Susan's Place Transgender Resources

I feel like I have been hearing a lot of people talk about GID being removed from the DSM in the next iteration.

Does anyone care to elaborate why GID should be removed?

I can't think of any reasons why.

As long as GID is in the DSM, transsexuals will be barred from military service.

Even if Don't Ask, Don't Tell is repealed, transsexuals will still be seen as suffering from a Personality Disorder that is incompatible with military service.

That's mine.

So with that logic, should we remove ADHD from the DSM, so they are allowed to enlist?

Diagnostic and Statistical Manual of Mental Disorders

I do not feel mentally disordered (at least not because I'm trans, lol).

However, I go back and forth in my opinion on this, I'm sure glad it isn't my decision. I can't argue with ensuring relative sanity before undertaking transition; but who am I, or anyone else really, to enforce that by pathologising the need? If it is removed, it will be interesting to see if the people who modify our bodies surgically and hormonally drop their SOC requirements. I don't imagine they will.

If it is removed from the DSM, then it could be looked at as a real medical condition.  That could open the doors to treatment being covered by the insurance companies.  Even the AMA Resolution 122 (http://www.tgender.net/taw/ama_resolutions.pdf) states that it should be covered by the health care industry. 


Janet

Quote from: Janet Lynn on October 24, 2009, 06:48:51 PM
If it is removed from the DSM, then it could be looked at as a real medical condition.  That could open the doors to treatment being covered by the insurance companies.  Even the AMA Resolution 122 (http://www.tgender.net/taw/ama_resolutions.pdf) states that it should be covered by the health care industry. 


Janet

I don't understand the logic there.  Mood disorders are listed in the DSM (bipolar, depression, etc) and they are considered "real" medical conditions and they get treatment.  How would removing GID from the DSM accomplish that?

Also, according to tsroadmap :
"A little background: SRS was routinely covered in the US until a couple of medical articles came out in the late 1970's showing high suicide rates among post-operative women. This came at the same time a couple of prominent gender clinics were closed, notably Johns Hopkins.

The insurance companies pounced on these events as a chance to decry the procedure as elective, cosmetic, or experimental. It's been an uphill battle since. "

Quote from: Becca on October 24, 2009, 06:47:11 PM
I do not feel mentally disordered (at least not because I'm trans, lol).

I get that. 


How about renaming the manual?  It would probably solve both reasons I quoted.  By migrating all the DSM disorders into a manual that includes all medical disorders would remove the stigma of it being a mental disorder, and it would be much harder for the insurance companies to refuse payment to.

Just a thought.

It's really a question of where mental disorders end and physical disorders begin.

In a sense, all mental disorders are also physical disorders because they're caused by physical differences in the brain, so really it's more a matter of if the condition can be "cured" through therapy or drugs (as with depression) and whether or not the condition is or isn't psychological along the same lines as other mental illnesses.

Maybe both forms exist, psychologically and neurophysically induced GID. I for one feel pretty sure from my own experiences and the various studies that have been done and examples like John Money's fantastically tragic efforts in discrediting his own theory, that brain sex does exist and can be in-congruent with the body. Likewise it's also not unheard of for people to feel they have GID only to later realize they don't, there's a lawsuit here in Australia against a gender clinic on grounds that they were misdiagnosed and now have genuine GID resulting from transition when their issues were related to something else.

Why should GID be removed? For one, there's increasing evidence that transexuality is literally a case of intersex brain structures. Not enough to prove it outright, but definitely enough to warrant consideration. If that turned out to be the case, then many, perhaps most examples of GID may in fact be subtle intersex conditions in the brain not causing any more noticeably mental illness. If that's the case, then those forms of GID would not be mental illnesses in the sense that there's nothing actually "wrong" with the mind itself.

I have very mixed feelings about the psychiatric profession, the more I learn about it the more I feel it exhibits an extreme amount of unscientific guess work, and that they really don't know much more about the underlying cause of mental or apparently mental disorders than the people who suffer from them would.

I for one would like to see GID removed from the DSM if for no other reason than its presence there assumes that it is a mental disorder when as time goes on more and more evidence is found that contradicts that assumption.

That and I don't like psychiatrists.  ;D

The primary problem here is, is GID a physical problem in the brain that can't be cured by conventional therapy, or is it a psychological problem that can be "cured". If it's the former, it's a birth defect and warrants just as much treatment as any intersex birth defect. If it's the latter, then it might be better if the psychological problem can be corrected, so the person can live a normal life without expensive surgical options.

I for one believe that it can be and frequently is a result of the former, in which case I don't think it should be listed in the DSM, or at least not as the same context as the latter possibility.

Its listing in the DSM has basically defined everyone with GID being as being assumed to be the latter category, and that it is the only category that exists. I think this is unhelpful to our situation and believe that in time it will come to be more widely recognized as a physical birth defect.

Homosexuality used to be considered a mental illness too, now it's widely believed it is simply a physical difference in the brain that is in no way a disorder of the mind, that's what I would like to see with GID.

OK.  Let's assume that there is nothing wrong with the brain of someone who has, under current rule been diagnosed with GID.  GID has been removed from the DSM.

What would be the way to diagnose it, and treat it?  Where should GID be located, if anywhere?  Who would would diagnose it?  Should it be diagnosed?

Quote from: Valerie Elizabeth on October 24, 2009, 07:37:23 PM
OK.  Let's assume that there is nothing wrong with the brain of someone who has, under current rule been diagnosed with GID.  GID has been removed from the DSM.

What would be the way to diagnose it, and treat it?  Where should GID be located, if anywhere?  Who would would diagnose it?  Should it be diagnosed?

Given that we don't know for sure what part of the brain is responsible for brain sex, and the best guess can't be detected with medical imaging technologies at this time, unfortunately there's no objective way to diagnose it. But the DSM is no better, it's simply a diagnosis made by one individual based on what if they think another individuals subjective experiences fit the criteria or not, not exactly hard science.

I don't know where GID should be located, where is AIS located? If GID is an intersex condition in some or most cases, it should be treated as one. As for who would diagnose it, I suppose a doctor would have too. It has to be diagnosed in order to provide treatment, but unfortunately we don't have any objective way to diagnose it as a physical disorder at this time. But I don't think assuming it's nothing more than a psychological disorder, which is what its presence in the DSM does for most people, is a great situation either.

I don't know what the answer is, and to be honest I'm not really interested in being involved in the politics of LGBT issues any more than I have to be, I just want to be able to live my life like everyone else.

But at this time most of us have no choice but to deal with the medical community to get treatment, and I don't think the medical community is doing a very good job at taking GID seriously. By and large there's a perception that people with GID have a mental disorder, nothing more. And I think that's holding back advancement in transgender care, and the DSM's listing of it is a part of the problem.

The same way the fibromyalgia is.  A set of symptoms was how fibro was diagnosed, it still is.  But the health care industry now cover it and the drug companies are now working to find drugs that help.  Why is it that Transsexualism is a mental disorder? 

They need to recognize that all we are asking is that we require the same respect that those who have suffered with Fibro.  My ex has fibro and for years she was told that it was 'all in her head'.  Was she mentally ill?  No she has a set of symptoms that need to be addressed.  Now they have medication that helps suffers.  And it is a recognized "Medical" condition.  We need to be recognized as a medical condition.

And a doctor finally told her "That of course it was all in her head, that's wear pain starts from".  And he helped her deal with the pain.

By being listed as a mental disorder, we will never get any medical establishment to take us seriously.


Janet

Quote from: Janet Lynn on October 24, 2009, 07:55:08 PM
By being listed as a mental disorder, we will never get any medical establishment to take us seriously.
Janet

Exactly, that's exactly what I was trying to say.

If people think it's a mental disorder, then they think there's nothing "actually" wrong with you.

If TS were considered a brain intersex condition, better yet if it could be detected as one, so many lives could be improved.

Quote from: Janet Lynn on October 24, 2009, 07:55:08 PM
By being listed as a mental disorder, we will never get any medical establishment to take us seriously.

While it is compelling, I don't think this is an statement that will get anywhere in either direction. My health plan takes it seriously, and pays for therapy and hormones both. As I understand it, some others are even more generous.

Just for the sake of discussion, because I'm undecided on this too, even if the existence of the disorder is pure nonsense, should we really, really remove gid from the dsm? Think about it, a diagnosis of gid means a lifetime of trauma. Poor little girls experienced male puberty, societal demands and expectations including practically forced  homosexuality and aggressiveness, not to mention seeing a monster in the mirror daily. Even if gid itself isn't real, someone diagnosed with it most likely needs help, and more than she realizes.

Mine only cover HRT.  Orchie was not medically necessary according to Kaiser.  Therapy was not covered because they had no one that was schooled in GID.  And now I have none.  So HRT will be up to me to find another doctor to prescribe.  At least I know on a couple, by it will be out-of-pocket.

My Orchie will also be out-of-pocket.  Medicaid here in Oregon covers nothing, because it isn't a medically diagnosis, only mental.  And even if it was, it would called preexisting.   But if I was diabetic, which would be preexisting, they cover it.  GID is just as life threading as diabetes.

It is like if you're diagnosed as having a mental disorder and you are not a threat to others, you get squat.  Why can we just be allowed to have medical treatment.  Because GID is mental, not medical.

JMHO


Janet

Quote from: asfsd4214 on October 24, 2009, 08:00:02 PM
Exactly, that's exactly what I was trying to say.

If people think it's a mental disorder, then they think there's nothing "actually" wrong with you.

If TS were considered a brain intersex condition, better yet if it could be detected as one, so many lives could be improved.

But the fact is that we can't, at this time prove what causes GID.  Do you think people who are bipolar have nothing wrong with them?  Just because a diagnosis falls under a mental disorder, doesn't mean it's "imaginary", and people who think that are idiots.

I think instead of trying to change whether or not it is a mental disorder, to try and change the insurance companies coverage of it.  I guess that I am looking at it from the insurance companies point of view.  I mean, there is no physical test, no symptoms that can't be faked, and to be honest the surgery is technically cosmetic.

I'm not saying that I don't think it's a real problem.  I have it and I sure as hell don't agree with paying out of pocket for it.  I just want to get a better feel for the reasons behind the push for change.

What happens if it gets pulled out of the DSM and we lose whatever coverage we have?  I understand that a lot of people don't have coverage at all, but the people who do get some coverage and lose it because of it not being anything medical would suck.

Lastly,

Quote from: asfsd4214 on October 24, 2009, 07:14:25 PM
Homosexuality used to be considered a mental illness too, now it's widely believed it is simply a physical difference in the brain that is in no way a disorder of the mind, that's what I would like to see with GID.

So, you would like to be seen as someone with nothing wrong with them, and get no treatment at all?


I didn't mean to step on anyone's toes.  This is partly me thinking out loud, and trying to get as much information as possible.  I want to be able to make the most informed decision as possible, and I want everyone else to as well.

Quote from: Valerie Elizabeth on October 24, 2009, 10:03:44 PM
So, you would like to be seen as someone with nothing wrong with them, and get no treatment at all?

Of course not, my point was that homosexuality is not considered a mental illness, and neither should GID. But in just the same was as multiple sclerosis is not a mental illness even though it causes damage in the brain, it still requires treatment.

And that's the difference, unlike homosexuality, GID requires treatment to improve the quality of life of the individual suffering from it.

And that's what I and I believe several other people here have a problem with, we feel GID can not be shown to be, and is not likely a mental disorder, and should not be classed as one.

Unlike a real mental disorder like bipolar disorder or depression, the mental and cognitive functioning of the individual is not impaired or unusual when put in the context of the individuals identified gender. So while GID is a problem in the brain, I feel it's not a mental disorder any more than homosexuality is, but unlike homosexuality it is not simply a physically harmless abnormality, it is debilitating and requires treatment. Problems for homosexuals come from the social implications of it, without socially induced harm, it's nothing more than a harmless human variation. GID on the other hand is debilitating enough without any socially induced problems. It is for me anyway.

That is what I meant in my previous post, and that is why it should not be in the DSM.

Yes, removing it from the DSM may in the short term cause serious problems for some of us, but in the long term we'll all be better off.

Multiple Sclerosis is an autoimmune disorder where nerve cells are demyelinated.  That's not even close to a mental illness.  I said it before, there are a ton of mental illnesses that are given medical coverage.  I think we need to look further into the reason why hormones, and surgery is not considered medically necessary in most cases.

According to WebMD, a mental illness is a psychological syndrome or behavioral pattern that is associated with subjective distress and/or objective impairment.
     I feel that GID falls under that.

Furthermore, there is no evidence (or at least none that I could find) that proves whether homosexuality it is caused by something physical in the brain, something mental, or a choice. 

I read some studies recently that are linking GID to genes (so far estrogen receptor), and polymorphous aromatase receptor genes and polymorphous estrogen receptor genes.  I support the notion that GID may be a mental illness caused by an underlying problem.  The issue is, we don't know what really causes GID, and the studies, albeit convincing are mostly preliminary.   


So far, my thoughts are that GID should remain in the DSM until a better diagnosis method is available.  I think we need to pressure the insurance companies back into covering GID.  I am going to do some digging into as many reasons as to why insurance companies no longer cover it.

But I do not have a mental illness, and by being classified as such can result in refusal to employ, refusal in housing, even refusal to certain medical procedures.  You can also be institutionalized by court order.

And you wonder why I feel it should be removed.  I have a medical disorder, not a mental one.


Janet

Quote from: Valerie Elizabeth on October 24, 2009, 11:55:49 PM
Multiple Sclerosis is an autoimmune disorder where nerve cells are demyelinated.  That's not even close to a mental illness.  I said it before, there are a ton of mental illnesses that are given medical coverage.  I think we need to look further into the reason why hormones, and surgery is not considered medically necessary in most cases.

According to WebMD, a mental illness is a psychological syndrome or behavioral pattern that is associated with subjective distress and/or objective impairment.
     I feel that GID falls under that.

Furthermore, there is no evidence (or at least none that I could find) that proves whether homosexuality it is caused by something physical in the brain, something mental, or a choice. 

I read some studies recently that are linking GID to genes (so far estrogen receptor), and polymorphous aromatase receptor genes and polymorphous estrogen receptor genes.  I support the notion that GID may be a mental illness caused by an underlying problem.  The issue is, we don't know what really causes GID, and the studies, albeit convincing are mostly preliminary.   


So far, my thoughts are that GID should remain in the DSM until a better diagnosis method is available.  I think we need to pressure the insurance companies back into covering GID.  I am going to do some digging into as many reasons as to why insurance companies no longer cover it.

I can save you the time, they'd rather keep the money for themselves.  ::)

And they justify it by considering it or aspects of treating it a lifestyle or cosmetic choice rather than a medical condition, which is much easier to do with something recognized as a mental illness rather than a physical illness. Some might argue "if it's a mental illness then hormones and surgery are indulging their delusions rather than treating the illness".

If GID were discovered conclusively to be a seemingly mental manifestation of what is actually a physical intersex disorder, it would be indisputable that hormones and surgery are treating the disorder rather than indulging a delusion.

http://en.wikipedia.org/wiki/Etiology_of_transsexualism#Possible_physical_causes (http://en.wikipedia.org/wiki/Etiology_of_transsexualism#Possible_physical_causes)

There is growing evidence that GID is more a physical disorder than what would traditionally be considered a mental disorder. The belief that it's a mental disorder is simply an assumption based on lack of evidence to the contrary at the time. Like so much in the fields of psychiatry and treatment of mental illness, the diagnostic criteria for GID is nothing more than guess work.

Yes, the studies supporting the notion that it is a physical disorder are still early, but they are becoming more numerous and more compelling as time goes on.

And scientific evidence that it is a mental disorder is virtually non-existent. If it were purely a mental disorder, it should be more receptive to psychotherapy.

I do believe that in some cases what would meet the diagnostic criteria for GID may in fact be a mental illness, this is evident by the relatively rare instances of regrets and detransitions.

Getting help in Australia recently took a serious blow because of instances such as this http://www.theage.com.au/national/sexchange-clinic-got-it-wrong-20090530-br3u.html (http://www.theage.com.au/national/sexchange-clinic-got-it-wrong-20090530-br3u.html)

But I also believe that the evidence we do have suggests that it is more likely than not that GID is more a physical disorder than a mental one. That is to say, the mind is not ill, and neither is the body, it's just that they aren't as compatible with each other as they should be.


Janet Lynn also makes an excellent point. By being a mental disorder we are not considered to be in a healthy state of mind, and could be deemed to not know how to act in our best interests. I can only speak for myself when I say the impression I have gotten from many medical professionals has been that I don't know what I'm doing. They don't want to hear what I have to say, they want a psychiatrist to hear what I have to say and then to hear what the psychiatrist thinks. Because clearly I might not be in a fit state of mind to make any decisions that effect my body.

This is largely a result of the treatment and utter refusal to acknowledge that GID could be anything but a mental illness.

As an alternative to removing GID from the DSM, we could just put everything else in.  Like being Catholic.  Liking chocolate.  Wanting to get married.  That way, psychiatrists can treat for everything.

Can I ask then why so many people on this board recommend people to a psychiatrist?

If everybody feels so strongly about it being removed, then why go to psychiatrists?  Doing so only furthers the idea that it is a mental illness.

Thoughts?

Quote from: Muddy on October 24, 2009, 06:39:10 PM
As long as GID is in the DSM, transsexuals will be barred from military service.

Even if Don't Ask, Don't Tell is repealed, transsexuals will still be seen as suffering from a Personality Disorder that is incompatible with military service.

That's mine.

So what? Why would you ever wanna fight for greedy, cigar-smoking suits anyway in wars that go nowhere and will never, ever end?

Quote from: Valerie Elizabeth on October 25, 2009, 12:29:53 AM
Can I ask then why so many people on this board recommend people to a psychiatrist?

If everybody feels so strongly about it being removed, then why go to psychiatrists?  Doing so only furthers the idea that it is a mental illness.

Thoughts?

Perhaps because the social and personal implications of the disorder are extremely stressful and often result in legitimate mental illness such as depression.

I would be interested to know how many of the people here are going to a psychiatrist with an aim to actually curing their gender identity incongruity by making the mind congruent with the body rather than vice verse. I doubt it's very many if any of the people here.

Furthermore, its listing in the DSM and the standards of care often give people little option.

I for one have been told so far by every doctor I've seen that they will not, under any circumstances prescribe HRT until a psychiatrist has given it the OK. I personally am at a point where if the next two doctors I see are no different, I simply have to go to a psychiatrist for an indefinite period of time until they give the go ahead, and KEEP going indefinitely after, or prescribed HRT is simply not going to happen.

It's a catch-22, I have to go to a psychiatrist and perpetuate the idea that it's a mental disorder, because of the perception that it's a mental disorder.

I personally after having seen two psychiatrist wouldn't recommend anyone to go to a psychiatrist FOR GID if they can avoid it, unless they genuinely feel it would benefit them.

Perhaps a psychologist would be a better choice.

But given my experiences with them, I don't feel I have a mental disorder, I feel going to a therapist that thinks me mentally ill for my condition to the point where they simply dismiss anything I have to say is unhelpful and is only of harm to my mental state, not help.

Don't misunderstand me, I don't think all psychiatrists are bad and that nobody could possibly benefit from seeing one. But if you have GID simply because you have GID, and not as a result of some kind of personality or other disorder, I don't think it's helpful to see one for THAT condition. To help with other issues in your life? To help with depression from your condition, sure, they might be very helpful.

But I don't feel that GID is a mental illness, and so I feel that the psychiatric professions ability to treat it directly is extremely limited.

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Post Merge: October 25, 2009, 12:43:42 AM

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Quote from: Kara-Xen on October 25, 2009, 12:38:37 AM
So what? Why would you ever wanna fight for greedy, cigar-smoking suits anyway in wars that go nowhere and will never, ever end?

