Susan's Place Transgender Resources

The recent decision in the United States Tax Court where it was overwhelmingly ruled (O'Donnabhain v. Commissioner of Internal Revenue (http://campaign.constantcontact.com/render?v=001UGlpv9WiH3UGfywOe2pfUT6EUZR6leNNEr6yT4nwAwDWtbAo4YUvjituwgmlz205WcFBhXHMb7PDZ_8yMU8hGm5780hXNMrLkaSzOOD14IsnOMDumoR2fOMhXh28nF6xc4qzQmGdyCthazDSQo1YGm8kCWuQyagn10Q2psSd-LpK3fQphDI3C-_AAZTZsjanyRQ7r8qz5j93UX0ZOUdMM03eSrAMkAzY5HFl-e2oZZeb8hf-bkpWLpTOAs4BfVLDxtL_202xRYkk59lSyoe7QQ%3D%3D)) that a transgender woman's medical expenses for hormone therapy and sex reassignment surgery were medically necessary and therefore tax-deductible under Federal law, gave further indication that GID being in the DSM will prevent gender identity from being considered a medical condition.

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

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

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

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

I have said it many many times.

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

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

Quote from: rejennyrated on February 04, 2010, 04:34:26 PM
I have said it many many times.

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

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

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

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

The AMA has already stated int resolution 122 (http://www.tgender.net/taw/ama_resolutions.pdf) that;

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

It also states that;

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

And further states:

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

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

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

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

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

Gennee

Quote from: gennee on February 04, 2010, 08:08:39 PM
I wonder why they called GID a disease in the first place.

Gennee

From wikipedia

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

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

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

*Resisting the urge to say something rather naughty about getting a bone and laughing*  >:-)

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

The mental part being triggered by the physical part

Not the physical part being triggered by the mental part

Does that make any sense?

It's an old school term for dice.

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

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

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

Quote from: Virginia Marie on February 04, 2010, 08:36:36 PM
But seriously, It should not be seen a mental disorder.

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

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

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

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

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

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

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

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

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

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

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

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

Quote from: tekla on February 04, 2010, 08:22:43 PM
What guarantee do you have (I'm guessing less than zero) that if you get it pulled that the medical community is going to be so hog wild on picking it up.  I'm down with it being out, but being out means no insurance coverage (or tax write off).  That's rollin' them laughing bones for a lot of people.

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

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

Robyn

Quote from: Robyn on February 05, 2010, 11:17:23 AM
Yes, it would have to be a coordinated effort: roll it out of DSM into whatever the medical equivalent is. (What is the medical equivalent?)

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

Robyn

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

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

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

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

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

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

All we have to do is not give up.

Key points

·          Transgender people have a recognised medical condition

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

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

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

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

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

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

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

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

Quote from: interalia on February 06, 2010, 02:27:12 AM
What is the abnormal physicality of GID that would classify it as a "medical disorder"?

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

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

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

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

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

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

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

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

Quote from: rejennyrated on February 06, 2010, 02:53:44 AM


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


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

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

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

Quote from: interalia on February 06, 2010, 03:44:40 AM
We can point to faulty genetics and physical abnormalities in the brain for various mental disorders - even things as "common cold" as major depression.  Should we de-classify those as mental disorders and and move them out of the DSM?

Interesting question.

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

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

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

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

Quote from: rejennyrated on February 06, 2010, 04:02:34 AM
Therefore just because someone chooses to have their gender defined by their brain sex rather than their outward physical appearance it does NOT mean that they have a mental disorder. Therefore the condition still does not belong in DSM. QED!

Think there are a few flaws in your reasoning Jenny.

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

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

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

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

Quote from: rejennyrated on February 06, 2010, 04:02:34 AM
It doesn't make the brain into a damaged or malfunctioning brain. It merely makes it perform "normally" but in the same way as the opposite gender to that of the physical body in which it resides.

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

Quote from: rejennyrated on February 06, 2010, 04:02:34 AM
Which then gives rise to the almost philosophical question about what it is which makes us who we are? If you have a normal but mismatched brain and body then which part is to be taken as the defining artifact.

