For those who think it's okay for TG to be a mental disorder

[Julie Marie]

Errrr that's because being homosexual is a sexual preference and not a mental disorder, no similarities what so ever.  Your turn

Steph

"Preference?"  Oh boy, don't go saying that in the company of LG activists.  You'll get an earful!

To your point:
1) Homosexuality is not a preference or a choice just as heterosexuality is not a preference or a choice just as being TG is not a preference or choice.  Similarity noted.
2) Homosexuality USED to be a mental disorder until it was removed from the DSM.

The point I've been trying to make from the beginning, and made several times since, seems to be falling on deaf ears.   

a) We are discriminated against, when identified as transgender

b) There is a negative stigma about us

c) The unemployment rate for TGs is dramatically higher than the general population

d) The under-employment situation is considerably worse than the general population

e) The general population discriminates against those it considers to be mentally disordered

f) The general population considers us to be screwed up in the head

g) The DSM, a professional reference book, says we are mentally disordered.

h) If we want a job or housing or other needs, we have to go out into the general population to get them, presently, as a mentally disordered person. 

"We just can't trust those people!  They're not right in the head."

And if you say, "Well I'm stealth and I don't experience those things", that doesn't disprove anything I said above.  All it proves is you had to be stealth to be treated as normal.  Look at the stealth threads here and you'll see how important it is to most of us.  Why?  So we don't have to deal with discrimination, prejudice and hatred.  The need for stealth is further proof of the damaging effects of the stigma.

If I was one of those people I often refer to as phobes and I came here and read this thread. I'd pick out all the posts that defend GID as a mental disorder and take that back to my local phobe group and use it to prove that TGs have a mental problem, not a physical problem.  And that they need psychotherapy for as long as it takes to fix their brains.  And until their brains are fixed they cannot be treated as normal citizens because they cannot think normally and cannot be trusted with the same rights and privileges as normal adults.  Besides, many of them are pedophiles and prostitutes and we don't want them in our society.  ENDA?  Not for those people?  They're nuts!

This thread reminds me of scenes from One Flew Over The Cuckoos Nest where McMurphy is trying to convince some of the inmates they don't belong in a mental institution and they vehemently argue they do.  I thought they were just funny scenes.  Now I'm not so sure.

I guess I'll have to just go back to what I said earlier:  If you think being TG is a mental disorder then you have a mental disorder.  If not, then you don't.  Same goes for having red hair, blue eyes, being short, being tall and anything else that's "wrong" with you.

[Steph]

"Preference?"  Oh boy, don't go saying that in the company of LG activists.  You'll get an earful!


The point I've been trying to make from the beginning, and made several times since, seems to be falling on deaf ears.   

a) We are discriminated against, when identified as transgender

b) There is a negative stigma about us

c) The unemployment rate for TGs is dramatically higher than the general population

d) The under-employment situation is considerably worse than the general population

e) The general population discriminates against those it considers to be mentally disordered

f) The general population considers us to be screwed up in the head

g) The DSM, a professional reference book, says we are mentally disordered.

h) If we want a job or housing or other needs, we have to go out into the general population to get them, presently, as a mentally disordered person. 

"We just can't trust those people!  They're not right in the head."

I agree Julie that these are all the reasons why something needs to change, but not GID in the DSM.  What needs to be changed is the various human rights legislations that govern your country.  It pains me so much to see the freest country in the world can oppress it's citizens .  You are not going to change people.  You can change the DSM but for many in society will still see you as TS, still discriminate, still create negative stigma, still prevent TS from employment and housing etc  What is needed is protection.

Ha, ha, I think we've beat this one to death

Steph

[Lacey Lynne]

Short, personal opinion:

Personally, I feel that the medical establishment should depathologize us.  Of course, that is not likely to happen.  Many of you have given excellent answers.  I have nothing to add.  You've all said it so well. 

As I write this, my favorite song from my favorite band in my favorite version just came on the radio.  Listening to it, my mentation is becoming most disordered ... happily so!  Give me a time machine.  Let's go back to 1968.  Those wavy lines, bright colors, beautiful girls ... The 1960s loom large before me.



Just kidding!       Okay, I admit it:  I'm a terminally-weird, life-long rock addict.  Love it!

Both sides of the "mental disorder" issue mentioned here have merit.  We are apt to be listed in the Diagnostic Statistical Manual for some time to come.  Personally, I kind of resent the medicalization of our treatment, not because of its necessity but rather because of it's expense.  The money ... always the money ... always.  It does not have to be this way, it really doesn't.  Well, enough from me.  Like all your answers on this thread.  So interesting.

