The GID Diagnosis Being in the DSM is a Barrier to Equality

All too often the APA acts in its own interests rather than in the interests of people it pathologizes.

In many ways APA is more akin to a religion than to a science.  And like other religions there may be good and nice people involved in something that is systematically rotten.

Part of the problem started with the popularity of psychology and psychiatry as academic fields that were not examined with the same sort of scrutiny one would expect of a “science”.

The DSM has become a profit generating tool.  Erasing individual differences and non-conformity is looked upon as a cash cow.

There are a great deal of politics involved in who among the LGBT/TQ alphabet soup gets pathologized.

Transsexuals were not in the DSM in 1973, the year they removed homosexuality from the DSM.

In 1973 transsexuals were being reviled by a number of  lesbians and gay men.  We were considered reactionary by lesbians, told we were the creators of gender stereotypes when we were as influenced by those patriarchal gender roles as women/girls, who were assigned female at birth. Gay men thought the only reason we got SRS was to be able to have sex with straight men.  They also regularly described transsexual to female people having SRS as ditsy queens getting their cocks chopped off.

Feminists held transsexual to female people to extremely high and often contradictory standards that they didn’t hold assigned at birth female people to.  It didn’t matter that AFAB women called each other girls or dressed in micro-mini dresses and wore make up as they were “socialized into that role”.  This was an argument that excluded the possibility that WBTs were also subject to the same sort of generalized socialization which said this is what women do, this is how women dress and act.

Transgender wasn’t yet a functioning social construct, even though there were people who fit the earliest and most specific definition of transgender.

Sex Reassignment Surgery was still considered “Experimental”.

We were screened to insure we weren’t mentally ill.  This is a position we should perhaps consider reverting back to.

The accusation laid upon us was that we read the texts and rehearsed our stories to fit what the doctors wanted.

While that sounds good, it isn’t accurate.  Other than Dr. Benjamin’s book we had Green and Money’s book, Transsexualism and Sex Reassignment.  Benjamin’s book was often our first step in self-discovery while Green & Money provided us with nut and bolt information we could give doctors regarding things like hormone dosages as well as information regarding what we were doing with our bodies or perhaps more accurately what we wanted from the surgeons.

Most of the doctors were male and thought that any person assigned male at birth would be insane to want to be reassigned female via sex change surgery.  Can we say, “Projection of their castration anxiety”?

But there was something else working.  Here were a bunch of people who often had interrupted educations telling doctors in fairly abstract terms what transsexualism was all about.  We were the experts, they weren’t.

Pathologizing us was a way for doctors to regain the upper hand.

But GID was also a way for surgeons performing SRS to continue to do so in the face of a rising tide of opposition from the Christian right wing, which was becoming an increasingly thuggish force in American politics and which was exerting a great deal of pressure upon the University hospitals to end their SRS programs.

Transgender Inc was the enemy of transsexual to female people right from the start.  Virginia Prince started laying the ground work for our being pathologized years before becoming Virginia (living as transgender).

The organizations founded by Prince were part of pushing the whole gender line.  The idea that transsexualism was all about gender.

They have also pushed the idea that there was one community and that community was “Transgender”.  The idea that transsexuals are just transvestites that went too far is straight from Virginia Prince.

GID actually encompasses far more oppressive terminology and ideas that are a cancer within the transsexual community.

The idea that some who get SRS aren’t really transsexual because they did this, that or the other thing.

I’m an existentialist the proof is in the doing not the claiming of an identity.

As for things like gender identity confusion.  I can see a point when I was “confused” due to lack of a vocabulary with which to articulate my feelings.  Confused in the face of the seeming impossibility. But this is something that is resolved by coming out and short of detransing, gender identity confusion doesn’t much apply to post-SRS women and men.

As for the sexuality of women born transsexual.  Well, our having a sexuality is problematic according to so many people I can almost understand people saying that, “It isn’t about sex, it is about gender.”  But that right there is allowing our having the same sorts of sexual feelings that cis-sex/gender people have to be perversified. You have BBLand Z as well as those who are sucked into the BBL & Z AGP/AP paradigm claiming that being one or the other validates their being transsexual.  Then you have one of the self proclaimed “classic transsexuals” who claims that she is one of the only real transsexuals since she was totally asexual prior and according to one of the right wing mental illness pushers (Lionel Ovesey) having sex with anyone prior to SRS means you are a pervert and not a real transsexual.