That's not really the point. The point is you should be able too if you are physically capable.

It's like the argument that women should be barred from combat rolls, sure, most women don't want to be in the military, let alone a combat roll to start with, but a few do and if they're physically capable, they should be able too.

I'm one of those who strongly believes GID should be removed from the DSM.  And I have no problem saying why, again.

You walk into your doctor's office and tell him/her what's bothering you.  After hearing you out, GID is initially diagnosed.  Since it's considered a MENTAL DISORDER, you are then directed to have psychiatric counseling.  And your insurance will cover that.

But that's all your insurance will cover because it's mental.  And if you become depressed, they will treat you for depression.  And if you become suicidal, they will lock you up in a psych ward.

Then there's the reaction of those who find out you have GID.  They will think it's all in your head.  After all, it's listed in a book of psychiatric disorders so treatments like hormones or surgery aren't the answer.  The only answer is more therapy.  And the goal will be to cure you of your GID.  And you can bet they will give it their best.

GID can be found under "Sexual Dysfunctions".  When you have a dysfunction, something isn't working right.  We like to fix things that aren't working right.

Here's what it says:

Etiology
Theories suggest that childhood issues may play a role in this disorder, such as the parent-child relationship at an early age and the identification a child is able to make with the parents of the same gender.

Symptoms
A strong and persistent identification with the opposite gender. There is a sense of discomfort in their own gender and may feel they were 'born the wrong sex.' This has been confused with cross-dressing or Transvestic Fetishism, but all are distinct diagnoses.

Treatment
Other disorders may be present with this one, including depression, anxiety, relationship difficulties, and personality disorders, and homosexuality is present in a majority of the cases. Treatment is likely to be long-term with small gains made on underlying issues as treatment progresses.

Prognosis
Mixed. The goals of treatment are not as clear as in other disorders, as same-sex identification may be very difficult to achieve. More achievable goals may include acceptance of assigned gender and resolution of other difficulties such as depression or anxiety.

In the Etiology, it says there may be some childhood issues, in other words, it's your environment that created the disorder.  Conclusion: we need to fix that.

In Treatment, they are saying treatment may be long term.  Yep, we're gonna keep working on you until we make you like everyone else.

And finally they say there may be other underlying factors like depression and anxiety.  Well, I get anxious when I am standing on the edge of a tall building. So why not suggest I walk away from the edge of the building instead of treating the anxiety?

When gays began fighting for their civil rights people said they were mentally ill and needed to be fixed.  "I don't hate homosexuals and I just think they need to be straightened out."  Homosexuality was listed in the DSM so it was widely believed it was all in their head.

As long as GID is listed in the DSM, don't expect society to embrace early hormone intervention as a viable option.  Instead it will be waiting for puberty to do irreparable damage that will result in paying (out of pocket) tens of thousands of dollars and endure a lot of pain just so you can achieve some semblance of what early intervention could have done easily.  And I won't go into the years of mental anguish that could have been avoided.

The DSM is for mental disorders.  I know I don't now nor ever did have a mental disorder.  It wasn't all in my head, it was all over my body.

Julie

Quote from: Julie Marie on October 25, 2009, 12:54:44 AM
I'm one of those who strongly believes GID should be removed from the DSM.  And I have no problem saying why, again.

You walk into your doctor's office and tell him/her what's bothering you.  After hearing you out, GID is initially diagnosed.  Since it's considered a MENTAL DISORDER, you are then directed to have psychiatric counseling.  And your insurance will cover that.

But that's all your insurance will cover because it's mental.  And if you become depressed, they will treat you for depression.  And if you become suicidal, they will lock you up in a psych ward.

Then there's the reaction of those who find out you have GID.  They will think it's all in your head.  After all, it's listed in a book of psychiatric disorders so treatments like hormones or surgery aren't the answer.  The only answer is more therapy.  And the goal will be to cure you of your GID.  And you can bet they will give it their best.

GID can be found under "Sexual Dysfunctions".  When you have a dysfunction, something isn't working right.  We like to fix things that aren't working right.

Here's what it says:

Etiology
Theories suggest that childhood issues may play a role in this disorder, such as the parent-child relationship at an early age and the identification a child is able to make with the parents of the same gender.

Symptoms
A strong and persistent identification with the opposite gender. There is a sense of discomfort in their own gender and may feel they were 'born the wrong sex.' This has been confused with cross-dressing or Transvestic Fetishism, but all are distinct diagnoses.

Treatment
Other disorders may be present with this one, including depression, anxiety, relationship difficulties, and personality disorders, and homosexuality is present in a majority of the cases. Treatment is likely to be long-term with small gains made on underlying issues as treatment progresses.

Prognosis
Mixed. The goals of treatment are not as clear as in other disorders, as same-sex identification may be very difficult to achieve. More achievable goals may include acceptance of assigned gender and resolution of other difficulties such as depression or anxiety.

In the Etiology, it says there may be some childhood issues, in other words, it's your environment that created the disorder.  Conclusion: we need to fix that.

In Treatment, they are saying treatment may be long term.  Yep, we're gonna keep working on you until we make you like everyone else.

And finally they say there may be other underlying factors like depression and anxiety.  Well, I get anxious when I am standing on the edge of a tall building. So why not suggest I walk away from the edge of the building instead of treating the anxiety?

When gays began fighting for their civil rights people said they were mentally ill and needed to be fixed.  "I don't hate homosexuals and I just think they need to be straightened out."  Homosexuality was listed in the DSM so it was widely believed it was all in their head.

As long as GID is listed in the DSM, don't expect society to embrace early hormone intervention as a viable option.  Instead it will be waiting for puberty to do irreparable damage that will result in paying (out of pocket) tens of thousands of dollars and endure a lot of pain just so you can achieve some semblance of what early intervention could have done easily.  And I won't go into the years of mental anguish that could have been avoided.

The DSM is for mental disorders.  I know I don't now nor ever did have a mental disorder.  It wasn't all in my head, it was all over my body.

Julie

I couldn't agree with you more.

We are in almost exactly the same situation today as homosexuals were in a few decades ago, and just look at how the psychiatric field "helped" them, and in a few decades from now as more of the science is understood, I believe the same thing will happen with us, we will be removed from the DSM.

QuoteTheories suggest that childhood issues may play a role in this disorder, such as the parent-child relationship at an early age and the identification a child is able to make with the parents of the same gender.

And who came up with those theories? Not us... other psychiatrists came up with them based on their interactions with us. And what scientific proof do they have for it? None whatsoever. It's pseudo scientific guess work.

The only scientific evidence we have on the Etiology of GID suggests a physical cause. Granted it's not quite enough to say for it for sure, but what evidence there is is quite compelling.

But nobody is going to stand up on our behalf and change the system, we have to do it just like the homosexuals did.

I'm not and have never been a scientologist, but there's a reason a lot of people don't like the psychiatric field of medicine.

Quote from: asfsd4214 on October 25, 2009, 12:41:50 AM
Perhaps because the social and personal implications of the disorder are extremely stressful and often result in legitimate mental illness such as depression.

I would be interested to know how many of the people here are going to a psychiatrist with an aim to actually curing their gender identity incongruity by making the mind congruent with the body rather than vice verse. I doubt it's very many if any of the people here.

Furthermore, its listing in the DSM and the standards of care often give people little option.

I for one have been told so far by every doctor I've seen that they will not, under any circumstances prescribe HRT until a psychiatrist has given it the OK. I personally am at a point where if the next two doctors I see are no different, I simply have to go to a psychiatrist for an indefinite period of time until they give the go ahead, and KEEP going indefinitely after, or prescribed HRT is simply not going to happen.

It's a catch-22, I have to go to a psychiatrist and perpetuate the idea that it's a mental disorder, because of the perception that it's a mental disorder.

I personally after having seen two psychiatrist wouldn't recommend anyone to go to a psychiatrist FOR GID if they can avoid it, unless they genuinely feel it would benefit them.

Perhaps a psychologist would be a better choice.

But given my experiences with them, I don't feel I have a mental disorder, I feel going to a therapist that thinks me mentally ill for my condition to the point where they simply dismiss anything I have to say is unhelpful and is only of harm to my mental state, not help.

Don't misunderstand me, I don't think all psychiatrists are bad and that nobody could possibly benefit from seeing one. But if you have GID simply because you have GID, and not as a result of some kind of personality or other disorder, I don't think it's helpful to see one for THAT condition. To help with other issues in your life? To help with depression from your condition, sure, they might be very helpful.

But I don't feel that GID is a mental illness, and so I feel that the psychiatric professions ability to treat it directly is extremely limited.

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Post Merge: October 24, 2009, 11:43:42 PM

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That's not really the point. The point is you should be able too if you are physically capable.

It's like the argument that women should be barred from combat rolls, sure, most women don't want to be in the military, let alone a combat roll to start with, but a few do and if they're physically capable, they should be able too.

Fine, sure, you can include that just for the points sake... But that should be SO low on the list of the trans communities priorities that you'd have to use binoculars to find it on the mile long paper list.... How about inclusion in some schools "Diversity, multicultural" lessons that don't make us look like glorified drag queens? That'd be A. Mazing.

And to merely list hardcore GID in the DSM would be to completely ignore the likely physical causes/manifestations of where GID comes from the body to begin with... Ultimately, its also a physical problem... Ideally people would see it as so too, and it would not JUST be a DSM issue.

Quote from: Kara-Xen on October 25, 2009, 01:07:01 AM
Fine, sure, you can include that just for the points sake... But that should be SO low on the list of the trans communities priorities that you'd have to use binoculars to find it on the mile long paper list.... How about inclusion in some schools "Diversity, multicultural" lessons that don't make us look like glorified drag queens? That'd be A. Mazing.

I agree it's not a priority, but getting it out of the DSM is, and that's really the issue for both situations, so it doesn't really matter.

Perhaps its because gender therapists have a better understanding of the 'condition' and its treatment and complications than many in the medical profession. I'm rather in agreement with you Valerie. Though my concern would be more in line with if it were removed, then whom takes over the care and treatment of those who are dealing with GID? As it has been stated, there are no medical tests that can be done, no scans that can point out where GID is and that a patient definitively has it and the solution is clear cut and medically sound. Granted the mental health side isn't overly successful with it either. I mean, sure I would love to be able to have transition covered under most insurance policies (though being unemployed I have no insurance to cover anything and no money to pay for it, so I'm completely stuck). I would love to be able to walk into an MDs office and say I think I have GID and have her say, yes, here is a prescription for hormones and we will go ahead and schedule you for SRS and FFS. I do believe that I am getting good care from my therapist and learning to cope with things related to my GID and dealing with past issues that came about because of my GID. Perhaps these mental problems came about as an effect of not getting medical treatment for GID, I don't know enough about it to argue for or against it. I'm more concerned about what the proposed alternative is and how it would affect me if it were removed from DSM?

Deanna

Quote from: Deanna_Renee on October 25, 2009, 01:12:21 AM
Perhaps its because gender therapists have a better understanding of the 'condition' and its treatment and complications than many in the medical profession. I'm rather in agreement with you Valerie. Though my concern would be more in line with if it were removed, then whom takes over the care and treatment of those who are dealing with GID? As it has been stated, there are no medical tests that can be done, no scans that can point out where GID is and that a patient definitively has it and the solution is clear cut and medically sound. Granted the mental health side isn't overly successful with it either. I mean, sure I would love to be able to have transition covered under most insurance policies (though being unemployed I have no insurance to cover anything and no money to pay for it, so I'm completely stuck). I would love to be able to walk into an MDs office and say I think I have GID and have her say, yes, here is a prescription for hormones and we will go ahead and schedule you for SRS and FFS. I do believe that I am getting good care from my therapist and learning to cope with things related to my GID and dealing with past issues that came about because of my GID. Perhaps these mental problems came about as an effect of not getting medical treatment for GID, I don't know enough about it to argue for or against it. I'm more concerned about what the proposed alternative is and how it would affect me if it were removed from DSM?

Deanna

You could still see a therapist if it were removed from the DSM, again I ask, how many people are seeing a therapist in an aim of bringing their gender identity in line with their bodies anyway?

QuotePerhaps its because gender therapists have a better understanding of the 'condition' and its treatment and complications than many in the medical profession.

I disagree, their only understanding comes from talking to people like us. They don't understand what causes it or how to scientifically affirm that you have it. They're just guessing as much as anyone else is.

Quote from: asfsd4214 on October 25, 2009, 01:16:27 AM
You could still see a therapist if it were removed from the DSM, again I ask, how many people are seeing a therapist in an aim of bringing their gender identity in line with their bodies anyway?

Not unless my therapist was effing Dumbledore, and could actually do something about this... That'd be PRETTY THERAPEUTIC... Or maybe gave me LESS things to worry about involving their buearucratic chain of liability, and my actual transition, so I can relax and let it all out...
You know. I'd rather have one of those egomaniacal hypocrites run me a bath, and give me a few hits of weed... maybe light a scented candle and play a guitar for me, than complicate this complicated MYSTICAL quest to better myself... To get hormones/learn more/etc...
Everyone has their own standards of care, and I feel like I'm just dealing with people who believe in varying Dungeons and Dragons manuals, not an actually official medical text/procedure. Finding doctors/therapists who can actually HELP you is like playing russian roulette with time, and time is very hot at that game.

Quote from: asfsd4214 on October 25, 2009, 12:41:50 AM
Perhaps because the social and personal implications of the disorder are extremely stressful and often result in legitimate mental illness such as depression.

I agree with social and personal implications resulting in depression or other mental illnesses.



Depression for example is a recognized mental illness.  According to the Mayo Clinic,

"It's not known specifically what causes depression. As with many mental illnesses, it's thought that a variety of biochemical, genetic and environmental factors may cause depression:

    * Biochemical. Some evidence from high-tech imaging studies indicates that people with depression have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. The naturally occurring brain chemicals called neurotransmitters, which are linked to mood, also may play a role in depression. Hormonal imbalances also could be a culprit.
    * Genes. Some studies show that depression is more common in people whose biological family members also have the condition. Researchers are trying to find genes that may be involved in causing depression.
    * Environment. Environment is also thought to play a causal role in some way. Environmental causes are situations in your life that are difficult to cope with, such as the loss of a loved one, financial problems and high stress."


This is the same type of information that is around for GID.  There is evidence for genes, evidence for bio-chemical (hormones too), and I am sure that there is evidence for the environment.

Do you think that depression is not a mental illness?  How about depression removed from the DSM?

What about the idea that mental illnesses are not confined to the brain?  Depression, again is my example.  The current theories on depression aren't limited to the brain, why should any other mental illness?

I also want to bring up that GID isn't the only illness that a GP refers you to a psychiatrist.  I understand that about half of antidepressant users are prescribed them by their GP, and not a psychiatrist (can't find the numbers of people who are prescribed antidepressants while in therapy).  Do you think that a GP is qualified to prescribe antidepressants and diagnose depression?  How about follow up care for the person on them, will they get all the treatment they need, or just the meds?

What happens if GID gets removed from the DSM, and instead of getting help for GID, we just get the meds?  It works out for people who actually have GID, but what about the people who don't?  Hormones, although aren't terribly dangerous, but they do cause a lot of irreversible changes that could cause mental illnesses in people who don't have them.  Should I be able to walk into my GP's office and say, "I have GID", and get hormones and a referral letter for SRS?

Quote from: Valerie Elizabeth on October 25, 2009, 01:26:46 AM
I agree with social and personal implications resulting in depression or other mental illnesses.



Depression for example is a recognized mental illness.  According to the Mayo Clinic,

"It's not known specifically what causes depression. As with many mental illnesses, it's thought that a variety of biochemical, genetic and environmental factors may cause depression:

    * Biochemical. Some evidence from high-tech imaging studies indicates that people with depression have physical changes in their brains. The significance of these changes is still uncertain but may eventually help pinpoint causes. The naturally occurring brain chemicals called neurotransmitters, which are linked to mood, also may play a role in depression. Hormonal imbalances also could be a culprit.
    * Genes. Some studies show that depression is more common in people whose biological family members also have the condition. Researchers are trying to find genes that may be involved in causing depression.
    * Environment. Environment is also thought to play a causal role in some way. Environmental causes are situations in your life that are difficult to cope with, such as the loss of a loved one, financial problems and high stress."


This is the same type of information that is around for GID.  There is evidence for genes, evidence for bio-chemical (hormones too), and I am sure that there is evidence for the environment.

Do you think that depression is not a mental illness?  How about depression removed from the DSM?

Once again, ALL mental disorders could be classified as physical disorders in the sense that they are all physically apart of the brain structure and/or chemistry.

I don't however think something should be classed as a mental disorder unless it's actually a disorder in the functioning of the mind, which I don't believe GID is. Depression is a disorder where the mind no longer see's thing's clearly, and a shroud of hopelessness washes over everything. That is a mental illness because it is an illness of the mind.

Having a gender identity opposite your body characteristics however, is no more an illness of the mind than an illness of the body. And is no more a mental illness than homosexuality.

Quote from: Valerie Elizabeth on October 25, 2009, 01:26:46 AM
What about the idea that mental illnesses are not confined to the brain?  Depression, again is my example.  The current theories on depression aren't limited to the brain, why should any other mental illness?

I also want to bring up that GID isn't the only illness that a GP refers you to a psychiatrist.  I understand that about half of antidepressant users are prescribed them by their GP, and not a psychiatrist (can't find the numbers of people who are prescribed antidepressants while in therapy).  Do you think that a GP is qualified to prescribe antidepressants and diagnose depression?  How about follow up care for the person on them, will they get all the treatment they need, or just the meds?

What happens if GID gets removed from the DSM, and instead of getting help for GID, we just get the meds?  It works out for people who actually have GID, but what about the people who don't?  Hormones, although aren't terribly dangerous, but they do cause a lot of irreversible changes that could cause mental illnesses in people who don't have them.  Should I be able to walk into my GP's office and say, "I have GID", and get hormones and a referral letter for SRS?

Incidents of detransition and regret are very rare, and happen even with concurrent psychological counseling. I feel that they are too uncommon to warrant the psychological stress and harm caused BY the psychiatric profession in an aim of "protecting you from yourself" because of the extremely rare cases of regret, which are often not prevented by psychological counseling anyway.

The system should help people who seek help, it should not however hinder people who seek help who by all other indications are perfectly mentally healthy because it assumes we're too incompetent to know what we're doing until we can prove otherwise. Which it does because we're classed as a mental disorder!

In an effort to be so overly cautious to prevent people from transitioning and regretting it, the system creates faaaar more victims in the people who need to transition but can't.

Quote from: asfsd4214 on October 25, 2009, 01:16:27 AM
You could still see a therapist if it were removed from the DSM, again I ask, how many people are seeing a therapist in an aim of bringing their gender identity in line with their bodies anyway?

I disagree, their only understanding comes from talking to people like us. They don't understand what causes it or how to scientifically affirm that you have it. They're just guessing as much as anyone else is.

I do see a therapist, but not to align my mind to my body, but my body to my mind. The former is impossible IMO.

I don't see why you disagree to what I said, I know that most of what they know is from working with those who are TS/TG or are themselves TS/TG (like my therapist). I didn't say how they know more or where they learned it, just that are more aware of the condition (from my experience). No one knows what causes it, didn't say they do.

My concern is that if it is taken out of the DSM, then who treats me? A doctor who knows nothing about it? Sure 30 years from now it may be as accepted as the gays are accepted now, but if that's the case I won't be here 30 years from now. I need to be treated now and now the only solution is the route I'm taking, take that away then WHAT? That is my question, my concern. What are you or others who are pushing to have it removed proposing takes their place in caring for us, for ME?