[Sarah B]

Hi Brainiac

Firstly, if you don't accurately tell your diagnostician about what you're going through, I think it's fairly obvious that they will not be able to appropriately diagnose you.

Well I'm sorry, that is not necessarily so.  I had a letter of referral from my GP, asking my psychiatrist to see me. On my first visit with him, yes I was dressed appropriately and I was as nervous as a bag of >-bleeped-<.  I also did not tell him that I was nervous either and as a side note between reading an article in a 'playboy magazine' which I will come to later and me visiting him, I had read maybe in a limited sense, about other girls and what they had to do and the problems they encountered,  I don't know, because it is nearly 20 to 30 years ago that I did any reading on these issues and at the time this information was extremely limited.

But one thing was for sure I understood 'psychiatrist's' in a limited sense, yes I was naive and I did not have the knowledge or understanding that I have now.  My instinctive nature told me that psychiatrists could and would play games.  Yes, there it is again, I knew I had to keep my big mouth shut.  Unfortunately that is me,  I know what is right and what is wrong and that is my nature.

Anyway back to the consultation with my psychiatrist, after handing him the letter and maybe a little about where I came from.  The consultation ended with an arrangement that I would see him regularly every two weeks, if I remember correctly.  Anyway in the mean time I had found a job and I was was working full time.  I then attended my second session.  I was happy, confident, relaxed and in a sense was not even worried about this consultation.  I told him I had a job and the conversation got around to my first visit and he remarked about my unease at the first consultation and I confirmed with him that I was nervous.

So he knew my 'state of being' without me saying anything.  Then at the end of this consultation or the next one he said, he only wanted to see me every month and this is what happened for the next two years.  Why did he change the appointment schedule?   Maybe he realised that I had my head screwed on properly and recognised that I was mentally sound.

Secondly, "strong and persistent" identification is not necessarily defined as the things you said. Acting it out is an unfair way to judge it, as you can identify with a gender without feeling able to express it.

Sorry the Criterion A states "There musty be evidence of a strong and persistent cross gender identification" note the operative words 'there must be evidence'. So what evidence must one present then?  You are right, 'one can identify with a gender without feeling able to express it.  I never expressed myself verbally or insisted I was a female, because I never had to.  People just saw me as a female.

Wanting and imagining that you are the correct gender is a CONSCIOUS identification--and denial can really strongly interfere with that. I know it did for me.

Point is I never ever denied my identification as a female, full stop period, I embraced it fully, so hence I never suffered per se.  Again I never told any one about it

(not merely a desire for any perceived cultural advantages of being the other sex).
I believe that you misinterpreted this line.

No I did not, because again the operative words are 'for any perceived cultural advantages', not my words, 'their words' and I wanted all the 'perceived cultural advantages", why? Because I'm a female that's why and why would I want all the perceived cultural disadvantages that are associated with being a female?  Because it's part of the culture of being a women and goes with the territory.

Anyway, I hope you really realised the heavy sarcasm that was being used and the mockery I made of this particular condition and in this day and age we have 'gender equality', yes I know it's not perfect.  Yes, I did consider all the ramifications of competing in swimming and not swimming was not an option.  There was no way I was going to give up swimming, because if I did, a part of me would have died and I was not prepared to accept that.  Yes I did win the short sprints and I did lose the longer distances.

Really? You had ZERO dysphoria about your body not being what it was supposed to, the way you were viewed as the wrong gender by others? You didn't feel pigeon holed into the wrong gender roles?

Really truly, I had no 'dysphoria', it's hard to believe is it not?  Well it goes like this.

Hypothesis: All trans people have dysphoria.  Which is basically what you are saying and the DSM manuals as well.  However, this statement is falsifiable, because it only takes one trans person to prove it wrong.  Well I'm that person.

Well actually no, I'm not, because I have never identified as being trans whatsoever and I find it absolutely distasteful that I have to use those terms and being referred as trans, but in this instance I will put up with the terms, because I find it absolutely repugnant that I can be labeled or I once was mentally ill, or had a mental disorder or suffer from any one of Julie Maria's eight points.  Now you know why, I never open my mouth period.

Lucky you. From my own experience and everything I've heard from other trans people, those feelings of dysphoria are very common. I'm wondering, though, how you figured out that you were TG if you had no dysphoria...?

Please, I'm not TG or TS,  I did not do what I knew had to be done just to be stuck with those labels.  I'm a female.  If other people want to be referred to as such, then that is there prerogative and I will address them appropriately.  Anyway sit back, read and you shall find out.

