Slave Like Acquiescence to the GID Diagnosis

Accepting, no claiming an absolute need for GID to remain in the DSM because otherwise people will not get health insurance coverage for treatment is akin to a slave not wanting freedom because then the master will no longer take care of him or her.

It is like going down to the crossroads and selling your soul for a pittance without even acquiring the skills too become the father of modern blues guitar playing.

About 20 years or so ago I read a piece by the late philosopher, Foucault regarding the evolution of homosexual as paradigm from sodomite abomination to sexual pervert to mentally ill homosexual and finally out and proud gay liberationists.  From Foucault I learned the power “experts” assert in altering the way we view ourselves.

In the 1970s I lived on Sunset Blvd in LA and considered myself a serious student of film.  In the later part of that decade we had the first gay and lesbian film festivals.  At one of those film festivals I first saw the work of Rosa von Praunheim,  an openly gay German film director and gay rights activist.  I remember being particularly struck by his film, “It Is Not the Homosexual Who Is Perverse, But the Society in Which He Live”.

Adding Foucault to the liberationist attitudes of the 1970s creates an ideological synergy that makes it impossible to see GID as anything but a highly oppressive paradigm.

McHugh, whose Taliban Catholicism was responsible for Johns Hopkins discontinuing its sex reassignment program, played a crooked game with a marked deck right from the start.  The Meyer’s “study” had a pre-determined outcome.

Most of us never expected SRS to change us into totally different people with completely different life histories or prospects.  We wanted to feel whole within our own skins.  Any reasonable person would or should realize the absurdity of expecting even such a radically transformative process as sex reassignment surgery to erase the scars of childhoods filled with abuse and alienation.

But that is exactly what McHugh and the Meyers study set as the definition of a successful outcome.  With the standard being conformity to a white, middle class heteronormative feminine mystique ideal.  And they expected this at a point when feminism was cresting at the high point of the Second Wave.  Most post-SRS women that I knew at that point were as caught up in the redefining of what it meant to be a woman in modern society as their assigned female at birth peers.

To paraphrase von Praunheim, it was not the women born with transsexualism who were perverse but rather those who were authoring the definition.  Those who were writing us into the DSM were the same lot of religious fanatics who were fighting a rear guard battle against the removal of homosexuality from the DSM.  They represented the vanguard of the Moral Majority, the predecessors of all the Catholic led neo-con reactionary forces of today who are fighting same sex marriage.  Indeed one has only to compare their use of various framing templates to see the interchangability of their rhetorical models.

The same world that is going to end if pre-SRS transsexual to female people and TG women use the ladies room is the same as the reason to not pass the Equal Rights Amendment.

In the Meyer’s study only heterosexual marriage to a man was given a positive of +2 points, living alone was given a neutral score of 0, living with another women, even if only as room mates with separate bedrooms was given a -2 points.  At a time when many women were choosing to not marry or marry at a later age.

Why do we put up with this self negation of our real life experiences?  For a pot of Fool’s Gold?  What is the payoff?  As I said earlier this journey to the crossroads doesn’t seem to offer much except permanent stigma.

Indeed much of our acceptance of this stigmatizing label seems based on fear.  They might not pay for SRS or other treatment if we don’t let them treat us as though we are mentally ill.  But most often within the US they do not do that now and even the craven pandering liberals who support a single payer option are too cowardly to defend things like contraception, abortion and SRS out of fear that the worshipers of the imaginary sky daddy will get their panties in a knot over government support of something even minimally sex positive.

This is but one element as to why GID is in the DSM.  Another more more suspect reason has to do with the viewing of people with transsexualism as consumers.  Our corporate/consumer based economy is based on separating the money earned by workers and channeling it back to the more powerful.  The use of GID creates a mandatory consumption that requires us to pay for the indoctrination into the ideology of being mentally ill in order to acquire the physical medical treatment we require.

Mandatory consumption of psychiatric services for treatment that may be neither necessary nor desired whether or not that treatment is reimbursed by an insurance provider or not should be anathema  to those who do not consider themselves to be mentally ill as it requires them to act as co-conspirator in the perpetration of a vile fiction.  This goes far beyond the mere being compelled to pay a bribe to the psychiatric professional in order to gain access to the required medical treatment.  Indeed even if the money paid to these psychiatric professionals were treated as a loathsome and unethical  bribe, it would be far better than what the person with transsexualism is asked to do which is to take upon themselves the label of mental illness.

