Quote from: Tink on May 29, 2007, 06:54:26 PM
Quote from: Amy T. on May 29, 2007, 03:36:29 PM
Quote from: Tink on May 27, 2007, 06:59:17 PM
I usually go by what is listed on the DSM since this is the only official, recognized manual that gender therapists (are supposed to) use to diagnose GID. Of course, you can always call it whatever you imagine it to be..........never mind. >
My choice: Gender Identity Disorder
tink 
Of course most therapist working in the field have ignored the DSM for quite some time, and the only reason even the SoC recognizes the coding is because it has to. They largely view the GID diagnosis as prejudiced and inaccurate. Even the SoC uses the less prejudiced ICD-9 definition, which is Transsexuality. Also if you read some of the dialog for the DSM-V it will probably lose the stigma of a "mental disorder" and will probably be considered a "syndrome" with psychological aspects. Basically if you are thinking the DSM is any way accurate, you really need to read it clearly, and have a better grasp on the technical language. We are not crazy people, we are not disordered.
Is this a personal attack, Amy? FYI, I work in the medical field, I have read the DSM more than once, and I am very familiar with technical language. I stand by what I said previously. However, based on what I have read from you on different threads, it is pretty obvious to me that you and I do not suffer from the same disorder.
tink
Thats the problem with the DSM. It is too inflexible, too inaccurate. It is built on a very narrow view of TS that is built on misogynistic views on femininity. So what my gender identity issues took on a nerdy feminist leaning, does that make me any less TS? No. Is this unusual or wrong? No it proves that having these narrow definitions that the DSM reinforces that there are major issues with the DSM itself. If anything the DSM needs to be brought up to do date, and be put into context with current understanding.
Additionally the sexuality aspect of the DSM-IV needs to be dropped period. I could go on with how this alone is a huge issue with the way the DSM-IV is written.
The problem with the definition and the course of treatment is the fact it is MY people, LAWYERS, who determine exclusions. As long as the DSM stands as it is written, as a DISORDER, especially when the course of treatment of HRT and SRS is stated as ineffective, I will have a major issue with the DSM. But that is just the start of my issues with the DSM-IV.
Also I will say the issue with the DSM is the fact that transsexuality effects everybody differently. Some of us do not fit clearly into the box the DSM-IV describes. Everybody has a different life experience, and this effects everybody differently. While you may fit into the box of the DSM quite well, quite a few of us do not.
On other boards, with younger TS, we often call this the "barbie" excuse. If you are on the trueselves board (which I have noticed takes a much heavier Transfeminist leaning, and tends to skew much younger) you would realize the major issues with just this section of the DSM. If you didn't play with Barbie or extremely girly toys when younger, you were not TS. The very poor therapist have used this as an excuse to block treatment. It comes from this part of the DSM:
In boys, the cross gender identification is manifested by a marked preoccupation with traditionally feminine activities. They may have a preference for dressing in girls' or women's clothes or may improvise such items from available materials when genuine articles are unavailable. Towels, aprons, and scarves are often used to represent long hair or skirts. There is a strong attraction for the stereotypical games and pastimes of girls. They particularly enjoy playing house, drawing pictures of beautiful girls and princesses, and watching television or videos of their favorite female-type dolls, such as Barbie, are often their favorite toys, and girls are their preferred playmates. When playing "house", these boys role-play female figures. Most commonly "mother roles", and often are quite preoccupied with female fantasy figures. they avoid rough-and-tumble play and competitive sports and have little interest in cars and trucks or other no-aggressive but stereotypical boy's toys. They may express a wish to be a girl and assert that they will grow up to be a woman. they may insist on sitting to urinate and pretend not to have a penis by pushing it in between their legs. More rarely, boys with Gender Identity Disorder may state that they find their penis or testes disgusting, that they want to remove them, or that they have, or wish to have, a vagina.I could go into the problems with just this particular section. Tear it down by its inherantly misogynistic tendencies and discrepancies. When I was younger I read Nancy Drew books, and I strongly identified with Velma from Scooby Doo. This was before I was really clear on my gender identity while younger (and trust me it is not uncommon for TS to be unclear on there own gender identity issues at a young age, honestly when I was young I felt I was an alien or fairy or something put into a boys body and a mistake had been made, it was just how my young overly imaginative mind processed things). I didn't know why I related, I just did. I could go on about my entire childhood and the issues I faced, if you put the pieces together you would realize that even at a young age I faced this issue, it just manifested in ways outside of the narrow definitions of the DSM.
I could go on, this is not a personal attack. My issue is with the narrowness of the DSM and those who buy into it as the only definition of TS. Most therapist at this point have thrown it out and so has the SoC. They realize that TS as a group are as complex and diverse as women themselves. The only thing with the DSM in the SoC that is used is the code, the definition and diagnostic tool they use fall outside the DSM to encompass a better and more flexible understanding of TS. The diagnostic elements and the descriptions have all but been abandoned for good reason.
