It is time to tell Alice Dreger to fuck off. We do not want the advice of a Michael Bailey lackey.
Her opinion is forever tainted and marked by her relationship to people we view as child torturers, liars, frauds and bigots. Not to mention her Catholicism, a religion distinguished by its anti gay, lesbian, transsexual and transgender bigotry. Indeed in the United States the Christo-Fascist Catholics have been a major force in denying equality to not only LGBT/T people but to women with their misogynistic stands on access to birth control and abortion.
There is a patronizing paternalism present whenever normborns take it upon themselves to tell TS/TG people what is in the best interests of TS/TG people. In every statement of seeming support there is a subtext, a threatening undercurrent of do what we tell you, accept the degraded position of freak that we offer you or we will deny you medical treatment.
There is also a hegemonic erasure of history. A pretending that transsexuals couldn’t get SRS prior to the psychiatric pseudo scientists invention of GID in 1979. To do so they have to erase the existence of all of us who actually had SRS prior to the invention of GID. In part this is easy because we were encouraged to STFU and disappear by both the “caring professionals” and social bigotry. This allowed the lie that there was an extremely high level of maladjustment and suicide.
Alice Dreger describes herself as a “wizened gender rights advocate” yet endorses the reparative therapy of Zucker and Blanchard that abuses and tortures transkids. How Catholic of her. Her support, no matter how tacit of reparative therapy is an endorsement of a genocidal violation of the human rights of transkids since it is aimed at the prevention of transsexuality.
Any claims that such treatment is meant to prevent the pain of an adulthood filled with abuse and pain is undercut by being part of an institution that prompts the denial of equal rights to not only LGBT/T people but to women. Thus making her not only prosecutor but jury. Now she expects us to accept her as defense attorney. I think not.
I like most TS/TG people have had to be my own defender as well as researcher since I came out in the 1960s due to the total ignorance and arrogance of normborns in the psych profession. TS/TG people always knew more about being transsexual or transgender than did the normborn psychs. But they refused to listen to us. They demanded we conform to their misogynistic expectations and used slurs to enforce that conformity.
So Ms. Dreger… you are the oppressor. It isn’t transsexuals and transgenders demanding the removal of GID from the DSM who should shut the fuck up, it is you who should STFU.
By the way Alice I understand both Walmart and Starbucks are hiring. Have you considered a career in something appropriate for your talents ,such as the fast food industry?
How and Why to Take “Gender Identity Disorder” Out of the DSM
How and Why to Take “Gender Identity Disorder” Out of the DSM
(Human Bodies) Permanent link
As a wizened gender rights advocate, I know better than to assume the
activists making the most noise are actually representative of “the
community” they insist they represent. So, while American transgender
activists have lately been fairly unified and very vocal about the
need to remove “Gender Identity Disorder” (GID) from the Diagnostic
and Statistical Manual of Mental Disorders (DSM), I know that not all
trans people agree.
Medicalization is, after all, a complex experience. Even while being
labeled as “mentally disordered” can be a stigmatizing experience, it
is also the case that the inclusion of GID in the DSM has functioned
to provide financial and institutional support for medical, surgical,
and psychological care for some transgender people.
This is not true in most of the United States, but is true in more
progressive places around the world, like Canada and the Netherlands.
Having GID in the DSM may also, to some extent, legitimize the
transgender experience as a “real” one for people who think a
transgender person should just “get over” the feeling that the gender
label assigned to them was the wrong one.
This is why, when I talk to clinicians about taking GID out of the
DSM, the first thing they say to me is that taking it out will harm a
good number of transgender people. Some foreign clinicians add that it
is the individualistic and selfish American transgender activists who
are forcing their identity politics on transfolk all over the world.
Having GID in the DSM has, they claim, helped many of their patients
and clients, particularly transgender youth who benefit from medically
supervised reassignments during their puberties.
Yet critics of the “GID” category respond that, in fact, the DSM
inclusion of what amounts to their identities results in more harm
than good. They liken the inclusion of “GID” to the DSM’s former
inclusion of homosexuality, saying that it medicalizes them and treats
them as diseased rather than just different.
They point to evidence from history and other societies that, in
cultures that accommodate people who don’t fit the usual categories of
male or female, transgender people do fine without being labeled
“mentally disordered.” Some of the most persuasive evidence for this
comes from recent work in Samoa by my colleagues (and friends) Paul
Vasey and Nancy Bartlett.
In fact, in an article I consider key to understanding the issue,
Bartlett, Vasey, and William Bukowski noted a fundamental
contradiction in the DSM specifically where GID in childhood is
concerned. Partly because of the history of the de-medicalization of
homosexuality, the DSM specifically defines mental disorder as
constituting a dysfunction in the individual, not “deviant” behavior
nor a conflict between an individual and his or her society.
Yet the current DSM allows children who are merely notably gender
atypical in their family’s culture to be labeled as having a mental
disorder, even though in another society (say, Samoa), they might be
considered perfectly acceptable. That sure does look a lot like the
history of the de-medicalization of homosexuality.