What pushed me to leave my family and friends?  Well several things, my thoughts on my problem were getting stronger and stronger and may be I was becoming a little unsettled.  I did not fight these thoughts but I accepted them for what they were, they were a part me.  These thoughts would not go away, this started to manifest more so after coming back from boarding school (high school),

One of the main pushes that led me to think more and more about my problem was discovering an article in a playboy (or similar) magazine which had a picture, which started of with a sketch of a boy or a man (my memories on this part of my life are sort of vague) and several sketches later (about 5 sketches in total) there was a picture of a girl (or a woman),

I suppose after reading the article to death.  I realized, what my problem was, I wanted to be a female.  The article mentioned the word transsexual, however I never thought I was one and to this day I never think of myself as such and as a matter of fact I detest those words and I never describe myself as such, not now, not ever.

I had completed a trade which took 4 years to complete part time, I did this trade right after I had finished boarding school and I was working in a government office (this was the time I started my swimming career) and in the office the guys often talked about going to university.  I was also in on those discussions as well and one of my dreams at the time was also to go on to university and get a degree.

After I finished my trade, I got involved in swimming in a big way and sure enough, something else came along and smacked me right in the face, literally and figuratively, I did not realize it at the time (one can be so dumb at times) and it took a couple of years for this one to sink in.

There was a young man who was also involved in swimming and we became very good friends.  We trained at the same pool, went to swimming meets, camped at different swimming spots before going on to a swimming meet, stayed at each others house, scuba dived and saw the odd movie together, I was at peace, I enjoyed his company, I felt comfortable around him and until he became involved with a girl, I then felt I was out of place after this.  Well as you can guess, I liked him more than I realized and I could not understand why I felt this way.

I knew I was not gay, I was not sexually active.  To put it bluntly I was not very happy at the current situation.  It took me a long while to figure this out until finally I connected the playboy article and these feelings, finally the penny dropped.   I was a female and my problem with this young man was that I loved him as a young woman.  He was in a sense to me, a soul mate and I 'wanted' him in every sense of the word.  Yes, this realization tore me apart,  I did not stop the friendship, but something had to give.  I also knew certain things about his attitude towards certain people.  My decision was going to tear me apart. 

I was also buying and wearing the clothes that I felt comfortable in a lot more, but nobody new what I was doing.  On one occasion I was nearly undone at one stage, maybe the burden was too much, or may be I wanted to live my life normally and as a result I was just plain careless.  Anyway my brothers and cousin were trying to get into my cupboard and I realized that one of them saw something (some of my clothes more than likely), so I managed to lock them away somewhere else.  I then showed them what they were trying to find was not there.

Later my uncle (same uncle who new why I left the family), who new about this stuff came to me and said to be careful.  So this was how one of the first family members came to know of my problem to a certain extent. In one of our discussions he said, I needed to live as woman and find out if that is what I wanted in life.

As I said things were coming to a head and the three things that finally made me decide to leave, was one, finding out I lost a soul mate, two, I wanted to sort out my personal problem once and for all and three, I wanted to go to university.  I had been with the government job for ten years, which meant that I had long service leave up my sleeve (which basically meant I could have a whole year of from work and still have money)  By this stage I had applied to several universities and I was accepted into several of them.

So at the start of 1989 I left my family and friends who believed that I was going to university and I had every intention of going to university, but not to the one that my family and friends thought I was going to.  I was going to a university that was situated near the resources that I needed to solve my personal problem and I wanted to attend the university that I had chosen in a more appropriate name, but that was not to be and that part of my dream where I would go to university would not happen for another 5 years.

When I left, I got a hotel room and I then went to a salon where they did ear piercings and got my ears done, why do I remember this so well? It's is because I had both ears done consecutively at the time and this was the start of more dramatic changes that were to come.

My aunt (wife of my uncle who knew and at this stage the second person in my immediate family who knew) came around to see me on my way that evening.  I was not going to see her again for a at least a couple of years, then she left.  After she left, the enormity of what I was embarking upon finally caught up with me and I started to cry and I did not stop for a couple of hours in a sense, I cried because I was alone, I cried for the loss of a soul mate, I cried because I believed I was never going to see my family again and I cried because I was happy at last that I was making a decision, that I knew resonated so deeply inside me with such conviction that I never questioned what I was doing or what I was going to do.  I knew it was the right thing to do.

Early in the morning I dressed myself properly, put a little make up on, did my hair in a French braid, which I could do because my hair is very long and I was travelling in a car and I wanted to be comfortable for the trip, it was going to take a couple of days and their was no rush, I was travelling from one part of the country to another and I was going to start my new life.