Sometimes… I swear we are our own worst enemies.

I’ve listened to too many people pre-op TS and TG who hang their legitimacy on that damned GID diagnosis.  They are perhaps legitimately afraid the forces of conservative darkness will use removing GID from the DSM as a path to denying them access to medical care and legal rights.

On the other hand, Jesse Helms saw to it GID was explicitly excluded from the Americans with Disabilities Act to prevent the AWDA from offering non-discrimination protections.

Now it is being used to exclude TS/TG folks from the repeal of DADT.  So, ending DADT is another act that protects gay and lesbian people while leaving TS/TG people over in the corner fuming about how the L/G community has betrayed us once again.

My partner, Tina has always said, “There is no future in being the “T” in LGBT.”

Their understanding of  transsexual to female people and our needs seems to begin and end with drag queens. Our brothers seem to fare better in their relationship with the queer alphabet but none of us fare particularly well.

What pisses me off big time is how I went and marched as well as argued for the removal of homosexuality from the DSM but haven’t seen a whole lot of lesbians or gay men arguing for the removal of GID from the DSM.

In fact there is a substantial segment of the “Lesbian Community” that is as hateful towards us as anyone of the Christo-Fascists in the “Kill the Gays Movement”.

I’m almost afraid that when the struggle to pass ENDA is again brought to the forefront TS/TG people will yet again be a bargaining chip to be discarded because after all we are mentally ill.  Just look at what the DSM and the equivalent of  Charles Socarides and Joseph Nicolosi have to say about us.

Shit we even have sisters who find validation in Bailey, Blanchard, Rekers, Lawrence, Zucker and Ovesey.

I fear GID being in the DSM poses a serious road block to any chance of TS/TG people making progress in the pursuit of non-discrimination laws or other matters of social justice and equality.

22 Responses to “The GID Diagnosis Being in the DSM is a Barrier to Equality”

  1. Marlene Says:

    I’m in total agreement with you on this, Suzan, but it’s in truth a double-edged sword.

    Because it’s in the DSM, there are transfolk who’ve been able to have their treatment covered by their health insurance, whether by policy or by forcing their way through.

    The other battle we need to wage is to eliminate the ban on Medicaid and Medicare treatment, pushed through thanks to that paragon of bigotry and hate, Jesse Helms (may karma have him living as a poor black woman in Haiti right now!).

    • Suzan Says:

      Considering some 50 million people in the US have no health insurance, up from 46 million since “Health Care Reform”, and given that transsexual people have an unemployed/under-employed rate some where in the mid 30% means those transsexual people with health insurance are a minority.

      For every health insurance policy that includes transsexual people because of GID there are 2-3 policies with specific exclusions. Face it right wing companies no more want to pay for the treatment of transsexualism than they want to cover abortion.

      Why should anyone have to lie about being mentally ill in order to receive medical treatment?

      GID harms us far more than it helps a highly privileged few.

  2. HenryHall Says:

    The solution lies through the political process, not through trying to educate a medical profession that does not wish to be enlightened.

    A process for change of legal sex without a need to produce medical evidence will solve a lot of problems. It allows transsexual to female people to be treated as disfigured women as contrasted with mentally ill men. It places people in transition on the right side of their legal rights.

    While a process for change of legal sex without a need to produce medical evidence does not solve all problems it empowers transfolk and gives them tools with which to fight oppression. And the way to achieve such legislative progress is through politics; an understanding that science is not the same as health and that the law should be promoting health over science wherever the two collide (such as in the issue of legal sex).

    In the end, GID does not so much need reform or even elimination, rather it needs to be rendered irrelevant by changes in the law.

    • Suzan Says:

      Changing paperwork is not changing sex no matter how one post-moderns it. Changing paper work is a polite legal fiction that helps people avoid discrimination.

      A person has to deal with the physical reality of the body every time they pee or bathe. Paperwork does nothing for that.

      Gender is not sex, sex is physical and gender is a social construct. No amount of paper work turns a pole into a hole, a surgeon’s knife does.

