Response to Alice Dreger’s “How and Why To Take GID out of the DSM”

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
Human Bodies
Alice Dreger
, 06/22/2009

http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=3602

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
news.

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
surgical transition.

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
“transgender.”

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
it.

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
media.

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
complex.

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.

10 Responses to “Response to Alice Dreger’s “How and Why To Take GID out of the DSM””

  1. Bad Hair Days Says:

    > But add in the DSM
    transgender feelings as a known possible cause of depression, anxiety,
    sexual dysfunction, and so forth.

    What good would that be for? Each of the named conditions are already covered without a GID prefix?

    • Suzan Says:

      I don’t know shit about transgender feelings as I have never experienced them and the people I was close enough to that I could ask are dead.

      As a woman born transsexual I know the cause of my depression and anxiety. Mostly it comes from pieces of shit like Dreger and the rest of the pseudo scientific assholes.

      The solution is revolution. Let the the Ph.D.s in the pseudo science get real jobs as baristas and burger flippers.

      Deal with the real world causes not the symptoms.

  2. Andrea Says:

    Suzy, you got it 100% right.

    WPATH, DSM revision, both APA’s and any other pathologising assholes who claims transsexualism is a mental disorder, clings to transsexualism being a mental disorder as a support mechanism or needs transsexualism to be mental disorder so they can play a ‘woe is me; activist, all need to be told to fuck of.

    Transsexualism is not a mental disorder.

    Transsexualism is in the DSM purely so that clinicans can bleed transsexual people dry and live of the backs of transsexual people. Those clinicans would not get a job flipping burgers in the real job market, they are so useless.

  3. Ariablue Says:

    “Medicalization is, after all, a complex experience.”

    She would know this how? What a narcissistic piece of work she is.

    What is going on with this person who continues try to speak for others? Who is paying her to write propaganda and hit pieces? How did she come to be involved in these gender games? Who asked this interloper to the table?

    And most importantly, why are people staying so nice towards these assholes who try to dominate us? Don’t people understand that at some point trying to be “respectable” is just a pair of handcuffs slapped on your wrists that your enemy takes advantage of?

    Alice Dreger, fuck OFF!

  4. Ariablue Says:

    Oh one more thing:

    “I was struck by that too-typical language of the “true
    identity,”

    and the stuff that follows in that paragraph…

    Do you see the (not so) subtle spin there? She dumbs down the transsexual condition to being one of identity by calling it transgender throughout the peice, then brings it to a head in that paragraph. We are to subordinate our identities as women to those whose experience is “more complex” that ours. And it is all spun up in the guise of help.

    Do you see why some of us have such a problem with transgender Suzan? It isn’t just that we don’t like crossdressers speaking for us. The connection without respecting who we are opens us to all sorts of attacks like the one Alice Dreger has written. Honest activism can’t come from a lie, and women should not be asked to subordinate their interests to others, no matter how transgender they are.

    I don’t want to start a fight with you on your blog, I just wanted you to know how some of us feel about the tangential relationship we have to transgender. We weren’t asked to ally, and I don’t think any good can come of it at this point, even if there was a miraculous change of heart among the “activists” and they suddenly respected us as women.

    That’s all I wanted to say, I don’t mean to start an argument with you about this trans business. I just hope you can understand my concern about the continuing linkage of our birth condition to other things that don’t relate to it.

    • Suzan Says:

      I do not include episodic cross dressers as transgender.

      But I also do not believe in throwing people under the bus to curry favor with Christo-Fascist bigots.

      But over and above that I do not have to like individuals to look beyond the shortcomings of individuals to see the reasonableness of working on class issues.

      I am simply tired of wasting my time on fighting with transgenders when they are equally powerless to impact my life. I would rather go after the real oppressors than do the oppressor’s work for them and waste my energy as well.

  5. Bad Hair Days Says:

    Suzan, I would clap my hands if it wouldn’t be so sad. I wondered if you do a show off resently because you said you want to become something of a professional in activism.

    Now I think I know better. And the discussion over at Sophias new fantastic blog offers better insights into the “TG-Problem” then any hate filled comment did before that ignores individuals.
    Its for example somewhat funny for me. When the problem is, that TG Lobby furthers Nurture vs. Nature Ideoligy I get stamped a TG activist, when I state that there most likeley is a cause to some TG conditions that are typical biological variants. When BabyBattyBats gets hit, when she states the same, yet in complete opossition of one of the more common point is that TGs further the thought of a changeble Gender, where they place GI which then is of no more use for Women born TS who see the correction of their body, not their social role.

    • Suzan Says:

      What is screaming invectives at each other accomplishing?

      Not much from where I stand. No matter how much we attack TGs the right wing normborns are not going to assimilate us into their class. Not that I much care as left wing hip progressive people are more accepting, have better art and music and are generally more fun to be around.

      But they are also not likely to be accepting of people who would rather fight each other than fight real oppression.

      In America at the bottom of the social economic classes there isn’t much difference in status between poor whites and poor people of color yet I have seen the way fighting among those groups of equally poor serves the capitalist pig masters.

      I think it is important to recognize the real enemy and not get distracted by fighting with equally oppressed people.

  6. Zoe Brain Says:

    I see three issues.

    The first is one of scientific fact. GID does not conform to the definition of “mental illness” in the DSM. Moreover, anyone who is sufficiently “mentally ill” to request mutilation is obviously incompetent to consent to it. The whole system of treatment is based on a fundamental contradiction, and the only reason it is still in existence is that it works, and nothing else does. It’s a Kludge, and a bad one.

    The second, and entirely separate, issue is what to do if GID is removed from the DSM-IV. Since we now have enough evidence to classify transsexuality as a form of neurological intersex, that’s how it should be so diagnosed. As a biological problem that has psychological implications. At the same time, we can clean up the other issues regarding Intersex too, preventing surgery without consent, and not just allowing but recommending surgery with consent.

    In passing, I don’t care who says something, Dreger, Bailey, Zucker, whoever. If it’s right it’s right, if wrong, wrong. I agree wholeheartedly with the first half of Dreger’s essay. I think her proposed solution though is at best flawed and incomplete, at worst rubbish. More of the same kludges.

    The third issue is of rights for the Transgendered. While I do not identify as TG in any way, and in fact the existence of TG is a barrier to my getting my own human rights, the point is that I cannot in all conscience argue for my rights and not theirs too. I also don’t identify as Patagonian, or an Aleut Eskimo, but I don’t think they should suffer discrimination either, whether or not others in their ignorance classify me as Patagonian or Aleut.

  7. Sanity from Suzan Cooke « ENDAblog Says:

    […] for good measure: It is time to tell Alice Dreger to fuck off.  We do not want the advice of a Michael Bailey […]


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