Lucky no, extremely lucky yes in more ways than I can say.  No dysphoria, able to pass instantly, got my hormones from my doctor GP on the first visit, able to get a job virtually straight away, no problems with my psychiatrists and I had my surgery within two years.

Not sure if you knew this, but this criterion is in about half of the disorders in the DSM. This line effectively says, "if it doesn't cause problems, it's not a disorder." You misinterpreted this one, too

Sorry, I did not misinterpret the condition, because even if your interpretation is correct, that is "if it doesn't cause problems, it's not a disorder."  Well my 'disturbance', wanting to be a female, something is not quite right did not cause me any problems, so 'it's not a disorder', hence, I still fail the diagnosis of Gender Dysphoria for Criterion D.

I find it hard to believe that you felt zero distress around living as the wrong sex, or else you wouldn't have transitioned.

But the point is, I did change and I had no distress in regards to my body or mind (well, maybe I just might concede a tiny bit of distress in my mind about, wanting to be a female, with the appropriate body, because I was constantly thinking about it more and more up until I left and wondering why I was thinking about it all the time).  I live my life as one who is extremely happy, confident, friendly outgoing, kind hearted, who cares for others that are around me and who passes the knowledge I have gained onto others.  My journey was different and everyone around here can attest to that.

I'm sorry that others suffer, it hurts me deeply in more words than I can say.  I wish that I could take their pain and suffering away, but I cannot. I wish they could have the safe and uneventful journey that I had.  I have never ever regretted my decision and I will always be eternally grateful to my surgeon who gave me my life that I have now.

My kindest regards to one and all
Sarah B

[Sarah B]

Hi Julie Marie

What you said below, is one of the reasons why I keep my big mouth shut and I do not tell anyone about me.

The point I've been trying to make from the beginning, and made several times since, seems to be falling on deaf ears.   

a) We are discriminated against, when identified as transgender

b) There is a negative stigma about us

c) The unemployment rate for TGs is dramatically higher than the general population

d) The under-employment situation is considerably worse than the general population

e) The general population discriminates against those it considers to be mentally disordered

f) The general population considers us to be screwed up in the head

g) The DSM, a professional reference book, says we are mentally disordered.

h) If we want a job or housing or other needs, we have to go out into the general population to get them, presently, as a mentally disordered person.

"We just can't trust those people!  They're not right in the head."

And if you say, "Well I'm stealth and I don't experience those things", that doesn't disprove anything I said above.  All it proves is you had to be stealth to be treated as normal.  Look at the stealth threads here and you'll see how important it is to most of us.  Why?  So we don't have to deal with discrimination, prejudice and hatred.  The need for stealth is further proof of the damaging effects of the stigma.

Kind regards
Sarah B

[Sarah B]

Hi Interalia

• Why do you want to remove GID as a mental disorder if you don't have it?
  Because it's not a mental disorder or mental illness, but a medical condition


• Is your interest purely altruistic, looking to right the wrongs of the DSM?
  Yes


• Perhaps you feel similarly about schizophrenia, or anti-social personality disorder (both of which I assume you don't have) and are out crusading for them too.
  Yes

Kind regards
Sarah B

[cynthialee]

After reading this thread a few times I think I can safely come to this conclusion......
You guys are not even listening to eachother. There is an attitude that seems to say "I am right and you are wrong" comeing from many diferant quarters.
Maybe it would be nice if one or two of you took the time to consider eachothers opinions instead of imediatly looking for flaws in eachothers reasoning and building your arguments just to make your self look inteligent. Pretty much all discussion stoped some time ago.

So my 2cents....You do not have any true desire to listen. Looking like you personaly have all the answers is more important than discourse.

[pebbles]

Because it's not a mental disorder or mental illness, but a medical condition[/li][/list]

I think you'd have to prove that. If it is a medical condition it has to have physical signs and symptoms. If it met those conditions then it would probably be bundled into the same bracket as IS conditions.

Definition of a medical disease.
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs

If I say I'm a transsexual and choose to transition people have to take that. There is no proof one way or another. There is no signs and symptoms within my body.

If I say I'm inter-sex you can test for that condition and examine certain aspects of my anatomy or DNA and confirm my claim or not.

[Sarah B]

Hi Steph

Why do we need to change medical practices to satisfy social stigmas, it makes no sense, surely we should be changing social stigmas.

Having a label of mental illness or mental disorder, will and can be used against you, for example custody battles, discrimination, better still see, Julie Marie's list.

And I would not be so naive as to think that removing GID from the DSM would automatically remove the stigmas

You are right it would not remove the stigmas, it would take time.

you will still be TS.

