The DSM Paradox

[androgynouspainter26]

The DSM currently lists Gender Identity Disorder as, well, a disorder.  If you're on this site, I'm just going to assume that you know what it is, and how ardently the trans community is fighting to have it revoked.  While discussing this issue with some friends, a paradox came up when I mentioned that if transexism can't be counted as a disorder, than SRS is not medically necessary.  If GID is not a real disorder, than transgenderism must be a "choice" (a word which I use very loosely) and hormones and surgery are therefore elective.  If hormones and surgery are actually medically necessary, then they must be treating a legitimate medical disorder.   

The subject is making me head ache, but it's a question that has always unsettled me because the way I see it, either way the answer carries some fairly grave implications for people like us.  Any thoughts?

[MadelineB]

Hi AP26, you will want to take a look at the newest DSM that was finally published this year. It retired the 'Gender Identity Disorder" diagnosis and replaced it with "Gender Dysphoria". If you do an advanced google search for susans.org and "DSM" you will find dozens of threads, many pointing to news articles and opinion pieces about the debate which led up to the publishing of the latest rephrasing.
To summarize, the point of the major change, was to make it clear that this is still a form of severe suffering that can only be alleviated by medical treatment, one that at the present time can only be diagnoses by psychological clinicians (through interview of the patient) but it is no longer being labeled as a mental disorder. By contrast, a dysphoria can be alleviated through proper treatment.
There may come a time when brain imaging or brain scanning is advanced enough that a test for the brain condition that exhibits as gender dysphoria can be used, at which time it will likely be removed from the DSM altogether, and have a new place in the ICD-11 or ICD-12 next to the other neurological diagnoses. The DSM primarily affects patients in the US and Canada.

[androgynouspainter26]

Madeline,

I am aware of the updates that have been made this past year; I apologize for my lazy wording.  I've still heard this diagnosis criticized at length by a number of organizations though.  The idea of it being categorized as a neurological disorder crossed my mind, though that has it's own set of drawbacks.  I guess this question is simply stemming from the outcry I've heard from so many people like us as of late-it's impossible to deny that if an entire community of people have a mental diagnoses stamped on them they tend to lose credibility.  The question was more a philosophical one.  Thank you very much for your expertise; it's a tragically rare thing these days.

[VeronicaLynn]

Did removing homosexuality from the DSM make it a choice? I don't think those that think it is a choice changed their mind based on a new edition of the DSM.

Really, the same people(mostly) that think homosexuality is a choice are going to think being transgendered is a choice, and they are going to think that regardless of what the DSM says. I'm not sure whether the stigma of it being considered a mental illness by many is worth the possibility of SRS and HRT being "medically necessary", not sure how much value that has anyway seeing how most insurance plans exclude it.