I agree that I don't want to be classified as having a mental condition, but I need to know how it would be changed from mental to medical. That's all.

Deanna

Nevermind, didn't read the last line of the above post.

It depens on a  lot of things. I put it in this way: What it tells about our society that we must demand moving the GID from the DSM? (Julie Marie mentioned the important things).

Quote from: glendagladwitch on October 25, 2009, 12:19:43 AM
As an alternative to removing GID from the DSM, we could just put everything else in.  Like being Catholic.  Liking chocolate.  Wanting to get married.  That way, psychiatrists can treat for everything.

Oh my goodness THANK YOU.

Quote from: Julie Marie on October 25, 2009, 12:54:44 AM
Since it's considered a MENTAL DISORDER, you are then directed to have psychiatric counseling.  And your insurance will cover that.

My insurance won't even cover that unless my therapist lies about it. He's not going to do that. And he shouldn't have to. So it's all out of pocket for me.

Quote from: asfsd4214 on October 25, 2009, 01:16:27 AM
I ask, how many people are seeing a therapist in an aim of bringing their gender identity in line with their bodies anyway?

I like this question.
My answer is this - because it's not an option.  Not in the sense that it's not available as an option, but in the sense that I don't know of any treatment that work that way.  Were the option available, I would take that road.  Save me a ton of money.  It goes back to "what if there was a pill that could make your GID go away, would you take it?"


I also think this is one of those types of questions that can never really be answered, until there is hard proof that points to something.  Until then, I think people will always argue over it.

Quote from: asfsd4214 on October 25, 2009, 01:43:59 AM
Incidents of detransition and regret are very rare, and happen even with concurrent psychological counseling. I feel that they are too uncommon to warrant the psychological stress and harm caused BY the psychiatric profession in an aim of "protecting you from yourself" because of the extremely rare cases of regret, which are often not prevented by psychological counseling anyway.

The system should help people who seek help, it should not however hinder people who seek help who by all other indications are perfectly mentally healthy because it assumes we're too incompetent to know what we're doing until we can prove otherwise. Which it does because we're classed as a mental disorder!

Who's to say we aren't incompetent?  Should a doctor give a person chemo therapy for claiming to have cancer?  Just because you have some symptoms that are common to a type of cancer, doesn't mean that you have cancer, and sure doesn't mean that you should be on chemo.  What about reading the symptoms of something online, and thinking you have it just because you have some of the symptoms?


Current postoperative regret is approximately 1%, maybe a little less.  I understand the argument for SRS requirements being restrictive, but do you honestly think that less people would regret it if they made the decision without any therapy?

Malpractice happens.  From what I can find, there are about 4 malpractice cases per 100 cases.  Maybe a little higher, maybe a little lower.  Maybe the current system is too restrictive.  The current numbers show that SRS regret is less than the amount of malpractice.  Maybe they should be less restrictive.  I don't know.

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Post Merge: October 25, 2009, 02:32:55 AM

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Quote from: Arch on October 25, 2009, 02:27:09 AM
My insurance won't even cover that unless my therapist lies about it. He's not going to do that. And he shouldn't have to. So it's all out of pocket for me.

I ask again, why should we change GID?

Why not work on changing insurance?

It's not a disorder.  Just like being homosexual isn't one.

Bam.  Case closed.

All of the insurance stuff is needlessly complicated.

Why do people think it's a disorder?

Quote from: Valerie Elizabeth on October 25, 2009, 02:31:39 AM
Who's to say we aren't incompetent?  Should a doctor give a person chemo therapy for claiming to have cancer?  Just because you have some symptoms that are common to a type of cancer, doesn't mean that you have cancer, and sure doesn't mean that you should be on chemo.  What about reading the symptoms of something online, and thinking you have it just because you have some of the symptoms?

If you can pay for it, maybe you should be able to get it.

But that's an entirely different situation, cancer can be scientifically proven as a condition you suffer from.
GID on the other hand, is entirely subjective no matter who diagnosis it. If a therapist diagnoses it, they are only doing so based on what you have told them. Is that any more accurate than you who is actually LIVING it can do?

Quote from: Valerie Elizabeth on October 25, 2009, 02:31:39 AM
Current postoperative regret is approximately 1%, maybe a little less.  I understand the argument for SRS requirements being restrictive, but do you honestly think that less people would regret it if they made the decision without any therapy?

We're not talking about SRS, you could easily restrict SRS on the basis of RLE if need be. If you are clearly living successfully in your identified gender, then SRS is simply correcting a problem with your body, and no longer anything to do with mental illness. We're talking about the diagnosis of GID and its place as a mental disorder. And by extension access to earlier stages of treatment like HRT. Which are also not entirely reversible, but far less so than SRS and potentially far more beneficial to social functioning.

Quote from: Valerie Elizabeth on October 25, 2009, 02:31:39 AM
I ask again, why should we change GID?

Why not work on changing insurance?

And I for one will answer again.... because there is absolutely no evidence it is a mental disorder, and growing evidence that it is not.

The DSM is for mental disorders.

That is why.

Ya I'll get the wrath of Khan for this but what the heck...

Firstly I have no problem with GID being listed as a mental disorder, it certainly isn't a physical disorder, for why would I have tried self mutilation to get rid of my male genitals, and why would I have planned suicide to get away from the pain?  My genitals didn't tell my brain that they should be female.

It would seem for many folks in the US that this is all about insurance coverage and the funding of treatment.  I thing it is wrong to go after the medical community, a community that for the most part recognizes our condition and supports us, we or in the case of the US, we should be going after the insurance companies.

-={LR}=-

Gender dysphoria, I rather like the words.  They seem accurate, descriptive, and appropriate.

What I don't understand is why you must bare your soul to a complete stranger while paying vast sums of money to convince them of something you knew with certainty when you where 4 years old?!  That's one of the reasons depression is associated with 'gender dysphoria'.

No matter what you call it, the medical 'establishment' requires a cubby hole to stick it in.  It makes them think they understand it.

It is required by the WPATH SOC.  In order to get anything.


Janet

Quote from: asfsd4214 on October 25, 2009, 03:59:37 AM
If you can pay for it, maybe you should be able to get it.

But that's an entirely different situation, cancer can be scientifically proven as a condition you suffer from.
GID on the other hand, is entirely subjective no matter who diagnosis it. If a therapist diagnoses it, they are only doing so based on what you have told them. Is that any more accurate than you who is actually LIVING it can do?

First of all, giving someone a treatment just because they can pay for it is irresponsible.

Secondly, my point wasn't whether or not you can prove the existence of the disorder, but the fact that there might be a lot more going on than just GID.  A person may claim to have symptoms that they don't have just for a diagnosis.  A person may also attribute their current symptoms to a disorder that they don't have.  Without a diagnosis, you're not treating anything.

Quote from: SarahFaceDoom on October 25, 2009, 03:14:50 AM
It's not a disorder.  Just like being homosexual isn't one.

Bam.  Case closed.

All of the insurance stuff is needlessly complicated.

Why do people think it's a disorder?

Because if you compare it to homosexuality, that says there is nothing wrong.  If nothing is wrong, then HRT, FFS, and SRS go out the window.  Not to mention any chance of insurance coverage.  If you want any kind of treatment, it has to be a disorder. 

Quote from: Ladyrider on October 25, 2009, 07:29:24 AM
It would seem for many folks in the US that this is all about insurance coverage and the funding of treatment.  I thing it is wrong to go after the medical community, a community that for the most part recognizes our condition and supports us, we or in the case of the US, we should be going after the insurance companies.

-={LR}=-

That's kind of been my point all along.

Why do doctors not prescribe HRT without you going to therapy?  Insurance.  Why do you have to wait 12 months after living full time for SRS?  Insurance.  I know that the WPATH guidelines say that, but the insurance companies are the ones enforcing it.


I will say it again.  A mental illness doesn't mean it's in your head.  Bipolar, depression, etc, are not mental illnesses that are only in your head.  They are caused by mental, physical, and external sources.  GID is caused by the same types of stimuli.  Mental, physical, and external stimuli.  You can't claim that GID isn't a mental illness and overlook other mental illnesses that have the same diagnostic criteria.

What about the fact that SRS used to be covered regularly?  What stopped that from being covered?  I know we aren't necessarily talking about SRS and insurance coverage, but it seems that insurance coverage is the reason most people want it removed from the DSM.  The other reason is so that people think that we are 'normal' like homosexuals.

The difference between us and homosexuals is the fact that we are seeking treatment for it, and they are not.  Wanting treatment implies that something is wrong.  If you want to be normal, you will probably have to pay for it out of pocket.

I still want to know what happens after it gets removed from the DSM?  Where will it go?  How will it be diagnosed?  Who Diagnoses it?  Should it be diagnosed?  What is the treatment?  Should there be treatment?

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Post Merge: October 25, 2009, 01:09:17 PM

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Lastly, I am stepping out of this conversation.

I really only wanted to know everyone's thoughts and reasons.  I don't want to argue this forever.

Well, I see that you're stepping out. But let me just add something anyway. For mental disorders, treatment focuses on the brain. We've got therapy, chemicals, and other brain-focused treatments like ECT. The recognized treatment for GID--and I really do loathe the term "GID"--focuses on the body. And it's the only treatment that seems to work.

Are there any other so-called mental disorders for which this is true? If so, should they perhaps be taken out of the DSM?

Quote from: Becca on October 24, 2009, 06:47:11 PMI do not feel mentally disordered (at least not because I'm trans, lol).

Well, I've got AD/HD and don't feel like that makes me "mentally disordered", but considering some of the disjointed real-life conversations I've had, I'm sure most others would beg to differ.  Furthermore, the vast majority of clinical sociopaths are of the opinion that they're perfectly normal, but I think everybody else here would agree that sociopathy is a mental disorder.

I have no real problem with GID/transsexualism being a mental disorder -- what I DO have a problem with is the American psycological associations are basically ignoring the fact that over 98% of all people given a GID diagnosis are reported to have vastly improved lives and mental states during and after the physical transition process -- meaning that this is basically the only "mental disorder" that is regularly denied treatment, so the APAs are essentially contradicting themselves.  That's where I have a problem -- that they first claim "it's a mental disorder" and then consistently deny patients the only consistently proved-effective treatment for that "mental disorder".

On the other hand, there is more and more evidence gathered every day that there is a massive physical / medical component to gender identity, suggesting that TS persons may be closer to Intersexed persons, in that it's a biological reality of their being.

Quote from: Valerie Elizabeth on October 24, 2009, 07:04:33 PMI don't understand the logic there.  Mood disorders are listed in the DSM (bipolar, depression, etc) and they are considered "real" medical conditions and they get treatment.  How would removing GID from the DSM accomplish that?

Also, according to tsroadmap :
"A little background: SRS was routinely covered in the US until a couple of medical articles came out in the late 1970's showing high suicide rates among post-operative women. This came at the same time a couple of prominent gender clinics were closed, notably Johns Hopkins.

The insurance companies pounced on these events as a chance to decry the procedure as elective, cosmetic, or experimental. It's been an uphill battle since. "

At least according to some of the older TS women, as in those who transitioned in the 1960s and early 1970s, I've discussed this with, these "high suicide rates" were more due to the natures of how those old gender clinics were run.  Patients were essentially shamed into cutting themselves off from all friends and family, and were all but explicitly forced to basically "compete" for who was more sexually attractive to the doctors in group therapy sessions.  The old clinics were seriously messed up, but for some reason, this is still a fact that is rarely brought to light.

Quote from: Janet Lynn on October 24, 2009, 07:55:08 PMBy being listed as a mental disorder, we will never get any medical establishment to take us seriously.

I've been diagnosed with Adult-type AD/HD and am rarely taken seriously by anybody.  My best friend is severely bipolar and still constantly runs into people, including the occasional doctor at the hospital she volunteers at, who thinks she can somehow just magically "snap out of" her depressive states.  I don't think "to be taken seriously" is a good-enough cause to remove GID from the DSM because there are dozens of "mental disorders" that I think we can all agree are near-crippling conditions for a person to live with, and those who have them are still rarely, if ever, taken seriously.

But I think we can agree that removing "bipolar disorder" from the DSM would eradicate any access to proper care that my friend and others who have that disorder currently have, and it could very well lead them to be taken even less seriously because there's not even a community of professionals agreeing that there's something the matter with their mental/emotional state.

If GID is going to be in the DSM, then the APAs need to allow treatment for it.  That's the real problem.

I haven't seen any consistent studies of, say, MRI or other types of brain scans of pre-HRT and post-HRT TS persons that would serve as evidence that this is, in fact, more biochemical than psychological.  That gender identity is apparently determined pre-natally in interesting, but it's not enough to do much more than posit interesting hypotheses.  And what if somebody's pre-HRT MRI somehow suggested that they weren't TS and were thus denied treatment that way?  I know if I had some sort of scan like that and was told "well, your brain suggests that you're really a woman, so you can't have man-juice" -- well, frankly, it would crush me and I'd be suicidal.  A mental/emotional diagnosis would be the only way to guarantee TS persons, across the board, treatment -- at least as soon as these associations can finally re-allow the only treatment proved effective.

Quote from: Valerie Elizabeth on October 25, 2009, 12:46:38 PM
Lastly, I am stepping out of this conversation.

I really only wanted to know everyone's thoughts and reasons.  I don't want to argue this forever.

I think that's wise, especially we've reached a point where I feel like you are simply ignoring half of the replies you get and then rephrasing the same questions.

Almost all of your post then I have already responded to...

Quote
I still want to know what happens after it gets removed from the DSM?  Where will it go?  How will it be diagnosed?  Who Diagnoses it?  Should it be diagnosed?  What is the treatment?  Should there be treatment?

Quote
I don't know where GID should be located, where is AIS located? If GID is an intersex condition in some or most cases, it should be treated as one. As for who would diagnose it, I suppose a doctor would have too. It has to be diagnosed in order to provide treatment, but unfortunately we don't have any objective way to diagnose it as a physical disorder at this time. But I don't think assuming it's nothing more than a psychological disorder, which is what its presence in the DSM does for most people, is a great situation either.

Quote
Because if you compare it to homosexuality, that says there is nothing wrong.  If nothing is wrong, then HRT, FFS, and SRS go out the window.  Not to mention any chance of insurance coverage.  If you want any kind of treatment, it has to be a disorder. 

Quote
my point was that homosexuality is not considered a mental illness, and neither should GID. But in just the same was as multiple sclerosis is not a mental illness even though it causes damage in the brain, it still requires treatment.

Quote
I will say it again.  A mental illness doesn't mean it's in your head.  Bipolar, depression, etc, are not mental illnesses that are only in your head.  They are caused by mental, physical, and external sources.  GID is caused by the same types of stimuli.  Mental, physical, and external stimuli.  You can't claim that GID isn't a mental illness and overlook other mental illnesses that have the same diagnostic criteria.

QuoteOnce again, ALL mental disorders could be classified as physical disorders in the sense that they are all physically apart of the brain structure and/or chemistry.

I don't however think something should be classed as a mental disorder unless it's actually a disorder in the functioning of the mind, which I don't believe GID is. Depression is a disorder where the mind no longer see's thing's clearly, and a shroud of hopelessness washes over everything. That is a mental illness because it is an illness of the mind.

Having a gender identity opposite your body characteristics however, is no more an illness of the mind than an illness of the body. And is no more a mental illness than homosexuality.

QuoteWhat about the fact that SRS used to be covered regularly?  What stopped that from being covered?  I know we aren't necessarily talking about SRS and insurance coverage, but it seems that insurance coverage is the reason most people want it removed from the DSM.  The other reason is so that people think that we are 'normal' like homosexuals.

No, if you would kindly reread most if not all of the posts made on this thread, I think you will find is that it's because most of us don't consider it a mental illness.

QuoteSecondly, my point wasn't whether or not you can prove the existence of the disorder, but the fact that there might be a lot more going on than just GID.  A person may claim to have symptoms that they don't have just for a diagnosis.  A person may also attribute their current symptoms to a disorder that they don't have.  Without a diagnosis, you're not treating anything.

That's exactly how the diagnosis is made right now. Why claim to have a set of symptoms, and they either believe us or they do not. There is no greater tool used to diagnose us at this time.

QuoteFirst of all, giving someone a treatment just because they can pay for it is irresponsible.

That's how most cosmetic operations are handled. If we were given responsibility for ourselves, only we would be to blame for being irresponsible.

I for one am seriously tired of being protected from myself, for the love of god stop helping!.  ;D

Quote from: Ladyrider on October 25, 2009, 07:29:24 AM
Ya I'll get the wrath of Khan for this but what the heck...

Firstly I have no problem with GID being listed as a mental disorder, it certainly isn't a physical disorder, for why would I have tried self mutilation to get rid of my male genitals, and why would I have planned suicide to get away from the pain?  My genitals didn't tell my brain that they should be female.

-={LR}=-

No, but maybe your brain told your brain that it should be female. If that is the issue and it is an issue of abnormal brain structures but your mind is otherwise perfectly healthy, then it's more a physical disorder than a mental one.

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Post Merge: October 25, 2009, 04:07:48 PM

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Quote from: YoungSoulRebel on October 25, 2009, 04:37:03 PM
Well, I've got AD/HD and don't feel like that makes me "mentally disordered", but considering some of the disjointed real-life conversations I've had, I'm sure most others would beg to differ.  Furthermore, the vast majority of clinical sociopaths are of the opinion that they're perfectly normal, but I think everybody else here would agree that sociopathy is a mental disorder.

So then who deems us sane or not?

Psychiatrists? Maybe they're insane too.

Ultimately the only truth to a mental disorder is if it can be scientifically proven, which most can't, or if it causes distress and problems in your life.

If you're hearing voices for instance, it's quite obvious you have a mental disorder, because your mind is hearing things that aren't there.

If your point is that we can't judge if we are sane or not, then that means that everybody in the world is "potentially insane" (I think that's probably how most psychiatrists view the world  ;D), but most people don't see a psychiatrist unless they're experiencing problems pertaining to the mind. GID CAN be viewed as a problem pertaining to the mind, but it can be just as viewed as a problem pertaining to the body, if it could be of a neurological nature. And there is growing evidence that it is.

Quote from: YoungSoulRebel on October 25, 2009, 04:37:03 PM
I have no real problem with GID/transsexualism being a mental disorder -- what I DO have a problem with is the American psycological associations are basically ignoring the fact that over 98% of all people given a GID diagnosis are reported to have vastly improved lives and mental states during and after the physical transition process -- meaning that this is basically the only "mental disorder" that is regularly denied treatment, so the APAs are essentially contradicting themselves.  That's where I have a problem -- that they first claim "it's a mental disorder" and then consistently deny patients the only consistently proved-effective treatment for that "mental disorder".

Because if it's a mental disorder, then transition isn't curing ANYTHING. It's like administering morphine for a broken arm, the arm's still broken, you just can't feel it anymore.

And that's the way they see it too, and it's all the more reason GID shouldn't be considered a mental disorder. There's no evidence that it is one, just a constantly decreasing lack of evidence to the contrary.

Quote from: YoungSoulRebel on October 25, 2009, 04:37:03 PM
On the other hand, there is more and more evidence gathered every day that there is a massive physical / medical component to gender identity, suggesting that TS persons may be closer to Intersexed persons, in that it's a biological reality of their being.

At least according to some of the older TS women, as in those who transitioned in the 1960s and early 1970s, I've discussed this with, these "high suicide rates" were more due to the natures of how those old gender clinics were run.  Patients were essentially shamed into cutting themselves off from all friends and family, and were all but explicitly forced to basically "compete" for who was more sexually attractive to the doctors in group therapy sessions.  The old clinics were seriously messed up, but for some reason, this is still a fact that is rarely brought to light.