Removal or not of GID from the DSM.  TS would still be an insult to me.

So if you didn't tell your psychiatrist why you were there, didn't he ask you why you needed therapy?

No, he did not ask why I was there, it was self evident. from the initial letter of introduction from my then GP.

Why you needed to see him, did you just drop in, did you expect him to guess?

I had to go, because of the SOC and no I did not drop in I made an appointment. and no again it was self evident why, I was there from the initial letter of introduction

If a person is going to be less than upfront with their therapist how can you honestly expect them to make a diagnosis.

I saw him for nearly two years, he gave me my letter for surgery.  The amount of personal questions that he asked and honestly, I'm trying to remember as much as I can of those consultations.  Was extremely limited as far as I can remember and as I have mentioned before I'm a very private person and that includes very personal information.  He knew I was functioning extremely well in my life and that was self evident from the second consultation.

You didn't see their notes, so you honestly can't relate what he was thinking, what he based his diagnosis on.

No, I did not see his notes.  But, I can infer what he could have been thinking and I just made a phone call to a long time friend who worked as a counsellor, said to me, "he was fair in dealing with his clients".  So he based his diagnosis on a genuine, reserved person and had her head screwed on correctly, was reliable and new what she wanted.

King regards
Sarah B

[Julie Marie]

Just a few comments...
To the need for therapy to get treatment: I started a thread here regarding implied consent HRT where the individual only needs to be evaluated by a doctor to determine health conditions and by a therapist to determine soundness of mind and a full understanding of what HRT does.  There's the initial doctor visit, then the therapist visit then back to the doctor for prescriptions if the person is healthy and sane.  That's it.  I thought this was something relatively new but it seems many here have implied consent where they live too.  In other words, this is being handled as a medical condition.  Even the AMA agrees.

As to the medical diagnosis criteria: My sister and my daughter have been diagnosed with fibromyalgia.  My sister was told for decades it was all in her head.  It wasn't until she was in her 40s that medical science started rethinking their attitude toward the patients who all complained of the same ailments.  Even my daughter had to initially endure the mental problem diagnosis.  I remember those days.  It was horrible.  Today we have ways of medically diagnosing the condition and medically approved treatments for the condition.  The same could happen with the gender identity condition.  Just because we don't have a way to medically diagnosis it today doesn't mean we never will.

That it's a mental condition: There is a theory that the brain is flushed with opposite gender hormones during the fetal stage and this causes the transgender condition.  But it could also be true that the brain continues to be influenced by this process all through life.  I've heard countless stories of people saying the feelings subsided for a while then came back with a vengeance then subsided again, and so on.  I experienced that all through my life.  So the body could be producing these chemicals that affect the brain and cause mind-body gender conflict.

The truth is no one really knows, at least not now.  Given sufficient funding and attention, one day we most likely will.  We have to be patient and open minded until that day comes.

And that brings me to that day when we read the headlines that say,

"Transgender Gene Discovered"
"Scientists Prove Condition is Genetic"

And suddenly people are saying, "Gee, it isn't a choice."  And that leads to better acceptance and one day maybe even being seen as normal.

But change those headlines to something like, "Scientists Prove Transgender People are Mentally Disordered."  What will the reaction of the public be then?

[Just Kate]

Hi Interalia

• Why do you want to remove GID as a mental disorder if you don't have it?
  Because it's not a mental disorder or mental illness, but a medical condition


• Is your interest purely altruistic, looking to right the wrongs of the DSM?
  Yes


• Perhaps you feel similarly about schizophrenia, or anti-social personality disorder (both of which I assume you don't have) and are out crusading for them too.
  Yes

Kind regards
Sarah B

I appreciate your consistency and can respect it even if I disagree vehemently.  Depathologizing anti-social personality disorder would mean an inevitable increase in violent crime - but since this isn't the focus of this thread, I'll refrain.

[Fencesitter]

I appreciate your consistency and can respect it even if I disagree vehemently.  Depathologizing anti-social personality disorder would mean an inevitable increase in violent crime - but since this isn't the focus of this thread, I'll refrain.

Even if this sounds mean - if I had the choice between both, I would still rather be transsexual than suffer from anti-social personality disorder as the former is very extreme and you cannot make it go away. Being transsexual means (in my case) I will always look like a freak once undressed, and have to figure out when to tell whom about my past, but that's "all". I think it's less awful altogether.

[brainiac]

Sarah B:

I believe that we are at an impasse at this point. We seem to have had very different experiences, and very different interpretations of these criteria. It was interesting to hear your story--I strongly identify as transgender and not just male.