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

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

Quote from: spacial on February 06, 2010, 04:27:53 AM
Think there are a few flaws in your reasoning Jenny.

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

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

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

Quote from: interalia on February 06, 2010, 04:28:26 AM
This is dang near impossible to prove.  I can no more say I know what it is like to have a normal male's brain much less claim a normal female's.  Ultimately an otherwise healthy male believes he is female or vice versa.  That screams damaged, malfunctioning, or disordered to me be it in the brain or body or wherever - something is definitely wrong.

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

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

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

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

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

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

Quote from: rejennyrated on February 06, 2010, 05:00:26 AM
Actually not so - as I understand it the study that I referred to used live subjects and brain imaging. It was studying activation patterns in response to stimulii and comparing them to gender norms. That is one of the things which makes this study so interesting.I think the point is that a diagnosis is a label, and the diagnosis of a mental disorder was originally intended for people whose condition made functioning normally in society impossible for them.

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

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

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

Quote from: rejennyrated on February 06, 2010, 05:00:26 AM
As it happens, I personally may not have been an otherwise healthy male, but that is actually fairly irrelevant in my opinion. The hegenomy that wishes to label the actions of others whom they do not understand as madness is insidious and dangerous - that way lies the thought police and repression and it should be strenuously resisted.

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

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

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

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

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

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

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

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

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

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

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

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

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

Quote from: Julie Marie on February 06, 2010, 10:03:48 AM
Engaging in discussions about the why and how is all well and good but the real problem we face is social rejection.  We would not be here discussing this is the world accepted the transgender condition the same as say, red hair.

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

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

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

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

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

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

Individual rights to be who we choose. Individualism.

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

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

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

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

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

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

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

Quote from: Cindy Stephens on February 06, 2010, 01:12:44 PM
As far as brain imaging, isn't the causal effect in question?  I believe that some have asked whether or not being transgendered causes the brain changes or vice verse.   To prove one way or another, you would have to examine a large population, at an early age, identify those whose function differs, then follow all to see if that does in fact identify a transgendered individual.  I don't believe that that has been done yet.  So the results remain interesting, but not compelling one way or the other.

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

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

I sure Ashley didn't intend any direct offense.

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

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

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

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

Quote from: LynnER on February 06, 2010, 02:17:59 PM
Theres even more hope now.  Doctors, surgeons are performing orchis for MtF's with out psychological referral letters.  GP's are prescribing HRT with out requesting psychological letters. Things are getting easier for us. My doctors are using what they called "informed consent" I'm obviously TS, why do I or they need letters from a shrink to tell them that these things need to be done for me to be a functional person?

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

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

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

I can really settle for unusual and unique.

Me, unusual and unique?

Well, yes, since you noticed. :D

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

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

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

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

I believe that it doesn't belong in the DSM, having it there adds a stigma of mental illness to who we are. Trans is a natural variation, it has existed throughout history. What I see as the real disorder is society's intolerance of our existence.

Z

Quote from: Zythyra on February 07, 2010, 02:26:59 PM
I believe that it doesn't belong in the DSM, having it there adds a stigma of mental illness to who we are. Trans is a natural variation, it has existed throughout history. What I see as the real disorder is society's intolerance of our existence.

Z

We have bought into the whole "God made you that way so..." idea.  If we follow that logic we'd have to go to the shrink to get a letter to change our hair color or to even practice good hygiene.  After all, God didn't make soap or hair color.

There's a common misconception that if the majority of people say something is abnormal then it is, which is absurd.  There are countless times in history where the majority of people at the time believed a certain thing to be fact and were later proven wrong.  And a lot of people have suffered because of this "majority is right attitude", the foundation of which has always been ignorance.

The average Joe out there thinks if you can't see it, it doesn't exist.  The idea that someone who has a brain gender different from their physical gender is beyond their comprehension.  They can't see gender in the brain so therefore we're mentally disordered.  Once our brains are imprinted, there's no changing that.  We may be able to fight it but we can't change it, at least not yet.