Today's clinics often aren't much better.

http://www.samesame.com.au/forum/showthread.php?t=9537 (http://www.samesame.com.au/forum/showthread.php?t=9537)

Quote from: YoungSoulRebel on October 25, 2009, 04:37:03 PM
I haven't seen any consistent studies of, say, MRI or other types of brain scans of pre-HRT and post-HRT TS persons that would serve as evidence that this is, in fact, more biochemical than psychological.  That gender identity is apparently determined pre-natally in interesting, but it's not enough to do much more than posit interesting hypotheses.  And what if somebody's pre-HRT MRI somehow suggested that they weren't TS and were thus denied treatment that way?  I know if I had some sort of scan like that and was told "well, your brain suggests that you're really a woman, so you can't have man-juice" -- well, frankly, it would crush me and I'd be suicidal.  A mental/emotional diagnosis would be the only way to guarantee TS persons, across the board, treatment -- at least as soon as these associations can finally re-allow the only treatment proved effective.

Really? I haven't.

As far as I'm aware the only brain structures that have been found to be consistently different are the BSTC, which is too small to be imaged and likely not a cause but more another symptom anyway.

And who's to say that if such a scan were available, it wouldn't find that 99% of the people on this forum legitimately have it. Just as detransition and regret are extremely low, feeling such a compelling need to change your body characteristics is likely very infrequently caused by purely mental reasons.

And wouldn't it be liberating to know that you're not crazy, that you're not delusional, that everything you're feeling has a tangible cause and that you were right? You ARE a man or woman, instead of the perception psychiatrists have that "you're not, you just want to be".

Quote from: Arch on October 25, 2009, 01:23:47 PM
I really do loathe the term "GID"--focuses on the body. And it's the only treatment that seems to work.

I actually think that GID is one of the very few terms that is somewhat decent in the transgenders medical world. Although I don't like its psychiatric or DSM origins, it's faaar better than "transexual" and related terms.

Quote from: asfsd4214 on October 25, 2009, 04:45:34 PMNo, if you would kindly reread most if not all of the posts made on this thread, I think you will find is that it's because most of us don't consider it a mental illness.

But if you consider the typical person with clinical sociopathy or certain forms of schizophrenia, you'd know that simply feeling that oneself is somehow disorder-free is not a good enough reason to remove GID from the DSM.

I myself, prior to starting the transition process, felt this was something so crippling that first I went through a highly self-destructive phase and then a severely agoraphobic phase.  In fact, I can't say that any of the TS persons I know personally describes their pre-transition lives in anything but negative terms riddled with negative feelings -- that seems pretty basic symptoms for many untreated mental disorders.  Heck, many anorectic persons claim that they "don't feel mentally disordered", but they way they live seems to severely point to the contrary.  Simply saying "I don't feel like this is a mental disorder" isn't good enough for the APAs.

Having been in these arguments for the last five years, I have yet to see somebody in the "it's not a mental disorder" camp posit a viable alternative to TS persons getting and consistently receiving treatment -- after all, there are no pre-HRT and post-HRT studies of MRIs performed on the same groups of TS persons to verify that this is a neurological form of Intersexxuality, which would make it a treatable physical disorder.  Those who are at least ambivalent to GID's inclusion in the DSM of mental disorders, on the other hand, all seem to at least be of the opinion that the APAs' and insurance agencies willingness to actually treat it needs to change.

Quote from: YoungSoulRebel on October 25, 2009, 05:13:08 PM
But if you consider the typical person with clinical sociopathy or certain forms of schizophrenia, you'd know that simply feeling that oneself is somehow disorder-free is not a good enough reason to remove GID from the DSM.

It's a good enough reason to not state that most people here want it removed purely for insurance reasons.  ::)

Quote from: YoungSoulRebel on October 25, 2009, 05:13:08 PM
I myself, prior to starting the transition process, felt this was something so crippling that first I went through a highly self-destructive phase and then a severely agoraphobic phase.  In fact, I can't say that any of the TS persons I know personally describes their pre-transition lives in anything but negative terms riddled with negative feelings -- that seems pretty basic symptoms for many untreated mental disorders.  Heck, many anorectic persons claim that they "don't feel mentally disordered", but they way they live seems to severely point to the contrary.  Simply saying "I don't feel like this is a mental disorder" isn't good enough for the APAs.

Having been in these arguments for the last five years, I have yet to see somebody in the "it's not a mental disorder" camp posit a viable alternative to TS persons getting and consistently receiving treatment -- after all, there are no pre-HRT and post-HRT studies of MRIs performed on the same groups of TS persons to verify that this is a neurological form of Intersexxuality, which would make it a treatable physical disorder.  Those who are at least ambivalent to GID's inclusion in the DSM of mental disorders, on the other hand, all seem to at least be of the opinion that the APAs' and insurance agencies willingness to actually treat it needs to change.

Maybe not having a system would be a better system. If people could simply elect to undergo HRT like they can cosmetic procedures without psychological evaluation and having to deal with gatekeeper logic, maybe we'd be better off.

Quote from: asfsd4214 on October 25, 2009, 04:45:34 PM
If your point is that we can't judge if we are sane or not, then that means that everybody in the world is "potentially insane" (I think that's probably how most psychiatrists view the world  ;D), but most people don't see a psychiatrist unless they're experiencing problems pertaining to the mind. GID CAN be viewed as a problem pertaining to the mind, but it can be just as viewed as a problem pertaining to the body, if it could be of a neurological nature. And there is growing evidence that it is.

You seem to be of the mistaken opinion that "mental disorder = insane".  It does not.  I means that there is a mental or emotional or potentially neurochemical peculiarity that differs enough from "average" to gain a diagnosis.  Like I said, I myself have a diagnosis of ADHD -- that's in the DSM, you can look it up.  That doesn't mean that ADHD is "clinical insanity" -- it simply means that i have a mental peculiarity giving me the attention-span of your average ferret.  As I had previously said, my best friend is severely bipolar, but that doesn't make her "insane" -- yet bipolar disorder is in the DSM.

Gee, maybe you should rethink that DSM criteria actually means?

Quote from: asfsd4214 on October 25, 2009, 04:45:34 PM
Because if it's a mental disorder, then transition isn't curing ANYTHING. It's like administering morphine for a broken arm, the arm's still broken, you just can't feel it anymore.

Then why prescribe ritalin to people whith ADHD?  Or lithium to Zoloft or Prozac to people with bipolar disorders?  By your own logic "that's not curing anything" so why not just let my friend go unmedicdated -- I mean, heck, she'll only be alternating between spending weeks at a time in bed and crying and weeks at a time "in total Jim Carey manic-mode" (as she puts it), and completely non-fuctional all the time.  Medication doesn't actually "cure anything", not by your logic, it just somehow magically sets her into a mode where she is living life to her fullest potential.

And here I thought that transitioning (which includes lifelong HRT in the same way my friend is going to be taking medications for the rest of her life) was setting me to a mode where I was living my life to its fullest potential.  Seems that means my friend and I are in a similar position, considering that.

The rest of your response doesn't really prove anything other than that the APAs need to actually treat GID in the only proved-effective form of treatment AND that apparently other people need to get it out of their heads that "mental disorder = crazy".  If you don't want to listen to reason, then I'm done.  I've argued with sound logic here, and I find the brand of logic you've argued against me with to be circular and thus fallacious (http://www.nizkor.org/features/fallacies/begging-the-question.html).  I wish you well with that.

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Post Merge: October 25, 2009, 04:34:26 PM

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Quote from: asfsd4214 on October 25, 2009, 05:17:55 PMMaybe not having a system would be a better system. If people could simply elect to undergo HRT like they can cosmetic procedures without psychological evaluation and having to deal with gatekeeper logic, maybe we'd be better off.

I'm hard pressed to realise how this suggestion would suddenly eradicate the problem some people have voiced of "people will take me more seriously".  Good call -- liken us all to the same realm as people like Mistress Rhiannon (do a search of you're that curious for photos) and other body-modification enthusiasts.  And here i thought my relationship with my penis was closer to what's colloqually known as "phantom limb syndrome" -- that it wasn't all about "wanting to look like ex" but about knowing that there was an incongruency between body and mind.

Quote from: YoungSoulRebel on October 25, 2009, 05:29:21 PM
You seem to be of the mistaken opinion that "mental disorder = insane".  It does not.  I means that there is a mental or emotional or potentially neurochemical peculiarity that differs enough from "average" to gain a diagnosis.  Like I said, I myself have a diagnosis of ADHD -- that's in the DSM, you can look it up.  That doesn't mean that ADHD is "clinical insanity" -- it simply means that i have a mental peculiarity giving me the attention-span of your average ferret.  As I had previously said, my best friend is severely bipolar, but that doesn't make her "insane" -- yet bipolar disorder is in the DSM.

Gee, maybe you should rethink that DSM criteria actually means?

It was a poor choice of words on my part, by insane what I meant was "mentally ill"

Quote from: YoungSoulRebel on October 25, 2009, 05:29:21 PM
And here I thought that transitioning (which includes lifelong HRT in the same way my friend is going to be taking medications for the rest of her life) was setting me to a mode where I was living my life to its fullest potential.  Seems that means my friend and I are in a similar position, considering that.

The rest of your response doesn't really prove anything other than that the APAs need to actually treat GID in the only proved-effective form of treatment AND that apparently other people need to get it out of their heads that "mental disorder = crazy".  If you don't want to listen to reason, then I'm done.  I've argued with sound logic here, and I find the brand of logic you've argued against me with to be circular and thus fallacious (http://www.nizkor.org/features/fallacies/begging-the-question.html).  I wish you well with that.

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Post Merge: October 25, 2009, 03:34:26 PM

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I'm hard pressed to realise how this suggestion would suddenly eradicate the problem some people have voiced of "people will take me more seriously".  Good call -- liken us all to the same realm as people like Mistress Rhiannon (do a search of you're that curious for photos) and other body-modification enthusiasts.  And here i thought my relationship with my penis was closer to what's colloqually known as "phantom limb syndrome" -- that it wasn't all about "wanting to look like ex" but about knowing that there was an incongruency between body and mind.

My use of the word insane was clearly a poor choice, but now you're just looking for something to find fault with. I didn't liken us to anything, you asked what I thought would be a better system, and I gave an example. An EXAMPLE, at no point at all did I so much as imply that we should be considered to be undergoing optional cosmetic surgery, I simply said that a freer, more elective system might be in our interests.

Quote from: YoungSoulRebel on October 25, 2009, 05:29:21 PM
Then why prescribe ritalin to people whith ADHD?  Or lithium to Zoloft or Prozac to people with bipolar disorders?  By your own logic "that's not curing anything" so why not just let my friend go unmedicdated -- I mean, heck, she'll only be alternating between spending weeks at a time in bed and crying and weeks at a time "in total Jim Carey manic-mode" (as she puts it), and completely non-fuctional all the time.  Medication doesn't actually "cure anything", not by your logic, it just somehow magically sets her into a mode where she is living life to her fullest potential.

In a sense, it's not "curing" the problem but rather treating the symptoms, and yes you're right, in that sense it's similar to transition as a treatment for GID.

I would argue that the difference is that in those cases they are treating problems of the mind and mental state of functioning directly. Transition on the other hand is more releaving sources of distress to an otherwise healthy mind.

I have explained this a few times, but perhaps I haven't been clear enough.

I do not feel GID is a mental disorder the way ADHD and Bipolar are, because if you take a step back and stop looking at distress of the mind resulting from being in the wrong body, the mind itself is not ill. In ADHD and Bipolar, there's no question that it's the mind that's abnormal. With GID it's much fuzzier. You could argue that it is also a mental disorder because the mind thinks it's the opposite gender to the body and it shouldn't, but you could also argue that it's not a mental disorder because the mind is not actually abnormal once you stop considering the bodies gender to be the only one relevant. If the minds gender is opposite the body, but otherwise healthy, I do not see how it is a mental disorder. The mind isn't abnormal per se, and neither is the body, but the incompatibility of the two is the source of the problem.

GID is simply too different from the traditional definition of a mental disorder to be considered one, in my opinion.

Quote from: asfsd4214 on October 25, 2009, 06:04:36 PM
It was a poor choice of words on my part, by insane what I meant was "mentally ill"

My use of the word insane was clearly a poor choice, but now you're just looking for something to find fault with. I didn't liken us to anything, you asked what I thought would be a better system, and I gave an example. An EXAMPLE, at no point at all did I so much as imply that we should be considered to be undergoing optional cosmetic surgery, I simply said that a freer, more elective system might be in our interests.

A free-er, more elective system, usually means that the 90% of the world can't afford it.

Quote from: Miniar on October 25, 2009, 06:07:47 PM
A free-er, more elective system, usually means that the 90% of the world can't afford it.

Perhaps both systems could exist concurrently then?

An elective private one, and a public one NOT managed by psychiatrists.  ::)

Quote from: asfsd4214 on October 25, 2009, 06:04:36 PM
It was a poor choice of words on my part, by insane what I meant was "mentally ill"

My use of the word insane was clearly a poor choice, but now you're just looking for something to find fault with. I didn't liken us to anything, you asked what I thought would be a better system, and I gave an example. An EXAMPLE, at no point at all did I so much as imply that we should be considered to be undergoing optional cosmetic surgery, I simply said that a freer, more elective system might be in our interests.

On this I will have to absolutely disagree.  Do i think certain procedures in the treatment process (like FSM for TS women or phalloplasties for TS men) be elective?  Sure -- because there are certain treatments for bipolar disorder and ADHD, as well as sociopathy, schizophrenia, and so forth that are totally optional and elective.  I don't see how an "elective system", one without basic treatment outlines and diagnostic criteria actually benefits individuals who would be suicidal if they couldn't get insurance coverage for transitioning.  And as it stands, a few insurances do cover certain physical transitioning processes (including genital recon) -- it's just not recommended by government agencies due to now-antiquated and ultimately misleading reports of the highly flawed "gender clinic" systems that were shut down in the 1970s (and these clinics were ostensibly shut down to prevent investigations into why they failed so many patients -- if those clinics had been open long enough to be investigated, they would have been shown to be unethical in the treatment of their patients in the first place).

I feel that most people here seem to be having little more than emotional reactions against the idea that fitting DSM criteria makes them somehow "mentally ill" -- as if this was somehow an inherently bad thing.  Is it "bad" for some mental disorders to go untreated?  Of course -- but as i sdaid, my best friend is severely bipolar, and with proper medication (for her -- not all bipolar individuals function best under the same medications), she's a wonderfully charming person to be with, and you'd never guess that she was, as you so eloquently put it "mentally ill".  I have no prejudices against those who fit DSM criteria in other areas, so that's probably the main reason I have no real quibble against GID being in the DSM in the first place -- my only quibble concerning it is that it's so far the only listing in the DSM that is consistently denied its most proved-effective treatment.

Quote from: asfsd4214 on October 25, 2009, 06:13:15 PM
Perhaps both systems could exist concurrently then?

An elective private one, and a public one NOT managed by psychiatrists.  ::)

And who should manage it then?
Who should make sure that the money they are spending on you for the sake of your health is "needed"?

Transsexualism, in my mind, is caused by a brain/body incongruence.
BUT, the reason we Need help correcting that incongruence is Because of the mental anguish it causes us.

Physical problem causes mental anguish, thus treating the physical problem with physical treatments is an appropriate way to alleviate the mental anguish.

Quote from: Miniar on October 25, 2009, 06:07:47 PM
A free-er, more elective system, usually means that the 90% of the world can't afford it.

Agreed.  I find the notion that any government agencies be eradicated to be essentially classist.  I mean, just think of how many dangerous paranoid schizophrenics would be left untreated if the government agencies were to be eradicated from the equation.  I, personally, would not have been able to afford my chest surgery without Medicare (and I was wearing a 38-K bra, as I've said in the FTM sub-forum, so that's pretty much how Medicatre covered it), and I wouldn't be able to afford my lifelong HRT without Medicare, either (and according to Walgreen's, I have the co-pay I have because of how they code it into their system -- i have no idea how they're classifying me, but I'm grateful).

It would be a lot easier, in some ways, and for many people, if this was something that they wouldn't have to search out loopholes to get coverage for.  To say it should all be elective is to say that one is perfectly fine to see hundreds, if not thousands of people go untreated for otherwise treatable conditions -- including transsexualism.

I can't believe that after ten years on the Internet that I'm still getting into these arguments with people using circular logic to explain why the current system sucks and without any of them offering a realistic alternative for everybody.  This whole argument seems to boil down to little more than 1) now-antiquated and largely misunderstood studies that certain agencies are trying to pass off as "proof" of why actual treatment of TS persons somehow "doesn't work"; and 2) a bunch of people offended at the notion of being somehow mentally peculiar, and reacting with the same prejudiced words and marginalising terminology that are constantly used to make people who fit DSM criteria for other reasons (like bipolar or schizotypal disorders) feel like sub-humans.

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Post Merge: October 25, 2009, 05:36:52 PM

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Quote from: Miniar on October 25, 2009, 06:26:12 PMTranssexualism, in my mind, is caused by a brain/body incongruence.
BUT, the reason we Need help correcting that incongruence is Because of the mental anguish it causes us.

Physical problem causes mental anguish, thus treating the physical problem with physical treatments is an appropriate way to alleviate the mental anguish.

This.

And as I said, being on HRT is as much a life-long endeavour as my best friend being on medication for her bipolar disorder.  Bipolar disorder is, in her case as well as most other cases, caused by a neurochemical imbalance (read: physical reason) that medication helps to correct -- yet I'm sure that we can all agree that the mental anguish caused by that neurochemical imbalance is a very real problem and so should probably be enough qualification for DSM criteria.  I really don't see that big of a difference between the two cases.

Quote from: Joandelynn on October 25, 2009, 05:48:36 PM
So if someone is born with a hideously deformed face, and eventually tries to commit suicide because of that, you would call that a mental disorder? After all, the face didn't tell the brain that it was hideously deformed.

I have no idea!  I just know about me,  I'm quite comfortable and thankful the medical profession was there for me and helped to become who I was.  I felt no fear, none of the  stigmatism some attach to the words "Mental Disorder" as those with the "Gate Keeper" mentality.

-={LR}=-

Imagine this...

GID is removed from the DSM.

The "professionals" realize it's just a natural variation and not a mental disorder.

The public accepts this and gender is no longer considered unchangeable.

It becomes widely known that this is a treatable condition and parents should put this on the list of things to be aware of as their kids grow up.

Early recognition means early intervention.  Hormonal treatments started around puberty mean no FFS, no electrolysis, no mastectomy and maybe even no phalloplasty.  Bone structure, voice, body hair all grow in accordance with your identified gender.  And on and on the benefits go.

When you reach adulthood you can live a life as you.  No trying to find a therapist who will treat your depression or your anxiety or write you a hormone or surgery letter.  No worrying about how you're going to get the tens of thousands of dollars to pay for gender related procedures (we're assuming bottom surgery was performed years ago).

If this sounds like a scenario preferable to what things are like today, gender identity dysphoria needs to be seen as a treatable physical condition and not a mental disorder.

As long as there's a book that says it's a mental disorder, it will be treated as such.

Julie

Quote from: Julie Marie on October 25, 2009, 07:48:50 PM
Imagine this...

GID is removed from the DSM.

The "professionals" realize it's just a natural variation and not a mental disorder.

The public accepts this and gender is no longer considered unchangeable.

It becomes widely known that this is a treatable condition and parents should put this on the list of things to be aware of as their kids grow up.

Early recognition means early intervention.  Hormonal treatments started around puberty mean no FFS, no electrolysis, no mastectomy and maybe even no phalloplasty.  Bone structure, voice, body hair all grow in accordance with your identified gender.  And on and on the benefits go.