Either way, what I'm interested in debating is the difference between "mental health" versus medical health. I think that if we're saying that we reject the diagnosis of GID as a mental disorder for reasons OTHER than the stigma against mental disorders, then we need to acknowledge what those differences really are.

In our society, I see a common interpretation of mental illness as being the patient's fault, or something they should have been able to prevent by "thinking straight", on one extreme, and on the other, it's viewed like most people see medical illnesses overall-- as blameless. The black and white view of mental health is inadequate. Research overwhelmingly demonstrates that mental disorders are both biological and social. The disorder is physically manifested in your brain somehow (just like everything in your mind), even if we don't understand exactly how yet; this is affected by your genetics, your environment, and your life experience.

So even if it's genetic... so what? Schizophrenia has genetic links. Depression has genetic links. ADHD has genetic links. That doesn't mean these disorders don't negatively affect your mental life in a significant way, which can and should be alleviated-- which is what I think should in part define a mental disorder.

[Julie Marie]

Julie - you are too late.

The Daily Telegraph in the UK has already carried almost exactly that headline. It was sometime last year. I've even posted links to the article in question on here before but most people evidently haven't seen it. It related to work done by Melbourne geneticist Dr Vincent Harley at the Prince Henry clinic, and although the article which followed was not actually as clear cut as the headline the fact remains that at least in the UK this has already happened.

Sadly all that has happened so far is that the argument has now moved to whether the research is flawed or not...

I read your post and Googled it.  Sure enough, a number of sites came up, most of which were LGBT but I did find one from The Daily Telegraph and one from BBC News.  And yes, I missed it when it was news.

However, as you mentioned, there seems to be more questions than answers as outlined in this article on POPSCI.

An important element in obtaining funding for any type of research is getting people behind the cause.  I'm not sure whether the discovery you mentioned has created further research but if it hasn't or it is going slowly I would guess it's because of poor funding.  If you took a poll of the general public, what percentage would even care about this?  Follow the empathy.

What I'm seeing more and more is acceptance towards early transition.  These kids will grow up "looking normal" and will therefore not be subjected to the level of prejudice and discrimination many of us have experienced.  And it's quite possible this direction may more quickly change public sentiment than an educational campaign, removing GID from the DSM or any other attempt to change the negative stigma attached to transgender.

If they can't find a way to "correct" the variant gene, they may simply accept the fact the gene is there and make early transition an acceptable treatment.  Whatever the case, the end result would be people who are affected by this would suffer less social trauma and therefore need less therapy, if any at all.  Fixing the body fixes the mind.

[Shana A]

Imagine you live in a world where those born with the mind and body being of different genders are revered, seen as a blessing to society.  You are believed to be gifted because you have a dual view into the genders and can relate to both in a way non TGs can.  People come to you for help.  They respect you and appreciate the insight you bring to their lives.  You are, in effect, placed in a higher position in society because you are TG.

Given that as your reality, how would you respond to someone who came to you and told you that you were mentally disordered?

I'm not Native American, and don't wish to co-opt their culture, however I perceive myself as being similar to the Two-Spirit that you describe. My response; I am not mentally ill, it is our western patriarchal society that is completely out of balance.

Z

[glendagladwitch]

I haven't read the whole thread (it's gotten pretty long) so I apologize if this has already been discussed. 

But I think it might be interesting to talk about the new draft of the DSM V, which proposes that post transitioners will no longer be considered mentally ill.

http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=193#

For the adult criteria, we propose, on a preliminary basis, the requirement of only 2 indicators. This is based on a preliminary secondary data analysis of 154 adolescent and adults patients with GID compared to 684 controls (Deogracias et al., 2007; Singh et al., 2010). From a 27-item dimensional measure of gender dysphoria, the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ), we extracted five items that correspond to the proposed A2-A6 indicators (we could not extract a corresponding item for A1). Each item was rated on a 5-point response scale, ranging from Never to Always, with the past 12 months as the time frame. For the current analysis, we coded a symptom as present if the participant endorsed one of the two most extreme response options (frequently or always) and as absent if the participant endorsed one of the three other options (never, rarely, sometimes). This yielded a true positive rate of 94.2% and a false positive rate of 0.7%. Because the wording of the items on the GIDYQ is not identical to the wording of the proposed indicators, further validational work will be required during field trials.



End notes

1. 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 (usually at birth) (Meyer-Bahlburg, 2009a; Winters, 2005). In a recent survey that we conducted among consumer organizations for transgendered people (Vance et al., in press), many very clearly indicated their rejection of the GID term because, in their view, it contributes to the stigmatization of their condition.