But what is really insane is the idea there is a one normal and everyone should fit that concept of normal.  There isn't any two people exactly alike, not even identical twins.  And the biggest difference in identical twins is their personalities.  Yet society insists we all act the same.  If that isn't mentally disordered, I don't know what is.

We need to stop defending who we are and start focusing on the real problem, intolerance and the source of that intolerance, phobias - a mental disorder, common yes, but still a mental disorder.  Imagine a world where phobias don't exist.  :eusa_think:

Well I've now read the draft and in the main it seems just as bad as the previous version.

It is worse, if you happen to be intersexed in some way because previously intersex people escaped the formal diagnosis of a menatl disorder, at least they did if the intersex condition was known at the time of transition, but now it seems that we are all to be lumped in the same boat - so not only intersexed but mad as well  ::) Brilliant!

It definitely should be removed IMO.

Something about being careful what you wish for because you just might get it comes to mind.

The DSM-V draft version has been published and is available for commenting here http://www.dsm5.org/Pages/Default.aspx (http://www.dsm5.org/Pages/Default.aspx)

"It is proposed that the name gender identity disorder (GID) be replaced by "Gender Incongruence" (GI) because the latter is a descriptive term that better reflects the core of the problem: an incongruence between, on the one hand, what identity one experiences and/or expresses and, on the other hand, how one is expected to live based on one's assigned gender."

Effectively, they are admitting that the expectations society has about how to live your life can cause unhappiness in those who don't meet societal expectations.  It's not what's inside that's bothering you, it's the outside stuff.

For now, it looks like gender identity will remain in the DSM in one form or another.  But what is interesting is their "exit clause:

"The term "sex" has been replaced by assigned "gender" in order to make the criteria applicable  to individuals with a DSD (Meyer-Bahlburg, 2009b). During the course of physical sex differentiation, some aspects of biological sex (e.g., 46,XY genes) may be incongruent with other aspects (e.g., the external genitalia); thus, using the term "sex" would be confusing. The change also makes it possible for individuals who have successfully transitioned to "lose" the diagnosis after satisfactory treatment. This resolves the problem that, in the DSM-IV-TR, there was a lack of an "exit clause," meaning that individuals once diagnosed with GID will always be considered to have the diagnosis, regardless of whether they have transitioned and are psychosocially adjusted in the identified gender role (Winters, 2008). The diagnosis will also be applicable to transitioned individuals who have regrets, because they did not feel like the other gender after all. For instance, a natal male living in the female role and having regrets experiences an incongruence between the "newly assigned" female gender and the experienced/expressed (still or again male) gender."

This makes it clear that one's happiness is crucial to a mental disorder diagnosis.  If you're unhappy, you have a problem.  It doesn't matter why you are unhappy.  It's like telling someone in a POW camp who is being tortured that they need to accept the fact they are tortured every day and find a way to be happy with that rather than trying to find a way for them to escape.  Escaping, however, would be their exit clause.

I will now be able to say, "I used to be mentally disordered then I had vaginoplasty and now I'm not."  Kinda silly.  But when you consider most post transitioners stop therapy, the shrinks have nothing to lose by saying you no longer have a mental problem.

We still have to get employers to recognize it and include it in their insurance coverage.  That will be a lot tougher.

I must say I have always disliked these conversations.

I always considered myself as a mental problem as a knew I was physically fit. My mind was breaking down and I was having suicial thoughts that I could not push away. The transition or die thing was put in front of my face and I had to at least try to see if it worked for me. As it turned out it did not and I lucky found another way out.

Alice

I've been thinking a lot on this topic.

Many here seem to avoid the scientific definition of a mental disorder because of the stigma.  It seems they say, "X is a mental disorder.  I don't like having a mental disorder.  Therefore X must not be a mental disorder."  So let me play the same game below.

If GID were removed from the DSM on the basis of it being a physical/medical condition, that would mean people with GID would have to seek out a medical solution.  Let's also assume the only medical solution seems to be hormones/surgery, etc. 