Ask someone like Dylan Scholinski as to the difficulty in escaping having been labeled as mentally ill based on a diagnosis of GID.

There was a more enlightened time before Reagan, Thatcher and the religious fundamentalist backlash of the 1980s when transsexualism was treated as transsexualism and not exoticized  into some form of bizarre mental illness.  Indeed, I went to several psychiatrists at the behest of social workers in Berkeley while trying to build a case for Medicaid coverage of SRS. The experiences validated conversations I had with Dr. Evelyn Hooker.  The Turing test for a mental illness diagnosis has to be based not on some scripted DSM entry but rather on an unbiased evaluation.  Granted appearance plays a role in such an evaluation and there is a far greater disconnect between interviewing someone who looks like a member of the sex they are transitioning to and some wne who looks like a member of the sex they are transitioning from.

But here the principle of prior assumption of mental illness prejudices the interview.  If the assumption is that of mental illness then nothing will dissuade from mental illness and the assumption will over ride all reasonableness on the part of the person being evaluated.

Thus we become the crazy people force to argue our case for sanity in front of a judge who wrote the very definition of our being crazy.

Further the assumption of GID as settling the matter precludes study that might show innate causes such as the influence of environmental hormonal receptor disruptors.  Or transsexualism as intersex conditon.  While the maintenance of GID helps to reinforce all sorts of people’s ideologies of gender and validate their Ph.Ds it does so at the expense of our oppression.

5 Responses to “Slave Like Acquiescence to the GID Diagnosis”

  1. karen A Says:

    There is the ideal world, and then there is the real world.

    I agree GID is problematic …

    But in the real world I firmly believe that not having ANY diagnosis would have significant ramifications beyond insurance coverage (which IS important and needs to expand instead of contract)

    On line at least, you have often been very idealistic, passionate, want immediate results, and tend to see things as black and white no matter which side on an issue you are. That is who you are an I guess have always been … and that is OK.

    But society does not move from one extreme to another too quickly, and making changes before all the right groundwork has been laid can cause a lot of those you are fight for to get hurt badly.

    The right time IMO is if and when an another diagnosis has both good scientific evidence behind it AND gained strong support in the medical community.

    As I said TSism is not like homosexuality in that it needs BOTH medical intervention and legal support.

    Without SOME diagnosis both get put in jeopardy IMO.

    Personally it should not matter to me, as I’ve got mine… I’m 11 years post op, have all my IDs and Birth Certificate changed etc…

    But I do worry about those that come after me… I don’t want to make getting through this harder than it is, or harder than it has to be. I think you want the same thing…

    We just see the path to that differently.

    – Karen

    • Suzan Says:

      But Karen we had treatment before the GID diagnosis. If anything the whole GID thing is a greater threat to SRS, acceptance and other medical treatment than it is a help.

      Too many people make the claim of, “Why should we treat a mental illness with surgery instead of psychiatry?”

      “Why should we humor these crazy people who are delusional?”

      I’ve had conversations with Judy van Maasdam, an assistant of Dr. Laub who says that GID is a fiction.

      Treating it as real is merely pandering to some very oppressive forces that very much hate us and would use GID to deny treatment.

  2. JoanieH Says:

    One of the problems with arguing about the DSM inclusion of GID (aka transsexualism) is that there is simply too much of the religious fundamentalist power behind the inclusion. I can see both the points of the original post and the comment made by Karen. One of the basic tenets of neo-Christian theology and dogma is that anything related to sex is a super-sin, thus they will do anything they can to inhibit an individual’s access to any therapy that counters their belief that this is a simple choice of lifestyle which infers that God made a mistake. In other words, denial of reality and the continuing insistence that any alternative viewpoint but their own is automatically flawed and to be totally dismissed. The common definition of such mental paradigms would be most aptly deemed to be bigotry, or more specifically eugenics, pure and simple.