2. In addition to the proposed name change for the diagnosis (see Endnote 1), there are 6  substantive proposed changes to the DSM-IV descriptive and diagnostic material: (a) we have proposed a change in conceptualization of the defining features by emphasizing the phenomenon of "gender incongruence" in contrast to cross-gender identification per se (Meyer-Bahlburg, 2009a); (b) we have proposed a merging of the A and B clinical indicator criteria in DSM-IV (see Endnotes 10, 13); (c) for the adolescent/adult criteria, we have proposed a more detailed and specific set of polythetic indicators than was the case in DSM-IV (Cohen-Kettenis & Pfäfflin, 2009; Zucker, 2006); (d) for the child criteria, we have proposed that the A1 indicator be necessary (but not sufficient) for the diagnosis of GI (see Endnote 5); (e) we have proposed that the "distress/impairment" criterion not be a prerequisite for the diagnosis of GI (see Endnote 15); and (f) we have proposed that subtyping by sexual attraction (for adolescents/adults) be eliminated (see Endnote 18) but that subtyping by the presence or absence of a co-occurring disorder of sex development (DSD) be introduced (see Endnote 14). As in DSM-IV, we recommend one overarching diagnosis, GI, with separate, developmentally-appropriate criteria sets for children vs. adolescents/adults. The text material will provide updated information on developmental trajectory data for clients who received the GI diagnosis in childhood vs. adolescence or adulthood.

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.

3. It has been recommended by the Workgroup to delete the "perceived cultural advantages" proviso. This was also recommended by the DSM-IV Subcommittee on Gender Identity Disorders (Bradley et al., 1991). There is no reason to "impute" one causal explanation for GI at the expense of others (Zucker, 1992, 2009).

4. The 6 month duration was introduced to make at least a minimal distinction between very transient and persistent GI. The duration criterion was decided upon by clinical consensus. However, there is no clear empirical literature supporting this particular period (e.g., 3 months vs. 6 months or 6 months vs. 12 months). There was, however, consensus among the group that a lower-bound duration of 6 months would be unlikely to yield false positives.

13. In the DSM-IV, there are two sets of clinical indicators (Criteria A and B). This distinction is not supported by factor analytic studies. The existing studies suggest that the concept of GI is best captured by one underlying dimension (Cohen-Kettenis & van Goozen, 1997; Deogracias et al., 2007; Green, 1987; Johnson et al., 2004; Singh et al., 2010).

14. There is considerable evidence individuals with a DSD experience GI and may wish to change from their assigned gender; the percentage of such individuals who experience GI is syndrome-dependent (Cohen-Kettenis, 2005; Dessens, Slijper, & Drop, 2005; Mazur, 2005; Meyer-Bahlburg, 1994, 2005, 2009a, 2009b). From a phenomenologic perspective, DSD individuals with GI have both similarities and differences to individuals with GI with no known DSD. Developmental trajectories also have similarities and differences. The presence of a DSD is suggestive of a specific causal mechanism that may not be present in individuals without a diagnosable DSD.

15. It is our recommendation that the GI diagnosis be given on the basis of the A criterion alone and that distress and/or impairment (the D criterion in DSM-IV) be evaluated separately and independently. This definitional issue remains under discussion in the DSM-V Task Force for all psychiatric disorders and may have to be revisited pending the outcome of that discussion. Although there are studies showing that adolescents and adults with the DSM-IV diagnosis of GID function poorly, this type of impairment is by no means a universal finding. In some studies, for example, adolescents or adults with GID were found to generally function psychologically in the non-clinical range (Cohen-Kettenis & Pfäfflin, 2009; Meyer-Bahlburg, 2009a). Moreover, increased psychiatric problems in transsexuals appear to be preceded by increased experiences of stigma (Nuttbrock et al., 2009). Postulating "inherent distress" in case one desires to be rid of body parts that do not fit one's identity is, in the absence of data, also questionable (Meyer-Bahlburg, 2009a).