  3. edith Says:

    x and y’s are the reductionist medical argument used to argue that poles and holes are just cosmetic alterations. The problem is with reducing sex to the twenty third pair of chromosomes and poles and holes. Sex is about the whole person and there are not just two kinds of people. x,y – hole, pole – cis, trans – democrat, republican – sex, gender – black, white – and on and on and on, all false dichotomies. The human race has to find a way to stop cutting the baby in half if there is going to be any hope for anyone. Transsexual people are just scapegoats used to uphold everyone else’s delusions about sex. Why is everyone so afraid of an wholistic approach rather than simplistic reductionist explanations? Everything is everything. Everything you are is what you are. It varies. What’s crazy about that?

    • Suzan Says:

      I don’t have a problem with identification paper. But saying something is so or claiming to something is so because one wishes it to be so encounter reality in the flesh on those mundane circumstances when one has to pee.

      Supporting the rights of transgender people to have identification that makes their lives livable doesn’t mean I buy the mountain of bullshit they have generated as an ideological sales pitch to convince me that gender is real and sex is the social construct when I see the reverse.

  4. edith Says:

    I don’t know if you are addressing me or Henry. I think Henry’s ideas are interesting but I see problems. I was not writing in support of Henry but I don’t totally disagree with him either. I don’t disagree with you. I understand the simple reality of the mechanical fit. I am familiar with plumbing fittings, plugs, outlets, etc. I have to pee sitting down. What makes successful transsexual procedures possible is the nature of sex which is a very diverse phenomenon and stranger than fiction. There are more than two possible arrangements for body parts. A lot of women and men do not have complete sets. If someone wants to say my vagina doesn’t mean anything, however, I think it’s just as wrong a thing to say that another woman’s ovaries and uterus don’t mean anything. There are women born without either. Some of them are born with vaginas. Some have to have surgery to make that happen. The reality is even more complicated. As improbable as this all may seem and be doesn’t have anything to do with space aliens. Probability and possibility are two different things and not mutually exclusive. That’s another false dichotomy.

  5. HenryHall Says:

    It needs to be understood that it is not proposed that changing legal sex corrects anatomy or social circumstances.

    However, what it does do it to immediately prevent any mental illness diagnosis pursuant to Gender Identity (which is NOT disordered in the new sex, it is only (possibly) disordered in the old sex). It also enables people to obtain swifter medical assistance for physical matters such as hormones and surgery and limits psychiatric involvement to bona fide psychiatric issues (such as the depression commonplace among every oppressed population).

    Moreover, it puts people on the right side of any laws or rules that might related to sex specific issues.

    A change of legal sex does not, of course, make it safe to live as a woman with a penis, that has always been dangerous. Very dangerous indeed. But it does mean that treatment of that disfigurement should occur without mental health approval (which is too often arbitrary in the extreme). Also, that disfigurement is NOT excluded from protection under the Americans with Disabilities Act.

    To spell that out in excruciating detail – ADA protects a person living as a woman with a penis if that person is legally female; but ADA does not protect a person living as a woman with a penis if that person is legally male.

    A process for change of legal sex without medical evidence needs safeguards against frivolous use. The simplest effective safeguard to to write the law in a way that makes the legal change irreversible.

    • Suzan Says:

      I think you are overly optimistic.

      At this point I’d be quite happy with SRS cures GID. Call that one the lowered expectations of “Hope & Change I can believe in.”

      Too many people in the process are afraid to let go of GID as diagnosis and give the current medical political climate that is understandable. OTOH the only people who will buy the transgender “disfigured woman with a penis” are people ensconced in the ideology of transgender.

      I don’t buy it as a reason to grant civil rights, legal papers and anti–discrimination laws. That argument tend more to validate a mental illness than invalidate one as it comes off as delusional.

      Human rights should be based on one being human not on people having to make a delusional sounding argument.

  6. edith Says:

    “However, what it does do it to immediately prevent any mental illness diagnosis pursuant to Gender Identity (which is NOT disordered in the new sex, it is only (possibly) disordered in the old sex).”