When you reach adulthood you can live a life as you.  No trying to find a therapist who will treat your depression or your anxiety or write you a hormone or surgery letter.  No worrying about how you're going to get the tens of thousands of dollars to pay for gender related procedures (we're assuming bottom surgery was performed years ago).

If this sounds like a scenario preferable to what things are like today, gender identity dysphoria needs to be seen as a treatable physical condition and not a mental disorder.

As long as there's a book that says it's a mental disorder, it will be treated as such.

Julie

It seems you have a vivid imagination.

Parents of intersexed children make the gender decision now and don't always get it right.

But it doesn't hurt to hope. :)

-={LR}=-

My therapist refused to write a diagnosis of GID on my HRT and surgery letters. He said that I did not have a mental disorder. I agreed.

For me, it has nothing to do with insurance issues and everything to do with who and what I am. My depression was a mental disorder for sure. My gender identity is not.

Sometimes I take out my HRT letter and reread it when I feel particularly freakish. The letter gives me a boost. I do not have a mental disorder. I have a screwed-up body. That is all.

Quote from: Ladyrider on October 25, 2009, 08:05:00 PM
It seems you have a vivid imagination.

Parents of intersexed children make the gender decision now and don't always get it right.

But it doesn't hurt to hope. :)

-={LR}=-

The problem is they tend to do it when the child it's only a few years old and can't express his or her gender identity.

Sometimes they get it right and everything works out, sometimes they don't.

Quote from: Arch on October 25, 2009, 08:06:21 PM
My therapist refused to write a diagnosis of GID on my HRT and surgery letters. He said that I did not have a mental disorder. I agreed.

For me, it has nothing to do with insurance issues and everything to do with who and what I am. My depression was a mental disorder for sure. My gender identity is not.

Sometimes I take out my HRT letter and reread it when I feel particularly freakish. The letter gives me a boost. I do not have a mental disorder. I have a screwed-up body. That is all.

God I wish I had your therapist.

All mine refuse to write me a letter until they've broken me down to the point that I DO have a mental illness.  ::)

Quote from: Julie Marie on October 25, 2009, 07:48:50 PMImagine this...

GID is removed from the DSM.

The "professionals" realize it's just a natural variation and not a mental disorder.

The public accepts this and gender is no longer considered unchangeable.

This is a very idealistic ("in a perfect world...") proposition.

Quote from: Julie Marie on October 25, 2009, 07:48:50 PMEarly recognition means early intervention.  Hormonal treatments started around puberty...

Not even countries that do allow some kind of hormonal intervention for TS pminors allow full-blown HRT on pubescent children who are not IS -- the most that Germany, for instance, consistently allows for TS minors is regime of hormonal suppressives.  The TS girl from Germany who had GRS (genital reconstruction surgery) at sixteen is widely acknowledged as a "special case", and I think she may technically have a sort of IS diagnosis that would allow for that in the first place (but seeing as Germany also has doctor-patient confidentiality, it's likely that this was kept out of the press).  But even in Germany, TS persons are still classified as having a "mental disorder" -- it's just that the standards of care for German TS persons is far superior to TS persons in the U$.

Quote from: Julie Marie on October 25, 2009, 07:48:50 PM... no mastectomy and maybe even no phalloplasty. 

No mastectomy for FTM TS persons having puberty intervened?  Quite probable, but not a guarantee -- at the age of twelve, I was already wearing a DDD bra and I had distinctly noticeable breasts at the age of nine (it's called "macromastia" and my paediatrician also considered me to have "precocious puberty", by all means, look 'em up); and I'm just one example of how your idealist suggestion is not a realistic one.  But "no phalloplasties"?  Are you seriously that ignorant of what TS men's GRS actually entails?  Neither the clitoris nor the penis grow exponentially with age and prolonged exposure to extra testosterone (and I use these words because minute degrees of testosterone are produced in the pituitary gland and, in females, within the ovaries).

Quote from: Julie Marie on October 25, 2009, 07:48:50 PMAs long as there's a book that says it's a mental disorder, it will be treated as such.

I'm really tempted to take this statent to an illogical extreme, but I will refrain because I know(nay, hope) that's not really how you meant it.

But as I've said numerous times already -- treating certain ailments as "mental disorders", like bipolar disorder, is not what causes the stigma in the mainstream medical community.

I keep using bipolar disorder because that's a condition with DSM criteria that has a very real and well-documented physical component:  It is almost always caused by a neurochemical imbalance of seratonin within the brain.  Bipolar disorder is still treated as a "mental disorder" in that it has DSM criteria, and it has DSM criteria because the symptoms affect the person's quality of live by putting the person in severe mental/emotional distress, and also because bipolar disorder has a far greater room for variation than most other physical ailments (like spina bifidia).  A severely bipolar person like my best friend literally needs a lifelong regime of medication to keep her mental state balanced enough to live her life to her fullest potential.  On the other hand, my room-mate is also bipolar, but much more mildly; all he really needs is the occasional Zoloft under periods of extreme stress to help balance himself out.  Both my friends have a proved seratonin imbalance that has resulted in their bipolar disorder; which is slightly more than what I have, in physical evidence, to back up my transsexualism -- my physician did a baseline hormone check and chromosomal analysis to see if I met any IS diagnostic criteria, and nope, I'm just a regular XX and with "high, but not uncommonly so for females" natural testosterone levels.

Basically, I have nothing byt DSM criteria validating my transsexual status.  I never had any sort of brain-scan prior to HRT, so any supposition that I may have had "male brainwave patterns" is purely speculation.  I highly doubt that more than maybe a handful of people in this thread, at best, have anything more than speculation (aside from DSM criteria, that is) to validate their ostensibly hard-wired gender identities.  Any supposition that gender identity is pre-natally determined is, even in the biomedical community, still in the realm of hypothesis -- it's an educated guess, on the part of a vocal population of doctors, based on intriguing evidence, but it's as-of-yet untested.

All we have is the DSM.  While I have a problem with the standards of care for TS persons as pushed by many people in the psychological communities, I see no reason to take GID off the DSM; it's the only way to guarantee that TS persons will receive care.

I'd like to step back in.

Julie, I think your scenario would be really awesome, but I think it hinges on being able to diagnose GID using blood tests, other type of biochemical test, imaging, or whatever.  I think before it comes out of the DSM, it needs to be diagnosable through some type of lab test.



I want to disagree with the idea of GID not being a mental illness.  I think it is.  When a human being is conceived, the sex is determined as soon as the sperm and egg join; XX or XY (most commonly, yes I know there are rare variations).  Gender Identity, as far as science can tell is caused by weird hormone levels during pregnancy, polymorphic gender specific genes, and a couple more reasons.  I read a ton of medical journals, and a lot of the journal experiments conclusions contradict each other.  They really don't know what causes gender identity, just ideas.

What I am trying to say, is that I think realistically, GID is actually the mind being different from the body, not the body being different from the mind.  In the case of GID, I think it is actually the mind having a problem.  Since there is no known treatment for the mind, the body has to be "fixed".

I know I am going to get flak for that last paragraph, but I felt it important for me to say.

I do agree that the underlaying cause of my problem isn't "Mental Disorder" but "brain, body, incongruence".
I do however consider myself mentally ill. I do. Because I am "mentally" unable to cope with my current situation without medication.
I've been diagnosed with dysthymia which is in all probability caused by this (and chronic pain and stuff connected with that).
I suffer serious mental pain.

My brain/body mismatch doesn't cause me "physical" pain. All the pain I feel is rooted in my mind.

The only piece of document in the world that acknowledges that pain and makes it treatable is the DSM.

I would love to see a system wherein the brain/body mismatch is documented and accepted. That sees my psychological symptoms as simply a symptom of the mismatch, and treats the mismatch accordingly.
BUT, until we have that mismatch documented and accepted by the medical community, I'm just not supportive of cutting me out of the one medical document that pretty much guarantees me the right to the medical help I need.

If it weren't for the DSM then transsexualism or GID wouldn't be recognized in Iceland.
I would not have any treatment options available to me.

I'm not crazy, I'm a man, but I "am" ill and my symptoms are completely mental.

Quote from: Valerie Elizabeth on October 25, 2009, 08:39:15 PM
What I am trying to say, is that I think realistically, GID is actually the mind being different from the body, not the body being different from the mind.  In the case of GID, I think it is actually the mind having a problem.  Since there is no known treatment for the mind, the body has to be "fixed".

I know I am going to get flak for that last paragraph, but I felt it important for me to say.

What's the difference? If the mind is different from the body, then the body is different from the mind as well. The question is, which one is actually wrong? Is the mind wrong for thinking it's the opposite gender? Or is the mind right in thinking it's the opposite gender, because it is.

If it's the former it's a mental illness, the latter it's not. Maybe it's not as simple as one or the other. My point is that the assumption that the mind is simply delusional in its perception as a different gender to the body is just that, an assumption, an unfounded one at that.

Check out this link for reasons why GID should be revised and/or removed from DSM. http://www.gidreform.org/wpath2009/ (http://www.gidreform.org/wpath2009/)

Z

This is what I got out of the article.  I didn't read it through in depth, but I went through it roughly.  A bit out of order, but what I got.  Care to discuss this?  Feel free to add anything I missed.


     -End discrimination on the basis of gender identity and expression
     -Gender identity and expression that differ from assigned birth sex do not, in themselves, constitute a mental disorder or an impairment in competence
     -Hormonal and/or surgical transition treatments to relieve gender dysphoria are medically necessary
     -Insurance and health care coverage for medically prescribed transition treatment
     -Legal recognition/documentation for all people that is consistent with their gender identity and expression.
     -Reform must fit everyone's needs, but as a social justice movement we must weigh more heavily the needs of those least enfranchised.


The article mentions that there are three groups of people.  I can say that we have seen all three of these people comment on this forum.  I feel like I fall under the third group.

     -Remove fro the DSM, code as a non-mental health disease in the ICD. 
     -Pragmatic: It's in DSM; change it to make it better at helping transpeople.  May believe it's not a mental illness, or may not be sure, or may not care. 
     -Gender Dysphoria is a mental illness, but we can change the DSM diagnosis to make it better at helping transpeople.


Summary:

      -It's about Dysphoria
      -Respectful Language
      -Not too Big; Not too Little; but Just Right
      -Accurate Classification Placement
      -Remove Tranvestism/Fetishism Categories

Our main points are:
1) gender dysphoria is the conceptual center of the diagnosis
2) use respectful language in nomenclature and description of individuals
3) include those who are in need of inclusion, do not include those who should not be
4) move the diagnosis out of the sexual and gender identity disorders chapter
5) and remove transvestic fetishim.


Summary of Proposed Diagnosis:

      -Dx Criteria – Both A and B
      -A: Strong and persistent distress with physical sex characteristics, or ascribed social gender role, that is incongruent with persistent gender identity.
      -B: Distress is clinically significant or causes impairment in social, occupational, or other important areas of functioning, when this distress or impairment is not solely due to external prejudice or discrimination.
      -GD in remission
      -No longer meets criteria, needs treatment to maintain remission
      -'Exit clause'
      -No longer meets criteria, doesn't need treatment to maintain remission


Location in the DSM:

GID Dx in Sexual & Gender Identity Disorders is neither clinically accurate nor palatable to many transpeople

Alternate Location in the DSM?

      -Separate section within Axis I
      -Disorders generally first diagnosed in infancy, childhood, or adolescence
      -Anxiety disorders


Inclusion of Those Who Need Care :

Clarify anatomical dysphoria to include:

      -Distress with current incongruent characteristics
      -Deprivation of congruent characteristics

Include full spectrum of human diversity as legitimate gender identities and expressions.

      -Remove binary language of 'other' and 'opposite' sex from criteria and supporting text
      -An InRemission specifier to provide care to those no longer dysphoric


Reduction of False-Positive Diagnosis:

Limit Dx to those experiencing dysphoria
Exclude those who are merely gender non-conforming

      -Remove gender expression stereotypes from Dx
      -Exclude gender non-conforming children who are not distressed by anatomy or birth assignment

It really does not matter how much we debate this issue, it is still up to the powers that be.  If they do go with the suggestions that were listed, it will become a medical issue even though it is still mental.  Changing the body makes more sense than trying to change the mind.

In my case I have always hated being male.  I have tried several times to alter the body to match, or just end the fight.  I am now in a personal state where at least dressed I am a woman.  I do not look at my body naked and I hide mirrors when showering.  When and if they ever decide that surgeries are to be part and partial of treatment and it gets covered by insurance, whether by private or public means, then and only then will hundreds of us be able to be true contributing members of society.


Janet

Maybe it doesn't matter what we think, but it's a fascinating topic for discussion nonetheless and it's good for us. Kinda like mental weight lifting if you will  8)

Quote from: Valerie Elizabeth on October 25, 2009, 08:39:15 PMI want to disagree with the idea of GID not being a mental illness.  I think it is.  When a human being is conceived, the sex is determined as soon as the sperm and egg join; XX or XY (most commonly, yes I know there are rare variations).  Gender Identity, as far as science can tell is caused by weird hormone levels during pregnancy, polymorphic gender specific genes, and a couple more reasons.  I read a ton of medical journals, and a lot of the journal experiments conclusions contradict each other.  They really don't know what causes gender identity, just ideas.

What I am trying to say, is that I think realistically, GID is actually the mind being different from the body, not the body being different from the mind.  In the case of GID, I think it is actually the mind having a problem.  Since there is no known treatment for the mind, the body has to be "fixed".

Agreed.

There are some oft-touted hypotheses about gender identity, but you're right, some studies are conflicting.  I think that, considering the scarcity of the condition (of being TS) and the severity to which those who are TS have it, that it may just be a hard-wired neurological trait, but neurobiologists have yet to discover what actually causes gender identity, without a doubt.  All there currently are, are hypotheses that have yet to be tested and re-tested to the point of proving them sound theory.

Quote from: Miniar on October 25, 2009, 08:39:23 PM
[...snip...]
My brain/body mismatch doesn't cause me "physical" pain. All the pain I feel is rooted in my mind.

The only piece of document in the world that acknowledges that pain and makes it treatable is the DSM.

[...snip...]

If it weren't for the DSM then transsexualism or GID wouldn't be recognized in Iceland.
I would not have any treatment options available to me.

I'm not crazy, I'm a man, but I "am" ill and my symptoms are completely mental.

Very well-said -- all of it, but snipped for length and to highlight two things to said to illustrate a point I've been trying to make:

It's not the fact that GID/TS persons are listed in the DSM that causes so much grief -- it's the standards of care in the U$ that is.  I really don't mean to see anti-American here (I was raised part-time in the UK and in the US I was mostly raised by British grandparents, so I know i have tendencies to seem such, at times), but I've noticed that many people in the US seem to have this idea that their experience is the same as everywhere else in the world -- even when this is proved to be the opposite case.  Ultimately every anti-DSM argument I've seen on dozens of TS/TG fora over the last decade has been a victim of the Corelation Does Not Equal Causation fallacy (http://www.nizkor.org/features/fallacies/confusing-cause-and-effect.html) -- it's the recommended approach (which is incentive for most insurance agencies not to pay for treatment) to care that is the problem in the United States, not the fact that TS persons are included in the DSM, in and of itself.

Quote from: Zythyra on October 25, 2009, 09:39:00 PM
Check out this link for reasons why GID should be revised and/or removed from DSM. http://www.gidreform.org/wpath2009/ (http://www.gidreform.org/wpath2009/)

That page hosts what is ultimately a call for revision, not removal.  And personally, I don't see how it's not a sex-gender dysfunction -- I mean, if my dysfunction (id est, mental distress and anguish) is gender-related, then it's a gender dysfunction.

But even this proposal makes it clear that GID / TS people Stateside would benefit from greatly improved standards of care, and proposes that standard care may greatly improve with a highly revised DSM criteria.  That's basically what this is saying -- it's not saying "eliminate TS persons from the DSM".

Quote from: Becca on October 25, 2009, 11:00:55 PM
Maybe it doesn't matter what we think, but it's a fascinating topic for discussion nonetheless and it's good for us. Kinda like mental weight lifting if you will  8)

LOL!  Well, that's one way to look at it, but as I've noted, I've been in and out of the on-line and off-line TS/TG community since 1999 -- I've seen this debate come up at least once every six months in that time, and from where I stand, it feels like the mental equivalent of shifting from neutral to fifth gear with the parking brake on; I've never tried that personally, but my autoshop teacher assured us that the force would send everybody in the front of the car through the windscreen.  :o

I have a thorn in my paw.  I can't remove it.  No one can see it.  It hurts.  I walk with a limp.  I get crabby and irritable.  I snap at people and sometimes I eat them even though I'm not hungry.

There's a book that says this is a mental disorder.  After all, no one can see the thorn.  It's too deep inside my paw for anyone to see it.  I know it's there but if they can't see it, they don't believe it.

I go to my doctor.  He can't find the thorn because he can't see it.  He says maybe it's all in my head and I need therapy and there's a book to back his diagnosis.  My family and friends agree... I have a problem. 

I say all I need is the thorn removed from my paw.

Interesting metaphor, Julie, but that doesn't really support anything more than a serious revision to the recommended care for TS/TG persons.  As Miniar pointed out, TS inclusion in the DSM is the only thing in Iceland that guarantees proper care -- which he is ostensibly receiving, as I recall a post where he's at least implied that he's getting HRT started soon.

The problem is NOT NOT NOT that we are included in the DSM -- the problem ABSOLUTELY is that the USofA has a highly backwards conception of what is best for us.  I mean, if most of the people here were in the UK, where we're covered under their NHS, this would be a non-issue because even genital reconstruction is covered under the UK NHS.  And UK Transsexuals have a "mental disorder", as well.  Advocating total removal from the DSM won;t have the effect that many people here seem to think it will.

Quote from: YoungSoulRebel on October 26, 2009, 12:15:55 AM
The problem is NOT NOT NOT that we are included in the DSM -- the problem ABSOLUTELY is that the USofA has a highly backwards conception of what is best for us.  I mean, if most of the people here were in the UK, where we're covered under their NHS, this would be a non-issue because even genital reconstruction is covered under the UK NHS.  And UK Transsexuals have a "mental disorder", as well.  Advocating total removal from the DSM won;t have the effect that many people here seem to think it will.

This may be the case for many people, but it sure doesn't apply to me. For me, the problem IS that I'm in the DSM as having a mental disorder. And one problem is that there's no way OUT of the DSM even now that I have transitioned and am legally male. That's freaking insulting.

I agree that there has to be a treatment path. I agree that, inevitably, mental health professionals will need to be consulted in trans cases because of the unique nature of our situation. I do not agree that removing us from the DSM will have a magical effect on how we are treated, and I don't believe that a lot of other trans people believe that either. But neither do I agree that my "GID," as they call it, qualifies as a mental disorder--certainly not the way it is described now, and perhaps not at all.

If we look at our situation simplistically, as a mind-versus-body incompatibility, we see how complicated it is to simply call this a mental disorder.

Well, I'm going to start going around in circles, so I'll shut up. But I do resent that transsexuality is in the DSM--at least as an incurable condition. Because that's essentially how it's described at present.

Then you've made an argument in favour of revision, at most.

Even so, I don't realy see what you feel so insulted by.  Unless you've had implanted flesh-and-blood testicles that are producing their own testosterone into your body, you're still taking HRT for the rest of your life, aren't you?  Under what conditions do you propose continuing your prescription for it?

Maybe it's cos I've been around people with "mental disorders" my whole life, and know that it's really no big deal as long as it's being managed, but I really don't see what's so "insulting".

Quote from: Valerie Elizabeth on October 24, 2009, 06:43:26 PM
So with that logic, should we remove ADHD from the DSM, so they are allowed to enlist?

ADHD has the potential to hinder someone's ability to perform their duty as a member of the military.