16. Although the DSM-IV diagnosis of GID encompasses more than transsexualism, it is still often used as an equivalent to transsexualism (Sohn & Bosinski, 2007). For instance, a man can meet the two core criteria if he only believes he has the typical feelings of a woman and does not feel at ease with the male gender role. The same holds for a woman who just frequently passes as a man (e.g., in terms of first name, clothing, and/or haircut) and does not feel comfortable living as a conventional woman. Someone having a GID diagnosis based on these subcriteria clearly differs from a person who identifies completely with the other gender, can only relax when permanently living in the other gender role, has a strong aversion against the sex characteristics of his/her body, and wants to adjust his/her body as much as technically possible in the direction of the desired sex. Those who are distressed by having problems with just one of the two criteria (e.g., feeling uncomfortable living as a conventional man or woman) will have a GIDNOS diagnosis. This is highly confusing for clinicians. It perpetuates the search for the "true transsexual" only, in order to identify the right candidates for hormone and surgical treatment instead of facilitating clinicians to assess the type and severity of any type of GI and offer appropriate treatment. Furthermore, in the DSM-IV, gender identity and gender role were described as a dichotomy (either male or female) rather than a multi-category concept or spectrum (Bockting, 2008; Bornstein, 1994; Ekins & King, 2006; Lev, 2007; Røn, 2002). The current formulation makes more explicit that a conceptualization of GI acknowledging the wide variation of conditions will make it less likely that only one type of treatment is connected to the diagnosis. Taking the above regarding the avoidance of male-female dichotomies into account, in the new formulation, the focus is on the discrepancy between experienced/expressed gender (which can be either male, female, in-between or otherwise) and assigned gender (in most societies male or female) rather than cross-gender identification and same-gender aversion (Cohen-Kettenis & Pfäfflin, 2009).

17. In referring to secondary sex characteristics, anticipation of the development of secondary sex characteristics has been added for young adolescents. Adolescents increasingly show up at gender identity clinics requesting gender reassignment, before the first signs of puberty are visible (Delemarre-van de Waal & Cohen-Kettenis, 2006; Zucker & Cohen-Kettenis, 2008).

18. In contemporary clinical practice, sexual orientation per se plays only a minor role in treatment protocols or decisions. Also, changes as to the preferred gender of sex partner occur during or after treatment (DeCuypere, Janes, & Rubens, 2005; Lawrence, 2005; Schroder & Carroll, 1999). It can be difficult to assess sexual orientation in individuals with a GI diagnosis, as they preoperatively might give incorrect information in order to be approved for hormonal and surgical treatment (Lawrence, 1999). Because sexual orientation subtyping is of interest to researchers in the field, it is recommended that reference to it be addressed in the text, but not as a specifier. It should also be assessed as a dimensional construct.

19. The subworkgroup has had extensive discussion about the placement of GI in the nomenclature for DSM-V, as the meta-structure of the entire manual is under review. The subworkgroup questions the rationale for the current DSM-IV chapter Sexual and Gender Identity Disorders, which contains three major classes of diagnoses: sexual dysfunctions, paraphilias, and gender identity disorders (see Meyer-Bahlburg, 2009a). Various alternative options to the current placement are under consideration.

[Julie Marie]

I haven't read the whole thread (it's gotten pretty long) so I apologize if this has already been discussed. 

But I think it might be interesting to talk about the new draft of the DSM V, which proposes that post transitioners will no longer be considered mentally ill.

Hi Glenda,

Yes, this was already mentioned.  That whole thing is kind of head scratching. 

"The day I realized I was a transsexual I also found out I had a mental disorder.  I later had surgery to make my body align with my brain.  Now I'm happy and I no longer have a mental disorder."

Wouldn't it have made a lot more sense to just remove TS from the DSM-V because, as the proposed changes imply, the cure is medical, not mental?  Therapy will still be necessary because surgeons will want some level of protection should a patient later try to sue them.  So for those who feel therapy is a necessary part of transition, it will still be there.

No matter what we think here, eventually most of the transgender condition will be removed from the DSM.  There are too many legitimate organizations behind that movement and that will only increase.  Society always favors progress in the long run and removing it from the DSM will help de-stigmatize it.

[eshaver]

You know , we don't have a  "Mental disorder " , the rest of the worl does ! Yep, I said this to my younger brother just the other day . I know he will never accept me for being a Transwoman . Heck , he dosent accept me for staying on dissability as I have terminal Emphazemiea but thats another story. I told him , "I'm not crazy, the rest of the world is insane . " Ellen

[Tammy Hope]

Everything I've said previously aside, if you told me that a set of changes would be put in place in which:

1. all implication that this is a mental illness was removed  and

2. the condition was universally recognized as a medically treatable (thus eligible for insurance coverage) birth defect with a standard course of treatment for resolution (just as one might fix a cleft palliate or whatever)

...then I'd be on board with that 150%

[Sarah B]

Hi Tammy Hope

I agree with what you said and I quote;

1. all implication that this is a mental illness was removed  and

2. the condition was universally recognized as a medically treatable (thus eligible for insurance coverage) birth defect with a standard course of treatment for resolution (just as one might fix a cleft palliate or whatever)

...then I'd be on board with that 150%

Kind regards
Sarah B