This means if the person doesn't want the accepted medical solution, he is stuck without treatment.  He cannot go to a psychologist except for generalized depression, because the psychologist will no longer consider his GID a mental disorder, and just continue to refer him to a doctor for surgery, etc.

It means someone like me, or someone who wishes to not transition to any degree, will be left out in the cold, unable to obtain treatment.  It also means that fewer psychologists will be researching new treatment methods (that don't involve transition) for GID.  After all, why research something not in your field?

It also means that anyone who recognizes they have GID will feel the only way to treat it is to go through the surgery, but we know that not everyone with GID needs complete transition to feel happy and in fact, some even regret it.

We are unnecessarily pigeon-holing a "cure" if we turn it into a medical condition.  Most doctors want something they can sit with you, run a test, determine the diagnosis and prescribe a treatment.  They aren't going to help you if you don't follow their accepted treatment regime, and they most likely aren't going to help you with the mental component of this condition - which brings us back to the psych.

Anyway, I'm not really worried about it happening this way because by the current definitions of what it means to have a mental disorder, GID fits the bill.  Stigma or no, it ain't gonna change unless one of two things happen:

1) The current definitions of mental disorders changes in such a way it doesn't include issues that are pervasive, cause distress, and are different than the society norm.
2) An incredibly accurate medical-based test is developed for the determination of GID, and a one size fits almost everyone medical solution is put into place.

I say fat chance to the first one, but the second one could come in time.  Until then, expect to remain "crazy". ;)

Quote from: interalia on February 14, 2010, 08:28:58 AMIf GID were removed from the DSM on the basis of it being a physical/medical condition, that would mean people with GID would have to seek out a medical solution.  Let's also assume the only medical solution seems to be hormones/surgery, etc.

When I was going through my physical transition my insurance company did not cover surgery or hormones.  Transsexualism was considered a mental disorder and they would have paid a portion of my therapy forever but not one cent toward hormones and surgery.  GID being in the DSM did nothing to help provide medical coverage for me and it's the same with most TSs out there.

QuoteThis means if the person doesn't want the accepted medical solution, he is stuck without treatment.  He cannot go to a psychologist except for generalized depression, because the psychologist will no longer consider his GID a mental disorder, and just continue to refer him to a doctor for surgery, etc.

Transvestic fetishism (TF) is still considered a mental disorder and probably will be for a long time.  It is considered to be a paraphillia, not a sexual disorder.  As far as I know, no one is fighting to have it eliminated from the DSM.  Non transitioning TGs would probably be classified as TF so you could still get therapy.  And even if they removed all gender incongruence from the DSM, anyone can walk into a therapist's office and say they are having problems and get insurance coverage.

What you seem to miss is there are degrees of gender related dysphoria.  Those who identify their dysphoria coming from anything but being TS can remain in treatment as long as they want because there is, as of this writing, no identified "cure".  The proposed DSM-V states that anyone who has "successfully transitioned" no longer has a mental disorder - surgery between the legs cured the mind.  That's why I believe that should be removed from the DSM.

QuoteWe are unnecessarily pigeon-holing a "cure" if we turn it into a medical condition.

We, as a society, are all about finding cures.  How can it ever be considered unnecessary when we come up with a cure?  That is the ultimate goal once a problem is identified.

QuoteThey aren't going to help you if you don't follow their accepted treatment regime, and they most likely aren't going to help you with the mental component of this condition

If you are diagnosed with cancer and it causes you stress, anxiety and/or depression, there's no way your doctor will tell you not to see a therapist or join a support group. 

It seems a lot of your fears are unfounded.

It is a good thing it doesn't worry me.  It is not likely at all to ever be removed from the DSM.  I was just doing a thought experiment if it were. 

On one of your points though, TF is not TS of course, and TF does not equal non-transitioning TS either.  My getting psych treatment for TF would be like getting treatment for a condition I don't have.  I'd like to be treated for what I do have which might be more difficult if the convention defines what I do have as exclusively a medical condition involving hormones and surgery.  But then again I'm dealing in extreme hypotheticals here.