Furthermore, people with ADHD CAN enlist, provided they have been medication free for one year prior to enlistment.

I fail to see how GID hinders my ability to serve as a member of the Armed Forces... seven years of service, thus far, and it hasn't impacted the quality of my service at all.

Quote from: Julie Marie on October 26, 2009, 12:04:51 AM
I have a thorn in my paw.  I can't remove it.  No one can see it.  It hurts.  I walk with a limp.  I get crabby and irritable.  I snap at people and sometimes I eat them even though I'm not hungry.

There's a book that says this is a mental disorder.  After all, no one can see the thorn.  It's too deep inside my paw for anyone to see it.  I know it's there but if they can't see it, they don't believe it.

I go to my doctor.  He can't find the thorn because he can't see it.  He says maybe it's all in my head and I need therapy and there's a book to back his diagnosis.  My family and friends agree... I have a problem. 

I say all I need is the thorn removed from my paw.

You have a thorn in your paw. No one can see it.

There is no book no-where that says anything about thorns in paws so no one knows what to do about it.

You go to a doctor and he doesn't see a thorn. He gives you a painkiller just to get you out of your office.

No one acknowledges that you have a thorn as no-one sees it at all and pretty soon, people stop acknowledging that you're in pain.

People start telling you to "get over it", and they don't stop.
Pretty soon you stop looking for help because you realize that there is none to be had at all.

You stop saying you have a thorn in your paw and suffer in silence... for as long as you can.

I don't have gender identity disorder.  I never did.  Any diagnosis to the contrary was wrong.  What I had was a physical condition called Incomplete Gender Assimilation (IGA).  It is often confused with the mental disorder, GID.  It is characterized by a body that is incongruent with brain gender.

People with IGA who live in socially repressive environments often grow up being pressured into a gender presentation opposite their real gender and this often causes emotional distress and dysphoria (traumatic stress).  Removal of the individual from the socially repressive environment typically results in cessation of emotional distress.  Depending on the individual, surgery may be necessary to complete treatment.

I no longer have IGA.  It's been treated and I'm cured.  But there is some residual post traumatic stress I still need to work on and a lot of educating to do.

Julie

Two questions Julie,

1. If you don't have GID and never have, then why the concern over removal from DSM? Why should those of us who have it suffer because those who don't have it don't want to be associated with them?

2. What are the fundamental differences between (diagnosed) GID and IGA? How is IGA diagnosed? Is the treatment for IGA the same as GID (i.e. HRT, SRS etc)?

I don't mean to come off as antagonistic, I'm just looking to become better educated. I am still trying to understand the particulars of my situation, so I have not developed a viable opinion as to whether I consider myself mentally ill, physically ill, etc. I cannot say whether I am for or against being listed in the DSM and I have read some decent arguements on both sides of this thread. What I am not seeing, with the limited exception of your suggestions a page or so back, is what is being proposed as a effective standard of care (if this is unoffensive).

Your proposed outline sounds potentially effective treatment for the youth of the future (5-10 years), but seems to me to be very exclusive of those of us who are well past puberty and have been dealing with/struggling with (whatever the commonly preferred term is, if not GID) and are trying to seek treatment. In any situation, there would need to be (IMO) some manner of diagnosis. I know of many people here who are 'confused', 'trying to figure what's wrong with me', 'why do I feel this way?", if this is removed from the DSM and is deemed no longer a mental (whatever you wish it to be called) and, as others have proposed, make it an elective/cosmetic procedure, then how do those who suffer,  and have no idea what they suffer from, know that they have whatever-it-is-to-be-called and how to get treated?

I prefer YoungSoulRebel's analysis of rewriting the DSM and SOC to include more up to date information and define the treatment to be more definitive (HRT, SRS being a necessary path not optional). But, even this can have problems - if HRT and SRS are declared necessary treatment for GID, then those who don't want surgery will be 'required' to undergo this necessity.

I don't want to elicit any tirades or a regurgitation of all of the same arguements that we have all read over and over in these past 5 or 6 pages. I, again, don't have an opinion or strong feelings of whether is should or should not be in DSM, but am more concerned about what viable option is proposed that takes its place and how that effects ME and others who are still trying to start transitioning and have long, long since past puberty.

Thank you for playing nice.

Deanna

Quote from: Deanna_Renee on October 26, 2009, 10:55:58 AM
Two questions Julie,

1. If you don't have GID and never have, then why the concern over removal from DSM? Why should those of us who have it suffer because those who don't have it don't want to be associated with them?

2. What are the fundamental differences between (diagnosed) GID and IGA? How is IGA diagnosed? Is the treatment for IGA the same as GID (i.e. HRT, SRS etc)?

Well, first of all I was trying to make a point, that being, there are many of us who don't want the label of being mentally disorded attached to us.  As I see it, there are no useful benefits to that.

If your reason is to get proper care, there are better ways to accomplish that without having to endure all the negativity that comes with the mentally disordered label.  The AMA has already recognized what I call IGA.  The next step is for WPATH to change their recommendations for treatment so those who feel they have GID can be separated from those who feel they have IGA.  That way those with GID can get the psychological help they need and those with IGA can get the physical treatments they need.

Because we live in a world where genitals are considered sacred, suing a doctor for performing bottom surgery on you will always be a major concern for surgeons.  Therefore they will still need some documentation to ease their mind (or the mind of their insurance carrier) before agreeing to perform bottom surgery.  So some psychiatric evaluation will have to still be done until society comes around to accepting IGA as a naturally occurring event.

But instead of a therapist focusing on your depression, anxiety, etc and trying to resolve that, it will be widely understood these are typical reactions to IGA.  So the focus will turn to, would you truly be happy living life in the gender opposite your birth gender?

From there, it's a simple letter and making an appointment with the surgeon of your choice.  If your insurance covers it, they will need the letter before approving the coverage.

To answer your questions:

1. I created IGA to allow for a separation between those who cling to GID as their proper diagnosis and those who want nothing to do with it.  Thus the claim I never had GID.  My concern isn't personal but universal.  No matter what the DSM says, it will affect my life little or not at all.  But I know what I lived with for over half a century and I don't want anyone to have to endure anything like that ever again.  That may be idealistic to some but so was ending slavery.  We have to work to end discrimination.  It just doesn't happen.

I want a better world for all, even if I don't personally benefit.

2. GID is a mental disorder, as it states in the DSM.  If you want that diagnosis, you are free to accept it and all that it offers.  IGA is a physical condition.  You won't find it in the DSM (if it were recognized) because the treatment for it is HRT and any other physical procedures that will help in aligning the body to better match brain gender.  You can't change brain gender.

One can initially accept GID as their correct diagnosis and later discover they have IGA.  But if one feels they need a lot of psychological treatment because their mind is where the problem exists, then they should pursue the GID treatment.  But if you know your body is the problem, then choose the IGA treatment.

The only reason I care about this so passionately is because I don't want anyone else to suffer what I did.  It's like the person who was found guilty of a crime they didn't commit and was imprisoned for 50 years.  When they get out they become an activist for all falsely imprisoned people.  While they will never be able to get back the 50 years they lost or benefit from any change in legal procedures, at least they can take some comfort in knowing the chances of that happening to someone else will be greatly reduced by making the public aware through their activism and subsequent education.

I hope I explained myself properly Deanna.

Julie

Thank you so much Julie for taking the time to clarify, this is what I was looking for. But, please excuse my ignorance, I am intrigued by the possibility of a different optional path. If you wouldn't mind clarifying the, I guess functional, differences between GD and IGA? I understand that in practice GID is regarded as a mental disorder and retains certain stigmas and prejudices, but the somewhat accepted treatment is HRT (for hormonal balance) and SRS/GRS (to bring body in congruence with the brain) in order for the patient to become less dysphoric (I apologize if I have any of this wrong or overly simplified).

For me, I know that my problem is not mental in the same way as other mental disorders, but that my mind sees my body as being wrong. The only solution that I can foresee to alleviate that dysphoria is HRT, SRS and possibly FFS, BFS. This sounds, to me, as though I may fit more in the class of IGA, but I am only now hearing the term so I completely ignorant of it. I am currently seeing a therapist (psychologist, if that has any worth) and will actually be seeing him tomorrow and I guess what I am wondering is how would I go about seeing about diagnosis of IGA (if that is what I have)? Is there a clinical difference between GD and IGA? I may have already asked that. You mention SRS as treatment for IGA, does that also include HRT? I understand that HRT is a necessary prerequisite for SRS, correct? Does diagnosis of IGA require RLE?

I am quite certain that the only way I will feel 'right' is by way of changing my body's sex to that of a female. As long as I look and feel like a male, then I will be in anguish and suffer from dysphoria (by any other name, still affects the same). If this is IGA or GD I don't know. I also know that it may be a very long time before I will be able to afford to pay for transition out of pocket. I am also unemployed at the moment, but looking at getting a job soon (been interviewing) with insurance. Are insurers more open to, accepting of, IGA diagnoses as a necessitating HRT and SRS as treatments?

Oh, so many questions and even more confusion than I had a day ago. I am happy that you were able to present some viable solution. Again, thank you Julie I appreciate your experience and tolerance of my ignorance.

Deanna

Quote from: Joandelynn on October 26, 2009, 01:02:13 PM
I understand your postion, but let's look at it this way:

What if I have a design (the genes) to build a computer (a person), but I misinterpret the design and accidently put in the wrong processor (the brain) so the computer doesn't work? Is the processor suddenly broken? No it isn't, it's a perfectly ok processor. It's the mismatch between the processor and the rest of the computer that is the problem.

The same can be said about GID. The brain is perfectly ok. So is the body. It's the mismatch between the two that is the actual problem. I wouldn't call that a mental disorder.

I agree with you fully on the whole "both brain and body are perfectly fine" front.
This is why I can't say that "my body is wrong" because there's nothing wrong with it (aside from fibro and.. BUT that's not the point). It's a perfectly normal woman's body.
And my brain is a perfectly normal man's brain.

The "problem" I have is the "mental" anguish that the "mismatch" causes me to experience.

I Would Love to see transsexualism be completely accepted as I see it and treated from that perspective and that would mean it wouldn't be seen as a mental illness per say, but a quirkyness of nature that "can" cause a mental illness and should be treated on a physical level to cure that problem. (And let's face it, severe depression, suicidal tendencies, feelings of disgust towards your own body, etcetera, all these symptoms of brain/body mismatch combined "are" a mental problem.)

But, until we can prove that brain/body mismatch definitively, all we can prove exist is our mental symptoms.
And I'd rather have someone acknowledge my pain even if they aren't sure why I'm in pain, than to have no acknowledgement at all.

That's all I'm saying.

I'm all for the DSM and SOC being refined, rewritten, made more accurate, but we can't expect them to take our symptoms out of the DSM until there's something else to cover our problem, and I wouldn't want them to.
I think instead of asking to be taken out of the DSM that a more productive approach is to ask for more research into the causes of the symptoms.

Quote from: Joandelynn on October 26, 2009, 01:02:13 PM
I understand your postion, but let's look at it this way:

What if I have a design (the genes) to build a computer (a person), but I misinterpret the design and accidently put in the wrong processor (the brain) so the computer doesn't work? Is the processor suddenly broken? No it isn't, it's a perfectly ok processor. It's the mismatch between the processor and the rest of the computer that is the problem.

The same can be said about GID. The brain is perfectly ok. So is the body. It's the mismatch between the two that is the actual problem. I wouldn't call that a mental disorder.

A problem with this analogy is that once you turn on the power to the computer with a mismatched processor (brain), then the processor (brain) is, typically, damaged and rendered inoperable (a rather severe disorder of the brain, ie mental). I'm not arguing that GD is, or is not, a mental disorder, I honesty have no clue. I don't have a medical degree, I'm not a neurologist, I'm not a mental health professional. I would not be surprised if you asked people of each of those disciplines if it was medical, neurological or psychological each may be able to argue in favor of their own profession and be correct to some degree. I admit that in my limited understanding, it does not fall neatly within the confines of any mental disorder/illness, nor does it specifically fall into diagnosable medical conditions. It seems to be a very enigmatic condition that defies clearly accepted and definable differentiation between mental and physical - since it is somewhat both.

What we need is a new design apparently. I just read the proposed changes to the DSM that Zythyra posted (previous page) and there seems to be some advantage, though I don't know if it goes far enough.

Deanna

Quote from: Muddy on October 26, 2009, 08:00:22 AM
ADHD has the potential to hinder someone's ability to perform their duty as a member of the military.

Furthermore, people with ADHD CAN enlist, provided they have been medication free for one year prior to enlistment.

I fail to see how GID hinders my ability to serve as a member of the Armed Forces... seven years of service, thus far, and it hasn't impacted the quality of my service at all.

Considering that HRT is technically medication and, without it, many TS people would emotionally collapse, I can understand the reasoning.

But I'm also one of those anti-war loonies, and see this as a bit of a bonus.

Quote from: Deanna_Renee on October 26, 2009, 10:55:58 AMI prefer YoungSoulRebel's analysis of rewriting the DSM and SOC to include more up to date information and define the treatment to be more definitive (HRT, SRS being a necessary path not optional). But, even this can have problems - if HRT and SRS are declared necessary treatment for GID, then those who don't want surgery will be 'required' to undergo this necessity.

Eh, if it were up to me and me alone to revise these things, I'd probably make HRT non-optional, but being FTM myself and understanding that many TS men prefer to skip GRS, I'd probably make the surgical requirements "the minimum procedures required by state for gender re-association" -- which, yes, for TS women is typically GRS-inclusive, but it's usually so vaguely worded to be inclusive of IS persons and TS men (I know Oregon, for example, simple requires "an irreversible surgical procedure") that I imagine if one really wanted to push it in court, FFS could prove "irreversible" enough.

Quote from: Julie Marie on October 26, 2009, 12:16:59 PM2. GID is a mental disorder, as it states in the DSM.  If you want that diagnosis, you are free to accept it and all that it offers.  IGA is a physical condition.

My best friend would find certain aspects of her life as a person with bipolar disorder much easier if she wasn't classified as having a "mental disorder".  It's very much a physical one, as well, as she's had blood tests to prove that she has the biochemical component shared by nearly every other person with a diagnosis of "bipolar".  On the other hand, she can't deny the fact that bipolar disorder affects her mental state to such a degree that she's completely non-functional without her medication.  Similarly, cutting off my HRT would make me suicidal.

Furthermore, it's been my own experiences that a scant few TS people actually have any sort of biochemical component validating their claim that "this is a physical condition, not a mental one".  If you have proof of a physical component in yourself (and no, I'm not asking you to post it -- I'll take your word for it), then more power to you -- but considering that in ten years, the TS persons I've encountered who have voiced having had a chromosomal analysis (myself included) can be counted on one hand, I'm willing to put money on the notion that you probably have as much backing up your claims of "physical disorder" as I would have.

Quote from: Joandelynn on October 26, 2009, 01:32:48 PM
Actually that makes the analogy even better, because the mismatch between body and brain also often 'breaks the brain' by causing mental disorders like for example depression.

Well, I guess it depends on which way you're arguing. For mental disorder - yes. For physical condition - not so much.

I agree with Miniar's explanation that the body is normal (male in my case) and the brain is normal (female for me) and that is where the problem lies.

There is no test that can say that there is a problem with me physically (unless your testing it for femaleness) and there is no test that can say there is a mental problem beyond the symptoms that I recount (depression, anxiety, hatred of my body, etc). Both are normal, they are just normally opposing. Drugs could be prescribed to deal with my depression, anxiety etc. but it wouldn't solve a damned thing (in my case). Changing my body is medically possible and appropriate to bring the two into balance. I don't know if there would be a way, or even if its an issue, of testing for a kind of allergic reaction/chemical reaction between the brain and the testosterone that is circulating my body produced by my male body. I have heard from so many TS people that after starting HRT there is a heightened sense of comfort of being 'right'. Perhaps that is largely where the imbalance is in the reaction to the dominant hormone and the brain. Since the body produces said dominant hormone, then changing the hormone and not the body would adversely affect the body, so GD would require HRT to bring the brain in balance and SRS/GRS etc would be needed to balance the body to the hormones.

Ideas?

Deanna

See, I honestly believed with all of my heart and soul for years and years that "this is a physical disorder, not a mental one".  I honestly believed that perhaps my anazing brain was just instinctively picking up on a chromosomal anomaly or an unheard-of hormonal imbalance, or that maybe an MRI or CAT-scan or some such could produce a brainwave pattern more-congruent with an otherwise typical homosexual man than it would with a heterosexual woman.

Then, in an effort to get my treatment covered through a potential loophole in Medicare and Medicaid, my doctor ordered a chromosomal analysis for diagnostic purposes.  I'm a basic XX.  Then she ordered a hormonal baseline; I'm in the "high normal" range (without HRT) for natal female, so just high enough to be potentially noteworthy in a study, but still too typical to be diagnosed with a hormonal imbalance.  I've never had a comparative brain-scan prior to HRT, so if there's a physical or neurological component, that may be all I have, but since I've never had it done, it's all just speculation -- not even good enough for a scientific hypothesis.

If other people want to continue to believe that they have a physical component that results in their own gender-sex incongruence, I suppose they're welcome to believe that, but extraordinary claims require extraordinary evidence -- and I've seen nobody making any genuine claims that they can back their suppositions up with hard physical evidence, at least not in this thread.  I know all of three TS persons in my off-line life who can make claims to a physical component (two TS women and one TS man), but I've met and spoken to over a hundred TS persons at my local TS/TG group off-line, most of who have no real idea what a chromosomal analysis, hormonal diagnostics, or even brain-scan would produce for themselves, and a handful of individuals, like myself, who lament that have no physical component.

All TS persons have, by and large, is what we say -- very few TS persons, as a whole, have any kind of biochemical component validating their "instincts" that there is an incongruence between physical sex and mental gender identity.  And if there's nothing physical / biochemical causing this incongruence, then it's mental -- and logically, if it's not "allowed" to be mental, then we have nothing and will be denied proper treatment.

As I said, I have no prejudices as to what being listed in the DSM actually means.  I have other reasons to be listed in the DSM, as so some of my non-TS friends.  Having a DSM listing that fits doesn't make one "crazy" and it doesn't automatically make one incompetent -- all it means is that there is something atypical about how one's brain operates when compared to everybody else, and that one may need specific treatments (such as medications for severely bipolar persons) in order to live one's life to the fullest.

Think about this hypothetical situation:
GID is completely removed from the DSM -- it's now viewed as a completely physical disorder, etc, etc....  Suddenly overnight, TS persons all over the United States are ordered to have chromosomal anaylses to judge qualifications for diagnosis.  All pre-op, post-ho TS persons are ordered off HRT for a period of four weeks to purge the body of excess hormones in order to do hormonal analyses and brain-scans.  Then, suddenly (using my off-line experiences to figure a percentage rate) 97% of TS persons are judged ineligible for treatment!  "You're not a transsexual," we're all told, "here's some anti-depressants for your anxiety. I recommend intensive therapy to get this idea out of your head.  You can take it or leave it, but until you pass through treatment, I'm diagnosing you as schizotypial (http://en.wikipedia.org/wiki/Schizotypal)."

That's the most-likely scenario if we have GID completely removed from the DSM -- now we're all just having "bizarre beliefs outside subcultural norms" and having "unusual perceptions of reality, including bodily illusions".  Well, all of us but that less-than-10% who actually seems to have a bona-fide physical component.


There is nothing wrong at all with including GID in the DSM, in and of itself.  All that needs changed is the wording and the recommended treatment options.  All most TS persons have is DSM criteria for GID.  The DSM in its current form already excludes IS persons (meaning the few people I know probably had that diagnosis dropped after this discovery), so if being TS is just another form of IS, then why are there so many TS persons who lack a physical component?