Importantly, the increasingly nasty discourse surrounding the GID-DSM
question obscures points on which both sides do actually agree. Most
critics and most proponents of the “GID” inclusion want high-quality,
safe, individualized care for people who are transgender. Most also
want to see systems where such care is financed through public or
private insurance, particularly for those who cannot pay for it
themselves. Perhaps most significantly, almost all want to see
transgender people suffer less, not more, stigma and shame.
Thus the people arguing back and forth may disagree on the methods to
achieve these goals, but not on the goals themselves. That’s good
So, what to do?
Keeping “GID” in the DSM is problematic for many reasons. At least in
this country, categorizing transgender people as “mentally disordered”
leaves them in a sort of never-neverland legislatively. In spite of
being labeled “mentally disordered,” trans people have been
specifically exempted from the Americans with Disabilities Act as a
protected group, and their medical care (including hormones and
surgeries) are not covered by most insurance systems, despite the fact
that studies have repeatedly shown well-screened transgender people
are better off psychologically and socially after hormonal and
Meanwhile, a number of legislators have used the fact that transgender
counts as a “mental disorder” to exclude transgender people from
identity-based protective legislation available to gay, lesbian, and
bisexual people, so that transgender people are not protected in many
venues from housing and employment discrimination, and their murders
are not recognized as hate crimes, in spite of much evidence that
that’s exactly what they are.
So transgender Americans are seen as too sick to be protected, but not
too sick to be provided help! Now that’s a sick system.
On top of that, keeping “GID” in the DSM marks all transgender people
as mentally disordered, no matter how well they are functioning, no
matter how sensible they are about dealing with the challenges of
being transgender. As philosopher Jake Hale has pointed out, the way
the World Professional Association for Transgender Health (WPATH)
“standards of care” work, transgender people are treated as
incompetent until proven otherwise – quite the opposite of pretty much
all other humans.
One response to this is to say, well, if you have a male body and feel
you’re more of a female, then obviously you’re sick. But as an
historian, I can’t help but remember all the gay men who were told
loving men made them sick, nor can I forget all my feminist
foremothers who were told – when they demanded education, professions,
and voting rights–that they were mentally ill.
Yet I cringe at the idea of taking GID out of the DSM if what it means
is that gender atypical children, teenagers, and adults can’t get the
care they deserve. I also worry that simply changing over from “GID”
(a mental disorder) to “transgender identity” will oversimplify the
reality of genders. Many people may legitimately seek professional
health care for complicated (or at least atypical) gender identities
without really fitting the oversimplified media vision of
So here is a proposed solution that I think should be seriously considered:
Remove “GID” from the DSM as a “mental disorder.” But add in the DSM
transgender feelings as a known possible cause of depression, anxiety,
sexual dysfunction, and so forth. (After all, sometimes being
transgender – like being a gay youth or a grieving widower – can lead
to depression, anxiety, and so forth.) And in those cases, where
evidence supports it, allow the treatment for those particular forms
of depression and anxiety to include hormone treatments and surgeries,
if the patient so wishes to follow those paths. After all, we have
lots of research that such treatments, almost without exception,
result in positive outcomes.
This DSM revision would cease the marking of all transgender people as
mentally disordered. It would simultaneously acknowledge that being
gender atypical is sometimes difficult, even in a society that accepts
This approach would have the added benefit of stopping legislators
from having the medical profession’s accidental support in the denial
of legal protections to people with transgender identities. And it
might actually increase available funding for psychological, medical,
and surgical care for transgender people, because it would recognize
that sometimes the best treatment for depression that arises out of
being transgender is hormonal or surgical. Thus it would treat
transgender people the way postpartum women are treated; if depression
or anxiety or profound sexual dysfunction arises in conjunction with
that identity, then it is treated, with evidence-based care.
Making this move might also finally bring the medical system up to
speed with the fact that more and more people are opting for some
transgender-ish interventions, but not all. It would upend the
one-size-fits-all traditional treatment model of transgender, and
implicitly recognize that sometimes people very purposely want “top”
surgery without “bottom” surgery, and sometimes people very purposely
want a hormonal “sex” change without any surgery. It might even force
open recognition that what gets labeled a “transgender” experience
varies enormously, far more than you’d imagine if you’re only hearing
about transgender lives from the usual suspects in the mainstream
Speaking of which, a postscript: As I was composing this, Chaz
(formerly Chastity) Bono announced his identity as a transman. When a
spokesperson hailed Bono’s “courageous decision to honor his true
identity,” I was struck by that too-typical language of the “true
identity,” and reminded again of how – though they often appear at
odds – the medical establishment and the transgender activist
community have long cooperated in speaking of transgender as if it is
simply a matter of establishing authenticity. The language of “true
selves” can be empowering, bonding, liberating, healing. But it can
also be alienating and isolating to those whose feelings are more
And regardless, it ought not be up to medicine to adjudicate who has a
true identity and who a false one. It seems to me much better, as I
have suggested here, for medical professionals to ask not, “Are you
real?” but instead, “Are you suffering? And if so, what evidence do we
have that we are the people who can help?”
Acknowledgements: The author thanks Lisa Lees, John Otto, Aron Sousa,
Paul Vasey, and a person wishing to remain anonymous for their
feedback on this essay and related ideas. Their kind help should not
be construed as endorsement of this essay.