Does this mean this issue does not effect me, far from it. It just means I have been able to grasp the inherent issues with the DSM and the way it describes things. I see it for the misogynistic and prejudiced claptrap it really is. I see the inherent problems in the way it addresses things. But most THERAPISTS who specialize in gender identity issues, see huge issues with the DSM. That is why the SoC were changed. They also have issues with it being called a disorder.
While you may fit into the box of the DSM, I see huge issues with it. I am not the only TS who has huge issues with how the DSM describes things. I read through it and see that it is wrought with stereotypes, prejudice and misogyny. While you may fit nicely into that box, not everybody does.
You were saying earlier you preferred the older SoC, the truth is the SoC moved on for a reason, largely because it moved beyond stereotypes. You may fit into these neat little boxes. But every individual is different, and the DSM to me is flawed for this reason, TS is not as narrow as it portrays. Not all TS women play with barbie when they are younger, and not all TS women fit into narrow definition, just like how not all women in general do not fit into narrow definitions. We are all different. As it stands the DSM-IV lacks flexibility, it sees TS through a very narrow lens.
Like I said, I don't suffer from a disorder. I suffer from a physical condition, a syndrome. I plan on treating my physical condition, even if the DSM calls it a disorder. According the the DSM-IV, SRS and HRT as a course of treatment are called into doubt, including for you. I seriously doubt that is actually the case, alas, another flaw with the DSM.
I am not saying ALL of the DSM is flawed. Trust me I fit into quite a bit of the diagnosis. (Peer ostracism, effeminate behaviors and speech, social avoidance and detachment, avoidance of rough play, disgust of genitials when I was younger for example). But the truth is, as it stands there is significant problems with the DSM-IV. There needs to be significant changes as it is currently written, it does need to be brought in line with the SoC. The stereotypes need to be dropped, I am sorry but Barbie should not even be mentioned. The DSM needs to reflect the SoC. It needs to recognize that HRT and SRS are effective treatments, and the course of treatment from the standards of care needs to be written in.
I am militant about it because I realize the DSM as currently written is mostly political and based on stereotypes, then an effective diagnostic tool. I want it changed because I know how insurance companies have used it to justify exclusions. It needs to be changed. I also realize that while we may suffer from the effects of depression and anxiety, we do not suffer from a lifelong disorder where we cannot function in society. Out of everything in the DSM, this is the one diagnosis that is most effectively treated, yet the DSM does not state the treatment as effective.
Just because I do not see it as a disorder, does not make me any less TS. You see yourself clearly fitting into a box. I see the box itself as an issue. The thing is I am not suffering from any disorder. I am a TS female, I am suffering from a physical defect that can be treated to a point.
Just because I do not fit well into the neat little misogynistic archaic box of GID that some TS seem to be attached too, does not make me any less TS. The way I see it, is that the SoC and other diagnostic tools that have moved away from the old definitions have come a long way in recognizing the real issues. A TS woman can be as much a militant feminist lesbian as Julia Serano as the classical architype of a woman trapped in a mans body. It could be somebody who is outspoken, or it could be somebody who chooses to live in the obscurity of deep stealth.
The point being is TS and gender identity issues do not come in narrow ranges. As it stands the DSM-IV presents a very narrow and very outdated way of viewing things and the way it is currently written would exclude many TS. There would be several TS, who are now happy and without regret that would have never gotten treated if the DSM-IV was used and the SoC did not exist. That is why the SoC are followed and the DSM is largely ignored with regards to TS with regards to many gender therapist. That is why the DSM-V will probably be pretty close to the SoC, and the "disorder" term will probably be dropped.
Don't question my gender identity, or my dedication, my gender identity issues, or the fact I am Transsexual. Because I will take that is a personal attack. I am extremely critical because I don't take things for face value. If I did, would I even be posting on this board.
We are still both TS according to the SoC. The difference is I come from a modern perspective on these issues, and you seem to be content with fitting into and accepting the archaic definitions that I view as misogynistic and trans-misogynistic. To me the SoC was a HUGE improvement because it dropped the stereotypical aspects that were previously there and adopted a clear cut definition of TS that took into account how much diversity there is with how transsexuality effects us, as well as how diverse the personalities of women themselves can be. We are all a bit different, TS women, are a diverse group, with diverse personalities.
You like the old SoC and the DSM-IV because you fit clearly into it. Quite a few of us do not however, in fact view those old definitions as problematic because they do rely on stereotypes. Please recognize that. That does not make us any less women, or any less TS. Also understand that there are huge issues with the DSM-IV, and just because you seem to fit with the DSM, does not mean the criticisms are not well justified.