    Henry, I am not sure that this is what would be accomplished. There are women who are born phenotypically female – with vaginas and sometimes a uterus – who the medical establishment considers to be disordered “genetic” males. Take a look on this one Google page:

    http://www.google.com/search?client=safari&rls=en&q=xy+female+dsd&ie=UTF-8&oe=UTF-8#q=xy+female+dsd&hl=en&client=safari&rls=en&prmd=ivnsb&source=univ&tbs=bks:1&tbo=u&ei=UGEdTcO_FoG0lQeoh6XkCw&sa=X&oi=book_group&ct=title&cad=bottom-3results&resnum=11&ved=0CGcQsAMwCg&fp=1a1a8ce92fba2198

    These women are assigned female because they look female. The doctors accept their “female gender identity” because the doctors cannot be proven wrong when they make a sex assignment. If someone rejects their sex assignment, it presents a challenge to the doctors and the possibility that a doctor made a big mistake which could become a liability concern. The medical establishment is aware of the kind of paper work this could generate. When one considers how much cover diagnosing someone with a mental disorder provides, it’s hard not to see why the GID was invented in the first place. If you notice, it’s easy to see that the only ones who have a mental disorder are the ones who say the doctor was wrong. The medical establishment has huge political clout. A Texas court order that insists you are what you are at birth is a lot of vindication for doctors who make sex assignments.

    Then, there is the rigid adherence to the power of sex chromosomes to determine a person’s sex. After the Chicago Consensus Statement, Alice Dreger and Emi Koyama were sent out to medical schools all around the country to proselytize about the management of people whose bodies do not conform to their karyotype. I went to see her preach at Brown.

    The GID is very evil. It has to be removed. It’s going to be like moving a mountain, though. A body that does not match a karyotype is considered disordered, regardless of the GI. The body does not stop short at the brain. . If you notice, the U K only agrees to recognize a person’s gender, not their sex. That is a problem because medical treatments do not exist in the abstract

    The karyotype reigns supreme. When one looks into it, it becomes easy to understand it is not very scientific because out of sixty five genes involved in sex determination, only fifteen are on the sex chromosomes. The medical establishment clings to the notion that sex determination should be based on the presence or absence of a “y” chromosome, regardless of how a person is assigned or reassigned, because of the implications it provides in confirming a patriarchal prejudice that sex is about development and that male development is the highest and complete form of sex development.

    A lot more people have mixed sex characteristics or characteristics that don’t develop into standard male or female than people who are transsexual but it should be obvious that by the nature of things, wrong assessments will be made at birth. I think the basic facts of biological diversity allow for the inevitability of transsexualism and other outcomes. The only solution is for doctors to acknowledge that sex assignment can be tenuous, that they need the necessary wiggle room, and that the means exist to make transsexual people live happier, more fulfilling lives.

  7. HenryHall Says:

    Edith writes “I am not sure that this is what would be accomplished. There are women who are born phenotypically female – with vaginas and sometimes a uterus – who the medical establishment considers to be disordered “genetic” males”

    I propose that a person such as you describe above (who also self-identifies as female) is better treated by the medical profession AND has a sounder basis for legal protection against discrimination than that experienced by a typical MTF person (who also self-identifies as female).

    What would be achieved then, is a leveling up for the typical MTF to the “treatment without psychiatry” and the legal protections against discrimination which are already granted to AIS women who self-identify as female.

    Genetically male, yes. Scientifically male, arguably. But legally, socially and medically female. As it should be. And the way to obtain medically female status for MTFs is to make them legally female and so able to demand that doctors respect the law (including the pursuant ADA protections) that makes them female.

  8. Zoe Brain Says:

    Edith writes “I am not sure that this is what would be accomplished. There are women who are born phenotypically female – with vaginas and sometimes a uterus – who the medical establishment considers to be disordered “genetic” males”

    I propose that a person such as you describe above (who also self-identifies as female) is better treated by the medical profession AND has a sounder basis for legal protection against discrimination than that experienced by a typical MTF person (who also self-identifies as female).

    YMMV. Often they are treated better by medics, but sometimes worse.

    Legally, it varies. In at least one jurisdiction in the US, there is no legal protection (see Wilma Woods vs M.C.Studios) , as they’re deemed neither male nor female.

    In general, they’re treated by the legal system not as well as transsexuals. Those latter, they have laws in place for.

  9. HenryHall Says:

    Zoe – it is true that a process for change of legal sex without a need to provide medical evidence leaves many problems unsolved.

    Nonetheless it will be (and it is coming in the Spanish speaking world) significant progress and improvement.

    Oh, and just to save others searching and in a constructive spirit of merely fixing a typo – the cited case is Wilma Wood v. C. G. Studios.

    • Suzan Says:

      I wouldn’t go along with that one.

      When I went through the process I was issued a card stating I was in treatment for transsexualism.

      Changing ID should require at bare minimum hormones and living 24/7/365.

  10. HenryHall Says:

    Suzan writes: Changing ID should require at bare minimum hormones and living 24/7/365.