    We are also dealing with the conflation of sex and gender within the scope of the current DSM paradigms. We now have the inclusion of pseudo-scientific conditions like homosexual transsexual and AGP to further complicate the sanity of the situation. Add to this the fact that the LBGt has included those of alternate gender variations under the term “transgendered” and we are dealing with a real can of worms when it comes to the appropriate treatment therapies, i.e. transitional medicine. This may be somewhat beneficial from a political perspective, however, it does tend to muddy the waters and deny appropriate medical therapies to those who really need it.

    Perhaps my greatest concern here is that we are dealing with a confirmed prenatal CNS dysgenisis in regard to the transsexual – not a behaviorists etiology. The fact that we have the highest suicide rate for those denied transitional medicine makes “GID” a life threatening condition, even with regard to the definitions contained within the DSM as was so aptly pointed out in the AMA’s resolution 122 of 2008 which advocated both public and private medical coverages to include transitional medicine as the therapies supported by the DSM give mixed results at best. I also find it disturbing that we are specifically excluded from being treated by any method other than supportive therapies (i.e. antidepressants, psychotherapy, etc.) when it has now been effectively demonstrated that transitional medicine is curative in the vast majority of cases. I am also chagrined that Medicare and other private sector and public health care coverages will cover the treatment of other “disabling conditions,” defined in the DSM, under the theory of parity, yet still disallow any form of coverage for the TS. From this perspective, only those who have both the money and ample resources have access to the appropriate therapies, making this pretty much a rich person’s affliction.

    The perfection of a therapy is also not a key component in determining whether or not a therapy has medical validity or desirability. The fact that we will never be “perfect” in our target sex has no more bearing on the validity of transitional medicine than the necessity of a person to become “perfect” who has had a prosthetic leg to deal with the fact that he was born without a lower leg on one side of their body. The point here being that it does increase that individual’s functionality and is indeed an appropriate application of medical technology.

    I guess the one thing we can all agree on is that a person who has known, throughout their entire cognitive memory, that they came into the world with the wrong accessories attached is not the one who is suffering from a mental defect. I would rather suspect that it is the innate bias, and the inability of the individual making the definitions and labels that are applied to others that is the innate pathology with which we are dealing. Even the best of the theories of those like Money, Blanchard, Lawrence and Zucker are extreme stretches when viewed in the light of Occam’s Razor* and scientific methodology.

    Perhaps the most succinct advantage to this particular conversation is that we need to shed some light on exactly what individuals, such as myself, are dealing with. For way too long we have been relegated to subhuman status, denied our rights as individuals and horribly misdiagnosed and treated as mentally defective based solely on religious superstition and those within the psychiatric and psychological communities that pander to, or subscribe to, the same intellectual and pseudo-scientific bents that creating a social stigma against a group that is in no way more culpable than one born without a limb or with a congenital deformity like a cleft palate. Before a social ill can be corrected, it must first be brought out into the open and exposed to the light of day. For way too long, the systematic repression of information pertaining to “GID” or transsexualism (I prefer pHBS) has been the rule of order in our society. The fact that we are a very small demographic still does not make our denial of access to treatment, discrimination, repression or denial of our humanity anything other than a great injustice.

    Best regards,


  3. Heli Says:

    Why does it have to be a psychiatric diagnosis. It could be diagnosed as a developmental disorder. Thus the medical intervention is easier to justify.

  4. dyssonance Says:

    As I understand it, the focus of the article here is strictly on the DSM, and not on the ICD.

    This matches the current gist of the arguments to remove it, which seek to remove GID from the DSM and then shift it to a different category within the ICD.

    The risk of insurance coverage only occurs when there is no diagnostic code at all — and then its not so much a lack of insurance for the individuals, as it is a lack of malpractice insurance for the doctors and nurses.

    Kelley, Becky, and the others working hard on this problem also know something else that doesn’t filter down in to the general trans population: the *current diagnosis* is predicated on a physiological variation (naturally occurring) that is classified as it is due to the mental suffering associated with it.

    This creates a situation that makes it even more difficult to remove from its current classification, but does allow for the shift in general perception if such a point is spread out to the general population.

    This gives it a classification akin to Alzheimer’s — which is a physical illness with extreme effects on the mind.

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