.  GP's are prescribing HRT with out requesting psychological letters. Things are getting easier for us. My doctors are using what they called "informed consent" I'm obviously TS, why do I or they need letters from a shrink to tell them that these things need to be done for me to be a functional person?

Here, here! We have a right to choose our life's course. The grip that the psychiatrists and their manuals have over my body is beginning to erode.

Personally, I do believe there is a medical basis to my condition. I've witnessed GID and other chromosomal gender conditions running in families, which make me think there is a genetic component. Such as it is, my only psychological ailments come from the way some very phobic, and narrow minded people treat those like me.

Just because we are not the majority, it does not make us "abnormal". Unusual or unique ,yes, but not abnormal. The problem as I see it is that phobic thinking, which is listed in the DSM, is practiced by the majority of the public. Unfortunately, too many of them would rather fear us or put us down, rather than become informed on the subject.

[spacial]

I can really settle for unusual and unique.

Me, unusual and unique?

Well, yes, since you noticed.

Sorry, getting a bit confused. This was the right thread. Just seemed a little jolly. 

[Asfsd4214]

I really hate these sorts of arguments, but just to throw in an idea...

I think something should cease to be a mental disorder when no modification of the mind is required or advised to correct it.

Oh and yes, I'm sorry if I was unclear before, I was saying that the assumption is ignorant, not any individual person here.