    That is stated without rationale. What is the purpose of such minima criteria?

    Granted there is a need to protect against abuse so that legal sex is changed only in good faith and without evasion of purpose or deceptive intent. But “hormones and living” are (at best) poor ways of achieving that; in contrast there are effective (and less invasive) means that do exist. So what then is the other purpose of those minima criteria?

    • Suzan Says:

      What are those other measures? Claims of identity? I’m an existentialist not a post-modernist. I believe in actions not claims of identity?

  11. HenryHall Says:

    Suzan avoids the issue of the purpose beyond preventing abuse of the system and asks: “What are those other measures?”

    The direct answer is that attempts to abuse the system can be expected those whose aim is to bring it into disrepute in order to discriminate against those who need to change their legal sex. The most obvious form of frivolous application is multiple applications, for example cynical and false to-ing and fro-ing.

    Such abuse is prevented by various measures. In Ecuador (where many people cannot afford hormones) it is necessary to bring a case in Equity (with legal aid). In Uruguay if an application to change sex is granted no further application can be made for ten years. Under the Catalonian (EFC) proposals it is necessary for the applicant to provide an affidavit of stability in the requested gender and the court accepts it unless there is contrary evidence (a prior application would be contrary evidence against a claim of stability).

    So, again, hormones and sex are not needed for protection against abuse of the system; so why is a (mere) sworn oath petition to solemnly become of a requested legal sex insufficient? (Given protections against abuse of the system).

    • Suzan Says:

      Henry, Don’t piss on my leg and tell me it is raining…
      Do you freaking think I came out yesterday or am that fucking naive?

      I’ve know the people who claim that they identify as women yet have nothing about them that could even be considered remotely feminine. I refuse to put the rights of the bulk of transgender women and all actual out transsexual women at risk so transvestites can game the system.

  12. HenryHall Says:

    I’m truly sorry you wish to discuss it in that way.
    The points you raise may or may not be valid but either way do not address the issue of consequences of a new legal process.

    • Suzan Says:

      I am able to separate actual transgender people who take hormones and live 24/7/365 from the transvestites and drag queens as well as the “gender variants” like those whithe beards and dresses (Cockettes/Sisters of Perpetual Indulgence) because of a lifetime worth of experience.

      I an neither transgender nor a gender variant. I had an operation that cured me of transsexualism.

      There is this whole post-modern ideology of gender and identity that I don’t really buy into.

      For me the proof is in the doing not the claiming to be.

  13. Anna Says:

    HenryHall:
    > A process for change of legal sex without medical evidence
    > needs safeguards against frivolous use. The simplest effective
    > safeguard to to write the law in a way that makes the legal
    > change irreversible.

    Which would be immediately overturned at the first challenge. You cannot make someone live without an appropriate legal identity. Not in any state with a decent respect for human rights, you can’t (which is why the UK can, and does).

  14. Anna Says:

    > Suzan:
    > We were screened to insure we weren’t mentally ill. This is a
    > position we should perhaps consider reverting back to.

    My goodness, some people would be blocked by that.

    Surely its too late now. Its almost as if some psychs require trans people to be a bit mad. They certainly don’t seem to provide mental health care for them. The communities, and the sufferers, and their families, live with the consequences every day.

    > The accusation laid upon us was that we read the texts and
    > rehearsed our stories to fit what the doctors wanted.

    And that is even spelled out in the HBIGDA SOC.

    The instant refutation, for me, is that transsexual children, who have met no one else like them, and neither read nor heard anything (their parents neither), say such similar things. It comes from how we actually feel, how we are affected by the transsexuality.

    > As for things like gender identity confusion. I can see a point
    > when I was “confused” due to lack of a vocabulary with which to
    > articulate my feelings. Confused in the face of the seeming
    > impossibility. But this is something that is resolved by coming
    > out and short of detransing, gender identity confusion doesn’t
    > much apply to post-SRS women and men.

    If 3-year-old children can express it then I’m sure you could without having encountered any specialised vocabulary. “Confusion”, when linked to “gender identity” is just a construct of those who oppose or hate us. Try the words in Google and see whose sites or writings lead the results (Zucker, Exodus, “Family” this and that, Reckers, etc.).

    We may well confuse people at times, but someone who is confused about their gender identity simply isn’t transsexual. At least not yet. Or else they are in the clutches of a transphobic cult.


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