Quote from: Deanna_Renee on October 26, 2009, 01:06:32 PMIf you wouldn't mind clarifying the, I guess functional, differences between GD and IGA?

Deanna, I want to make this clear, IGA or Incomplete Gender Assimilation, is a term I created for this thread primarily for the purpose of allowing those who don't identify their challenge as being a mental disorder.  To the best of my knowledge, you won't find anything anywhere about it other than what is in this thread.

In the last 50+ years a lot has changed in the recognition, acceptance and treatment of gender related issues.  It's been an evolutionary process brought about through trial & error, study, education and awareness.  The Internet sent this process into hyper-drive.  But there's still a lot to be done.

I doubt there's many TSs who wouldn't have liked to have begun HRT early in their life so they wouldn't have had to deal with physical maturation in the wrong gender and all that goes with it.  But the idea of doing that is in direct conflict with the general consensus that holds genitalia so sacred.  There have been a few instances where early hormone intervention has been done but we're a far cry from that being the accepted form of treatment.

The older you are, the less making changes in the way gender related issues are handled will affect your life.  And vice-versa.  But if there's a push from the TG community to categorize gender transition as a medical issue and remove it from being a mental disorder, it will have a positive effect and a lot faster than taking a passive approach.

But first we need social acceptance and that won't come easily.  People have been conditioned to believe this is wrong, religiously, morally, ethically and naturally (by Nature's Law).  And if they can refer to a book of mental disorders and say, "See!  You have a mental problem!" it will make it a lot easier on them.  They won't have to deal with their ignorance.  They won't have to learn something which is contrary to what their parents, teachers and friends told them.  Their social order will remain intact.

Remove GID from the DSM.  Eliminate it as a term altogether, since it has the word "disorder" in it.  Replace it with a term that more properly defines the condition where the body doesn't match brain gender.  I created "Incomplete Gender Assimilation" for that purpose.  Establish a set of treatment options for physicians to follow.  Revamp the SOC so it too eliminates GID and is as up to date as possible with what we know now, now what we thought we knew.

Another suggestion, drop all reference to any word that has a negative stigma attached to it and create new ones and use those exclusively.  It's usually pretty effective and a hell of a lot easier than trying to change society's image of the existing words & terms.

Julie

Quote from: Julie Marie on October 26, 2009, 04:47:23 PM
But if there's a push from the TG community to categorize gender transition as a medical issue and remove it from being a mental disorder, it will have a positive effect and a lot faster than taking a passive approach.

[snip]

Remove GID from the DSM.  Eliminate it as a term altogether, since it has the word "disorder" in it.   Replace it with a term that more properly defines the condition where the body doesn't match brain gender.

1) How do you propose defining TS persons as having a "medical issue"?  How do you propose those who do not meet your diagnostic criteria be treated?

2) What's wrong with having a disorder?  Most people with bipolar disorder are just fine when given the proper medications; in fact, you'd hardly guess that, under proper medications, that they have any disorder at all.  I myself have Attendtion-Deficiet/Hyperactive Disorder, but I've found a way to make this manageable for my lifestyle, so in most circumstances, the average person would hardly guess that I had any sort of disorder.  Another friend of mine has a sleep disorder that she is managing in her own way.

I don't see anything wrong with having a disorder except in the eyes of the prejudiced.

And what you continue to describe sounds like the basic definition of any kind of clinical disorder (http://en.wikipedia.org/wiki/Disorder_%28medicine%29#Disorder) -- "something is functionally atypical about this person".  If you have a problem with the word "disorder", then I think that may be nothing more than a prejudice on your part that needs to be examined and rectified.  Most people really don't attach all the stigmas to it that you've been doing here.

Fibromyalgia is a set of symptoms and is a MUPS.  Transsexuality is a set of symptoms, therefore it is also a MUPS.  Transsexualism is just like Fibromyalgia, a medical condition.

Quote from: wkipedia.orgMedically unexplained physical symptoms (MUPS) or medically unexplained symptoms (MUS) are patient symptoms for which the treating physician, other healthcare providers, and research scientists have found no medical cause. The term does not necessarily imply that a physical cause does not exist, but rather notes that cause(s) for given symptoms are uncertain, unknown or disputed

It isn't a mental disorder, but medically unexplained physical symptom.  The treatment is a medical approach.  Hormone Replacement Therapy, , Gender Reconstruction Surgery ( Mastectomy, Hysterectomy, Phalloplasty for the guys )( Orchidectomy, Vaginoplasty, Breast Augmentation, Facial Feminization Surgery for us girls ).  All of these are medical procedures.  The only reason it is a mental disorder is because they ask "Who in their 'right' mind would want to remove their genitalia".  They already think we are nuts.  And the medical community and their malpractice insurance carriers are afraid that they will be sued.


Janet

Fibromyalgia has Physical pain, and Physical symptoms.

Transsexualism has Emotional/Psychological pain, and Emotional/Psychological symptoms.

For many years the medical community treated it as if it was all in the patent's head, and referred the patients to psychiatry.  I know because my ex was told that for years and the only thing they ever gave her was Prozac, Wellbutrin, Zoloft and other anti-depressants.  My ex was given disability because the SSA said she has major depression.

Now they have new medications for it.  It is just now becoming main stream medicine.  Fibro is as real as Transsexuality.  Yes, suffers of Fibro have debilitating physical pain, bouts of depression.  While we may not have physical symptoms, it is still treated by medical institutions.

I use Fibro because it is a set of symptoms as is Transsexualism.  Yes they are true physical symptoms, and I do not make light of it.  You may dear Min suffer from it, so does my ex.  I know and have seen the results of Fibro.  And I have said for a long time they need to set Fibro as a true medical condition.  They should do the same for Trans.


Janet

I agree that setting as a true medical condition is a good idea and I'd like to work towards that, but that's not gonna happen automatically if it's removed from the DSM.

Whereas, if it does get acknowledged as a true medical condition, then removal from DSM will in all probability follow.

And Fibro is a poor comparison in my opinion because the physical symptoms for serious sufferers can be obvious, whereas no one can see you "limp" from psychological pain.

I use it for two reasons.  1) I know it personally, because of my ex and now you, dear friend.  2) It is a set of symptoms, all be it physical, just a Trans.

No offense meant, I hope none taken.  And you are right it would need to be medically recognized before it would be removed.  Even the AMA says so.


Janet

Quote from: Janet Lynn on October 26, 2009, 05:33:20 PM
Fibromyalgia is a set of symptoms and is a MUPS.  Transsexuality is a set of symptoms, therefore it is also a MUPS.  Transsexualism is just like Fibromyalgia, a medical condition.

It isn't a mental disorder, but medically unexplained physical symptom.  The treatment is a medical approach.  Hormone Replacement Therapy, , Gender Reconstruction Surgery ( Mastectomy, Hysterectomy, Phalloplasty for the guys )( Orchidectomy, Vaginoplasty, Breast Augmentation, Facial Feminization Surgery for us girls ).  All of these are medical procedures.  The only reason it is a mental disorder is because they ask "Who in their 'right' mind would want to remove their genitalia".  They already think we are nuts.  And the medical community and their malpractice insurance carriers are afraid that they will be sued.


Janet

I'm sorry Janet but the more we try to self analyze and self diagnose the more confusing the whole topic becomes.  And not meaning to seem insensitive to anyone but it seems to me that it is those who can't get funding, those who don't have the insurance (US folks mostly), those who have barriers to treatment that want to GID delisted.

I wholeheartedly agree with YoungSoulRebel and echo his arguments and logic.  One of the issues that is prevalent in all these arguments is the TS resentment of being labeled with a "Mental Disorder" and the stigmas' attached to such labelling.  This is a quote from the Mayo Clinic on the stigmas associated with Mental Health:

QuoteStigma may be obvious and direct, such someone making a negative remark about your mental health condition or your treatment. Or it can be subtle, such a someone assuming you could be violent or dangerous because you have a mental health condition. These and other forms of stigma can lead to feelings of anger, frustration, shame and low self-esteem — as well as discrimination at work, school and in other areas of your life. For someone with a mental illness, the consequences of stigma can be devastating. Some of the harmful effects of stigma include:

Trying to pretend nothing is wrong
Refusal to seek treatment
Rejection by family and friends
Work or school problems or discrimination
Difficulty finding housing
Being subjected to physical violence or harassment
Inadequate health insurance coverage of mental illnesses

Sound familiar...

-={LR}=-

^^ I almost never take offense.

And I do hope people aren't too offended by my opinion.

I am in favor of removing GID from the DSM as a mental disorder. My gender is not a mental illness or a disease. If anything, I see my gender variance as a spiritual path. What we now call "transgender" has existed throughout history. The only disorder is our modern society's inability to recognize and accept the full diversity of the gender spectrum.

I do support it being classified in such a way so that people can have HRT, surgeries, etc., covered by insurance.

Z

Quote from: Zythyra on October 26, 2009, 09:56:08 PM
I am in favor of removing GID from the DSM as a mental disorder. My gender is not a mental illness or a disease. If anything, I see my gender variance as a spiritual path. What we now call "transgender" has existed throughout history. The only disorder is our modern society's inability to recognize and accept the full diversity of the gender spectrum.

I do support it being classified in such a way so that people can have HRT, surgeries, etc., covered by insurance.

Z

Two points...

I thought Transgender was an umbrella term that includes everyone on this site from CD's, TV's, IS, TS, etc.  Surely there are some in this group who don't require any form of treatment nor is it prescribed or warranted?

Next...

Why does it need to be covered by Insurance.  Shouldn't those diagnosed be provided the care they need to live normal lives regardless of their financial status?

-={LR}=-

Quote from: YoungSoulRebel on October 26, 2009, 04:41:22 PM
See, I honestly believed with all of my heart and soul for years and years that "this is a physical disorder, not a mental one".  I honestly believed that perhaps my anazing brain was just instinctively picking up on a chromosomal anomaly or an unheard-of hormonal imbalance, or that maybe an MRI or CAT-scan or some such could produce a brainwave pattern more-congruent with an otherwise typical homosexual man than it would with a heterosexual woman.

Then, in an effort to get my treatment covered through a potential loophole in Medicare and Medicaid, my doctor ordered a chromosomal analysis for diagnostic purposes.  I'm a basic XX.  Then she ordered a hormonal baseline; I'm in the "high normal" range (without HRT) for natal female, so just high enough to be potentially noteworthy in a study, but still too typical to be diagnosed with a hormonal imbalance.  I've never had a comparative brain-scan prior to HRT, so if there's a physical or neurological component, that may be all I have, but since I've never had it done, it's all just speculation -- not even good enough for a scientific hypothesis.

If other people want to continue to believe that they have a physical component that results in their own gender-sex incongruence, I suppose they're welcome to believe that, but extraordinary claims require extraordinary evidence -- and I've seen nobody making any genuine claims that they can back their suppositions up with hard physical evidence, at least not in this thread.  I know all of three TS persons in my off-line life who can make claims to a physical component (two TS women and one TS man), but I've met and spoken to over a hundred TS persons at my local TS/TG group off-line, most of who have no real idea what a chromosomal analysis, hormonal diagnostics, or even brain-scan would produce for themselves, and a handful of individuals, like myself, who lament that have no physical component.

All TS persons have, by and large, is what we say -- very few TS persons, as a whole, have any kind of biochemical component validating their "instincts" that there is an incongruence between physical sex and mental gender identity.  And if there's nothing physical / biochemical causing this incongruence, then it's mental -- and logically, if it's not "allowed" to be mental, then we have nothing and will be denied proper treatment.

Very few Ts persons, as a whole, have any kind of biochemical component validating their "intrinsics" that they know of.

The fact we haven't found with enough certainty what the physical component is, is not proof that one doesn't exist. What little research has been done however, continues to lead in that direction.

Quote from: YoungSoulRebel on October 26, 2009, 04:41:22 PM
As I said, I have no prejudices as to what being listed in the DSM actually means.  I have other reasons to be listed in the DSM, as so some of my non-TS friends.  Having a DSM listing that fits doesn't make one "crazy" and it doesn't automatically make one incompetent -- all it means is that there is something atypical about how one's brain operates when compared to everybody else, and that one may need specific treatments (such as medications for severely bipolar persons) in order to live one's life to the fullest.

Think about this hypothetical situation:
GID is completely removed from the DSM -- it's now viewed as a completely physical disorder, etc, etc....  Suddenly overnight, TS persons all over the United States are ordered to have chromosomal anaylses to judge qualifications for diagnosis.  All pre-op, post-ho TS persons are ordered off HRT for a period of four weeks to purge the body of excess hormones in order to do hormonal analyses and brain-scans.  Then, suddenly (using my off-line experiences to figure a percentage rate) 97% of TS persons are judged ineligible for treatment!  "You're not a transsexual," we're all told, "here's some anti-depressants for your anxiety. I recommend intensive therapy to get this idea out of your head.  You can take it or leave it, but until you pass through treatment, I'm diagnosing you as schizotypial (http://en.wikipedia.org/wiki/Schizotypal)."

That's the most-likely scenario if we have GID completely removed from the DSM -- now we're all just having "bizarre beliefs outside subcultural norms" and having "unusual perceptions of reality, including bodily illusions".  Well, all of us but that less-than-10% who actually seems to have a bona-fide physical component.

No, that scenario is nothing short of preposterous and easily the least likely scenario from such a situation.

We already know that chromosomes aren't an absolute 100% rule governing gender identity, mental OR physical, complete androgen insensitivity syndrome is nothing short of proof of that fact.

We already know hormonal irregularities have little or nothing to do with gender identity, you only need to look at examples like the John Money incident to see that. And increasing natal hormone levels has already been tried in the past to treat TS, to no success.

And because there is no proof either of those have anything to do with gender identity, which is what we're really talking about, no such absurd "overnight crackdown on TS's" would take place, and that's really one of the more minor reasons for that scenario being preposterous.

Your scenario only makes the slightest bit of sense if you assume that there has to be an easily detectable example of one of the intersex medical conditions we already know about for a persons cross gender identity to have a physical basis, which is just ridiculous.

Examples like the John Money experiment give cause to believe that there is such a thing as brain sex. The key word there being "brain" sex. Chromosomes can't be assumed to indicate brain sex anymore than they absolutely dictate physical sex.

Your hypothetical seems to work under the reasoning that only if someone has an already recognized intersex condition could they get a "choice" in gender identity (by choice I mean a choice between conforming to societies expectations of a simplistic gender binary, and being able to express your internal gender identity). Which simply doesn't make any sense.

I will say this again, a lack of solid, extensive evidence for a physical basis is NOT evidence that one does not exist, not when the lack of solid, extensive evidence can be easily explained by a lack of solid, extensive research.

Quote from: YoungSoulRebel on October 26, 2009, 04:41:22 PM
There is nothing wrong at all with including GID in the DSM, in and of itself.  All that needs changed is the wording and the recommended treatment options.  All most TS persons have is DSM criteria for GID.  The DSM in its current form already excludes IS persons (meaning the few people I know probably had that diagnosis dropped after this discovery), so if being TS is just another form of IS, then why are there so many TS persons who lack a physical component?

How do you know that so many Ts persons lack a physical component? Because of a lack of chromosomal irregularities which would have no more to do with intersex brain structures than they have to do with other intersex physical characteristics? Because of a lack of post-natal hormone levels which would have even less to do with it?

If there's such a thing as brain sex, then that is what needs to be discovered and checked for. But I don't think making a blind assumption that it's a mental disorder until then is a good situation for us to be in, especially when what little research has been done points in the direction that it is not.

http://news.bbc.co.uk/2/hi/health/7689007.stm (http://news.bbc.co.uk/2/hi/health/7689007.stm)
http://www.sciencedirect.com/science/article/B6TBX-4H16P9S-1/2/ae91dff18b1b99385054e3bf971d47f9 (http://www.sciencedirect.com/science/article/B6TBX-4H16P9S-1/2/ae91dff18b1b99385054e3bf971d47f9)
http://jcem.endojournals.org/cgi/content/full/85/5/2034 (http://jcem.endojournals.org/cgi/content/full/85/5/2034)

The third one's perhaps the most interesting.

Quote from: Miniar on October 26, 2009, 06:00:53 PM
Fibromyalgia has Physical pain, and Physical symptoms.

Transsexualism has Emotional/Psychological pain, and Emotional/Psychological symptoms.

This.  Fibromyalgia isn't even comparable to what I'm going through as a TS person.  Aside from having a pre-op chest that was causing scoliosis, there are absolutely no physical symptoms.

Quote from: Miniar on October 26, 2009, 06:20:17 PM
I agree that setting as a true medical condition is a good idea and I'd like to work towards that, but that's not gonna happen automatically if it's removed from the DSM.

Whereas, if it does get acknowledged as a true medical condition, then removal from DSM will in all probability follow.

Yes, that's pretty much how the process works.  There has to be an establishment as a "physical condition" before it's to be removed from the DSM.

Quote from: Miniar on October 26, 2009, 06:20:17 PM
And Fibro is a poor comparison in my opinion because the physical symptoms for serious sufferers can be obvious, whereas no one can see you "limp" from psychological pain.

And not only that, the current technology that would diagnose somebody physically are either DNA/chromosomal analysis, *or* a hormonal imbalance, or *possibly* comparative EEG brainwave scans (I stand corrected from my previous statement for MRI or CAT scans; I now know better).  In my experiences, most TS people don't really get any of those diagnostic tests performed, and I myself have only two out of three.  If all of my supposition for how my EEG results may look fail out, then by physical means, this means my instincts as to what my gender is are somehow wrong.  Flailing on about how "it's a physical condition" without any proof that it really is a physical condition -- furthermore, Down Syndrome is in the DSM-IV (as a Cognative Disorder) and has a proved physical component (chromosomal), so even if I can prove biochemically or through neurodiagnostic procedures such as EEG, that doesn't remove the mental/emotional component.

Quote from: Ladyrider on October 26, 2009, 06:35:01 PM
I'm sorry Janet but the more we try to self analyze and self diagnose the more confusing the whole topic becomes.  And not meaning to seem insensitive to anyone but it seems to me that it is those who can't get funding, those who don't have the insurance (US folks mostly), those who have barriers to treatment that want to GID delisted.

Yes, I've noticed that this is typically a US-specific rallying cry.  This is a non-issue to persons in Canada, the UK, Scandanavia, Germany, and elsewhere that the proper treatment of TS individuals (and by "proper treatment", I mean "by allowing means for a physical transition") is covered under those countris' NHS.

The reason it's not typically covered in the U$ has more to do with now-antiquated survey of the now-obsolete and malicious "gender clinics" that shut down the in 1970s.  Those "old school" gender clinics concentrated completely on TS women --despite other countries recognising TS men since the 1940s (the UK being the first country to perform FTM phalloplasty), the U$ recognised *only* TS women until 1977 *25 years after Christine Jourgensen*-- and practically shamed these poor women into moving away, cutting off all familial and social ties, and going "deep stealth", then proceeded to practically make these women compete to be who could be more sexually attractive to the doctors.  Needless to say, with all of that shaming and isolation, the suicide rates were abnormally high and the clinics shut down before any proper investigation could be conducted.  I met one of those women who survived the "old school", and it was absolutely horrid.

Prior to a late-1970s survey that revealed high suicide rates amongst those at the gender clinics, it was supposedly rather easy to get US insurances to cover treatment through various technicalities.  But in the UK, Canada, etc... -- TS treatments are covered under the NHS and all private insurance agencies (because what insurance agency wants an NHS to show them up, right?); and it's covered under these NHS' as a mental/emotional disorder.  This is a non-issue for much of the Western world.  The problem is not that it's a DSM listing, the problem is that the US recommended care for TS persons is such crap that it's pretty much the only "mental / emotional disorder" that is consistently afforded little or no treatment at all.

