Search Eminism.org

  • Enter search term(s):

Gender Identity Disorder in DSM: Removal or Reform?

modest proposals to reduce harms in the meantime

First comment is from a discussion about the DSM-IV diagnosis of "gender identity disorder" and pros and cons of removing it from the list of psychiatric conditions. The second comment is from another discussion forum where the question of whether or not transsexualism should be considered intersex, given some evidences that it may be biologically rooted. I put the two posts together because I felt they dealt with the same issue.


Forum: Strap-on.org
Date: 04/05/2004

Classification system such as DSM has been developed in order to identify needs and make available social and medical resources to meet them. Of course that's not how it works in the U.S., so many are feeling only the stigmatizing effects of inclusion without any personal benefits. But I have reservations about attempting to remove GID from the classification system without seriously challenging the stigmatization of mental illness and the fact that diagnoses are being used to dismiss and discriminate against people rather than to help allocate resources to people.

Some arguments for removing GID from DSM are faulty, as others have pointed out:

1) It's a biological condition! -> Many conditions listed in DSM are physiological conditions that occur in the brain.

2) It's not an illness! -> Many conditions listed in DSM are not illnesses.

3) Transsexual people are not crazy! -> People with many conditions listed in DSM are not crazy.

These arguments seems to be saying that "we are better than those crazy people, we don't deserve to be stigmatized like they do!"

That aside, I think there are two changes to GID classification in DSM-IV-TR perhaps we can agree on.

First, 302.6 Gender Identity Disorder in Children should be striked immediately. Some trans people fear losing services if GID were to be removed from DSM completely, but since no child in America is currently receiving any services under that diagnosis that are supportive of who they are anyway, we won't lose anything by removing GID in Childhood from DSM-IV. And it will make it difficult for the medical community to abuse children perceived to be gender-different (unfortunately, I predict that they will continue to do so, using the diagnoses of Conduct Disorder and Disruptive Behavior Disorder).

Second, the criteria C of 302.85 Gender Identity Disorder in Adolescents and Adults should be removed. The criteria C states that "the distrubance is not concurrent with a physical intersex condition." Intersex adults who pursue gender transitioning are diagnosed with 302.6 Gender Identity Disorder Not Otherwise Specified instead, whose treatment is pretty much the same as the plain old GID. There is no reason to distinguish between the two here, and by removing the criteria C there will no longer be a need to "rule out" intersex conditions before the diagnosis of GID can be made: that means less physically invasive examinations.

By the way, they also need to fix the stupid numbering system. As you see above, GID in Childhood now has the same diagnostic code, 302.6, as does GID NOS. GID in adulthood is given 302.85, which by the way used to be the code for GID NOS back in DSM-III. "Transsexualism" in DSM-III and DSM-III-R had been 302.50, which somehow disappeared. It would have made more sense if GID in Adulthood had replaced "Transsexualism" as 302.50 in DSM-IV, with GID in childhood being 302.60 and GID NOS 302.85. How did they get into this mess anyway? Whoever it is, the people who are writing the GID portion of DSM aren't very smart, and that worries me.


Forum: Bodies Like Ours Forum
Date: 04/10/2004

uriela,

I think that Transsexualism is more and more being accepted as a biological condition rather than psychological.

Actually, many psychiatric conditions are considered biological, so two categories are not mutually exclusive.

And even if a psychiatric condition (say, schizophrenia) is biologically rooted, we would not consider it a physical disability.

Likewise, even if transsexuality is caused biologically in the brain, we probably would not consider it to be a physical intersexuality.

But there's one condition under which I might consider transsexuality an intersex condition: That's if and when they start diagnosing GID in infancy and performing brain surgeries to fix it without the child's consent. That's when I feel that the treatment of transsexuality is similar enough to other intersex conditions that it makes sense to join together as a movement.