Quote from: Ladyrider on October 26, 2009, 06:35:01 PM
I wholeheartedly agree with YoungSoulRebel and echo his arguments and logic.  One of the issues that is prevalent in all these arguments is the TS resentment of being labeled with a "Mental Disorder" and the stigmas' attached to such labelling.  This is a quote from the Mayo Clinic on the stigmas associated with Mental Health:

Sound familiar...

-={LR}=-

As I've said before, maybe it's because I meet other DSM criteria and because I've been around people who've met all sorts of DSM criteria my whole life -- but I don't have any form of resentment toward the term "mental disorder" or "emotional disorder".  All it means is that there is a developmental quirk that, at some point in my neurological maturation, made me atypical in a certain kind of way, and so there are certain things that I can do to greatly improve my potential for happiness; if I don't do those things, then my potential for happiness will be greatly diminished.  It's like my bipolar friend -- she has a mental disorder, but her potential for happiness is greatly improved under proper medicative treatments.

And not to sound like a weiner, but I've noticed that a lot of the most vocal people insisting that there's "no disorder" seem, well, older.  I think there are more people of older generations who've retained certain internalised stigmas about the term "mental disorder" than people of my age or younger.  Seriously, I was just at the local TS/TG group earlier this evening, and it seems that it was mostly the older people ranting and raving about how they're "not disordered", but it was mostly the younger people who seemed to be of the opinion that "there's nothing wrong with having a mental disorder, it's just something that people sometimes have to deal with".


With the current technology and the current knowledge of the medical community, being listed in the DSM is all us TS people have to get treatment; in countries like Iceland and the UK, DSM listing is the only guarantee of treatment, if not the only avenue entirely for treatment that TS persons have.  It's therefore not the DSM listing that's the problem -- it's the system put in play to treat people with mental disorders in the US has rendered being TS the only classified mental disorder that is consistently refused proper treatment.

I'm going to take a laundry break now.  If i keep going, i can easily produce a rant about how "...and this is why Capitalism fails..." -- but I'll spare you.

---

Post Merge: October 26, 2009, 10:52:39 PM

---

oh jeez...

sORRY, BUT REALLY BOWING OUT AFTER THIS: (oops, capslock...)


asfsd4214:
You're going on nothing but supposition and hypothesis here.  I'm sorry, but you are.  I can produce you just as many papers with opposite results, rendering the whole of these "compelling studies" inconclusive.


I find it far more telling that all of the anti-DSM persons have so far been Amerikans.  That says far more to me than any hypothesis you can queue up on the Internet.

Quote from: Ladyrider on October 26, 2009, 10:09:14 PM
Two points...

I thought Transgender was an umbrella term that includes everyone on this site from CD's, TV's, IS, TS, etc.  Surely there are some in this group who don't require any form of treatment nor is it prescribed or warranted?

Absolutely true. If a person doesn't want surgeries, hrt, they shouldn't be required to undergo them to be recognized as their gender. Likewise, those that want/need treatment should be able to get it.

Quote
Next...

Why does it need to be covered by Insurance.  Shouldn't those diagnosed be provided the care they need to live normal lives regardless of their financial status?

-={LR}=-

I live in USA, and am among the 45+ million without health insurance. I've paid for all of my transition related health care out of pocket, or gone without it. Personally, I would like to see a single payer system, but doubt that we'll get it due to powerful insurance and pharmaceutical interests. At this point we'll be lucky to get a public option.

Yes, those of us diagnosed as trans should be able to receive the care we need regardless of financial status. Unfortunately this isn't the case. I speak from personal experience.

Z

Quote from: Zythyra on October 26, 2009, 10:59:29 PM
I live in USA, and am among the 45+ million without health insurance. I've paid for all of my transition related health care out of pocket, or gone without it.

I have full health insurance coverage EXCEPT for what my union calls "sex transferral".  Once they suspected what was going on they've been watching me like a hawk and denied even covered medical expenses requiring me to fight them on it.  As for my "sex transferral" costs - all $50,000+, out of pocket.  But they would have paid for therapy forever, regardless of the cost, because I'm mentally disturbed.

For anyone who wants to say they have a mental disorder, you may too enjoy the same discrimination I have.  Enjoy!

Julie

Quote from: YoungSoulRebel on October 26, 2009, 10:48:04 PM
asfsd4214:
You're going on nothing but supposition and hypothesis here.  I'm sorry, but you are.  I can produce you just as many papers with opposite results, rendering the whole of these "compelling studies" inconclusive.


I find it far more telling that all of the anti-DSM persons have so far been Amerikans.  That says far more to me than any hypothesis you can queue up on the Internet.

The theories regarding the causes of GID purely as a mental disorder are ALSO nothing but supposition and hypothesis, even less grounded in science that the theories that it's not.

As for papers producing the opposite results, since you won't produce them I will simply say this. If you are searching for the cause of something, of course you will likely come across many dead ends and things to rule out before finding the answers. A lack of evidence is not proof evidence yet to be discovered doesn't exist. I have said this countless times on this thread.

And for your information, I'm Australian, born and raised. And I like the US.  ::)

You seem to have a tendency for making assumptions based on absolutely nothing.

But what do I know, apparently I'm just a stupid American.  ::) News to me, but whatever.

Perhaps you feel that a lack of evidence that there are Non-American's against the DSM is proof that they don't exist.  ;D

You display a clear lack of understanding of what scientific hypothesis is.  I have immense doubt that anything you say on this subject is of value.

Quote from: YoungSoulRebel on October 27, 2009, 02:53:34 AM
You display a clear lack of understanding of what scientific hypothesis is.  I have immense doubt that anything you say on this subject is of value.

I have immense doubt you have anything to say on this subject that changes the fact you made an unfounded accusation that turned out to be hilariously incorrect.  ::)

But congratulations to us, I think we have officially derailed this thread. Not that it seemed to be going anywhere productive for the past couple pages.

When I was diagnosed with Gender Identity Disorder my therapist feverishly stressed that I do not have a disorder and was perfectly normal. I wish they would make this diagnosis a medical one instead of a mental one but currently this at least opens the door for me to get hormones under a doctor's care as well as therapy I need.

Studies, papers, whatever.  You can prove anything you set out to prove.  But there is one thing that speaks most loudly, virtually all those who choose the route of transition are content with their choice.  It doesn't matter why.  Those I personally know, confirm my belief that transitioning is the only treatment with a very high success rate. 

Gender identity is a physical condition and therefore does not belong in the DSM, it belongs in a physicians manual as a treatable condition with a high success rate when gender transition is the focus.

The last thing I will say on this subject is that GID is a mental disorder according to the powers that be.  We can argue till we are blue in the face.

I am a woman, but without insurance, I am going at a slow pace.  I am unemployed and pay everything out of pocket.  Say what you might about 'if you want it bad enough', it still is carp ( yes I spelled it that way on purpose ).  I have extreme pain in my hip and back and can not even get medical help for it.  So unless the US has a public option that includes GID treatment, which will have to be at least termed medical, I am going to have to stop at an Orchie.  It does not matter if I need FFS or a BA, let alone SRS.  I simple can not afford it without help.

You don't realize that many of us are in the same boat.  We need to have the public option, which means being deemed medical, or face a life of suicidal thoughts and the possible loss of more brothers and sisters.  Or move to Canada, which is also not feasible because of cost.


Janet

Quote from: Janet Lynn on October 27, 2009, 08:39:48 AM
You don't realize that many of us are in the same boat.  We need to have the public option, which means being deemed medical, or face a life of suicidal thoughts and the possible loss of more brothers and sisters.  Or move to Canada, which is also not feasible because of cost.


Janet

I agree, we should have single payer, or second best, public option.

Unfortunately, I believe there are restrictions for applying for Canadian citizenship past age 55.

Z

And that is the only reason that I stay here in the states.  If I am stuck in this form, I will endure it as long as I can.  At least I will die a woman and not what I was born as.  Deformed.


Janet

Quote from: Janet Lynn on October 27, 2009, 08:39:48 AM
The last thing I will say on this subject is that GID is a mental disorder according to the powers that be.  We can argue till we are blue in the face.[/size][/font]

So was homosexuality.

If you don't like something, you can always work to change it.  The powers that be are human and make mistakes and can be convinced they made a mistake here. 

When GID is removed from the DSM (and it will be) it will be reclassified and renamed and moved to the medical books where recognition and treatment will be outlined for physicians to follow.  It will happen.  I don't know when but it will.  The change is already underway.

Julie

Quote from: Julie Marie on October 27, 2009, 12:40:22 PM
So was homosexuality.

Yes, but [cisgendered] homosexuals typically don't need a regime of lifetime medication and surgery to "correct a perceived birth defect" to live their lives to their fullest potential.  Comparing homosexuality and transsexualism is problematic for all sorts of reasons -- this is one of them.

Quote from: YoungSoulRebel on October 28, 2009, 01:15:32 AM
Yes, but [cisgendered] homosexuals typically don't need medication and surgery to live their lives to their fullest potential.  Comparing homosexuality and transsexualism is problematic for all sorts of reasons -- this is one of them.

It's not problematic, it's quite easy.

Homosexuality was considered a mental disorder that affected behavior but was otherwise not an impairment in a persons mental state of being.
GID IS considered a mental disorder that affects behaviour but otherwise is not an impairment on a persons mental state of being.

In both cases, prejudice and intolerance and lack of self acceptance can result in genuine mental disorders like depression.

In homosexualiy, the homosexuals successfully had it removed from the DSM, in GID, many want the same thing to happen.

The only practical political difference is that one requires treatment and one does not. Neither situations require it to be listed in the DSM.

But then, you've already decided to dismiss everything I say offhand after I pointed out that your irrational hatred of america fueled observation against those of us against the DSM was flat out wrong. And this thread is just going around in circles, so maybe it's time for someone to close it.  ::)

Stay on topic everyone. Discuss the issue and not each other.

Why are GID issues needlessly divisive?

The transgender community and civil rights advocates have long been polarized by fear that access to sex reassignment procedures would be lost if the GID classification were revised. This division over issues of psychiatric stigma versus access to SRS has allowed little dialogue and no progress on GID reform in over two decades. In truth, however, transsexual individuals are poorly served by a diagnosis that both stigmatizes them unconditionally as mentally deficient and undermines the legitimacy of sex reassignment procedures that have been easily dismissed as "elective" and "cosmetic" by insurers, governments and employers. GID reform is not a question of less stigma versus improved SRS access, it is a question of less stigma and improved SRS access. We need dialogue among people who wish to move beyond division and polarization to proposals for diagnostic reform that will lead to consensus and forward progress.

Quoted from GID Reform Advocates (http://www.gidreform.org/).  I couldn't have said it better.

Julie

Quote from: Julie Marie on October 28, 2009, 09:26:18 AM
Why are GID issues needlessly divisive?
We need dialogue among people who wish to move beyond division and polarization to proposals for diagnostic reform that will lead to consensus and forward progress.

Quoted from GID Reform Advocates (http://www.gidreform.org/).  I couldn't have said it better.

Julie

Thank you for posting this Julie. I agree with the essence of the statement and agree that it would be good/better if a proposal could be established that removes us from the DSM and better facilitates transition. Everyone is happy.

However, even the closing sentence points out the heart of the problem and the heart of the problem with this thread. There is so much division between the "take it out of DSM - I'm not mentally disabled" and the "It's okay in the DSM because we get treated" camps and so much argument over the fundamental reasons why it should stay or change and no serious proposals or recommendations about HOW to redefine and clarify dysphoria and HOW it would be diagnosed and treated as a medical condition, remove the social stigma, term it as a required treatment, remove the implications of "elective" and "cosmetic" from the treatment, and get it to be covered by insurance for that whatever percentage of people that have insurance (still leaves me and Janet and a whole lot of others out).

I have nothing to do, or influence, with the medical profession, the authors of the DSM, WPATH, or any of the 'powers that be', so I don' see myself as having any voice in the process and only hope that someday soon something happens where I am able to transition, or kill myself (that could be construed as mental in most circles).

I'm done with this, thank you for playing,

Deanna

This is what the DSM recommends for treatment of Gender Identity Disorder:

Treatment
Other disorders may be present with this one, including depression, anxiety, relationship difficulties, and personality disorders, and homosexuality is present in a majority of the cases. Treatment is likely to be long-term with small gains made on underlying issues as treatment progresses.

How does anyone go from there to GRS?  In what other mental illnesses is surgery recommended?  How does the DSM guarantee us MEDICAL coverage?

The World Professional Association of Transgender Health (WPATH) is the organization that addresses the medical necessity issue.  That will not be affected by the elimination of GID from the DSM, except to change GID to some other accepted terminology.  You will still be able to get therapy because you'll be going in for anxiety, depression, etc.

So removing GID will really have no negative effect on available treatment but it opens the door to a lot of positive effects. 

- Imagine the entire medical profession seeing transitional surgeries in their physician's manual.  They would be more prone to researching it and improving on it. 

- Insurance companies would have a hard time defending their "cosmetic" and "elective" defense as reasons not to cover it.  The AMA would most likely apply more pressure to the insurance companies.

- More money could be funneled into better treatment options because it is now a medical issue and not a mental issue.

And the list goes on...

As far as not having a voice, all you'd have to do is something like voluntary social work and you can apply for a full membership to WPATH.  You would then have voting rights.

Julie

From the WPATH website:

The Association Welcomes Applications for the Following Types of Memberships:

Full professional membership is available to professionals working in disciplines such as medicine, psychology, law, social work, counseling, psychotherapy, family studies, sociology, anthropology, speech and voice therapy and sexology. Full membership costs $175 (US) per year, and carries voting privileges within the Association.

Quote from: Julie Marie on October 28, 2009, 02:53:47 PM
Treatment
Other disorders may be present with this one, including depression, anxiety, relationship difficulties, and personality disorders, and homosexuality is present in a majority of the cases. Treatment is likely to be long-term with small gains made on underlying issues as treatment progresses.

Don't you love that they apply the term "homosexual" to us with respect to assigned gender at birth?  ::)

Again, I'm all for removing it from the DSM...
But it has to be gone about the right way.
Which in my mind is:

Work towards getting it acknowledged as a genuine medical problem that "then" will be removed from the DSM.
Don't work towards removing it from the DSM first and foremost.

Mind you, I do believe it belongs in the DSM because of the mental problems the physical problem causes us, but it needs to be revised quite a bit.
If I had my way, I'd have transsexualism acknowledged as a real medical condition and listed in physician's guides or whatnot, and have the D in GID changed to "dysphoria" not "disorder" and have that listing reworded to emphasize that it's a result of a physical condition that while it would be beneficial to treat the stress, anxiety, and depression that comes with the physical condition, in some/most cases it is better to work on correcting the physical condition to alleviate those symptoms.
Keeping it in the DSM would also allow those individuals that which take a "non-op" path and make it easier for them to seek what help they need to make that path easier to walk, and with a revision, like I would suggest, that help would be based on an understanding of the underlaying problem.

All the emotional problems we suffer from being different come from outside/social pressures, conditioning, etc.  If we grew up in a world where we were thought of as the Berdache or Two Spirit, we'd be proud to be transgender.

A faction of our society decided we weren't normal and placed that in a book that professionals in the psychiatric community refer to when determining if a person has a mental/emotional problem.  They gave us this problem.  It did not come from within.

The same mindset that decided we were different enough to be abnormal was also present in an ignorant society conditioned to shun anyone different.  They added to our problem.

Our only emotional problem is we live in an unaccepting society.  That society believes the mind can be changed to what they consider normal.  It's a lot easier than them having to deal with you being different.  Without this myopic mindset, our condition would have been considered physical the moment it was discovered.

Who we are is determined by what's between our ears, not our legs.  We know that.  We just need to teach those who don't.

Quote from: juliekins on October 29, 2009, 06:45:00 AM
All the emotional problems we suffer from being different come from outside/social pressures, conditioning, etc.  If we grew up in a world where we were thought of as the Berdache or Two Spirit, we'd be proud to be transgender.

I'm pretty sure I'd be just as unhappy living like that as I was living a male roll.

I feel like I'm female, not male, and not some sort of in between third gender either. If everyone on the planet disappeared and I was the only one left, I would still feel like that, and still be depressed over it.

Quote from: asfsd4214 on October 29, 2009, 07:14:04 AM
I'm pretty sure I'd be just as unhappy living like that as I was living a male roll.

I feel like I'm female, not male, and not some sort of in between third gender either. If everyone on the planet disappeared and I was the only one left, I would still feel like that, and still be depressed over it.

I can guarantee you, Julie and I both feel exactly as you.  We are female and having a body in conflict is not good.

Julie and I were discussing this before her post.  I was the one who injected the Berdache analogy.  It was intended to mean only how our lives would have been so much easier if we were revered rather than repressed.  We wouldn't be ashamed to be TG.  For many of the Berdache and Two Spirits of the past, I'd imagine many of them would choose physical transition if it were available.

Julie

I have Bipolar Disorder. It's a real, medical illness. It makes me sad that there's so much stigma surrounding the idea a mental illness. Bipolar, schizophrenia, and other mental illnesses are also physically visible in the brain. It also comes from genetics.

I don't think something is less real because it occurs in the brain.

Being bipolar -- having a mental illness -- doesn't make me a freak. I'm normal. This is a normal human condition that's been around for ever and a day.

Having a mental illness doesn't mean that it's just all in my head, unreal, or make me less-than-human.

I'm being treated with medication, counseling, and other life skill sets. There's nothing wrong with that.

People are going to argue until they turn blue in the face about GID and whether it's a mental illness or not. Personally, I don't see the difference between a medical and mental illness. Both are medical and both follow treatment procedures.

The problem I see with society is the stigma surrounding mental illness. It's the stigma, not the condition that hurts us.

DSM or not, there's still the same treatment procedure: counceling, HRT, surgery, and so on.

Going through and reading these posts really made me feel like I must be some freak of nature, invisible, and less than human.

Is my bipolar less real because it's in the DSM? Is bipolar a less valid medical issue? Is bipolar invisible? Am I invisible?

In my world, it's the stigma of mental illness. That I am "crazy." I see the stigma as the driving force. I can understand why someone wouldn't want to be called "crazy," 'cause I get that a lot. It's not fun. It makes me feel less-than-human.

So, yeah, I an see why one would want to remove GID from the DSM -- you don't want the stigma of mental illness. I don't blame you.

But, you know what. I'm not crazy. I'm not less than human. I'm not a freak of nature. I'm me.

I'm an amazing, loving, and caring person who has a lot to offer the world. And so are all of you. My mental illness doesn't define me. Yes, it's part of me and it's something I have to live with, but I'm much more than bipolar. We all have something to give to the world.

It's the fear of stigma, of being labeled, and feeling as if you have no validation to be who you are. Validate yourself. You don't need some medical construct to validate who you are.

And, to be honest, even if GID was taken out of the DSM, people are still gonna say GID is in your head. People are still gonna say transsexuals are freaks. And people are still gonna try to treat you less-than-human -- No matter what external validation you bring to the table. Do not let others validate who you are.

That's my view point, anyway.

--natalie

Quote from: gothique11 on October 29, 2009, 06:49:39 PM
And, to be honest, even if GID was taken out of the DSM, people are still gonna say GID is in your head. People are still gonna say transsexuals are freaks. And people are still gonna try to treat you less-than-human -- No matter what external validation you bring to the table. Do not let others validate who you are.

That's my view point, anyway.

--natalie

Some people are. Some people still today think homosexuality is a choice, and that atheists are evil, and that Obama isn't eligible to be president. Stupid people aren't going to go away any time soon, that's not really the point. The point is that these people are becoming a minority (or at least a far less extreme majority) by loss of respected recognition instead of the accepted as a fact majority, that they once were.