From Dented Blue Mercedes: http://dentedbluemercedes.wordpress.com/2012/12/05/about-that-gid-is-removed-from-the-dsm-thing/
By Mercedes Allen
December 5, 2012
Reposted with permission.
Oh god, please make it stop.
Yesterday morning, I woke up to a rash of headlines proclaiming that transexuality was no longer considered “disordered” by the American Psychiatric Association. This morning, it grew worse, with a rash of panicked emails from people who were wondering if their medical access would be jeopardized, after some LGBT and even mainstream news sites and blogs reported this as meaning that “Gender Identity Disorder” (GID) will no longer be considered in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), or had been “removed” from the DSM altogether. No, it hasn’t. That’s not true at all.
I hate to be a wet blanket, but the change that’s being heralded is mostly just in name, and “Gender Dysphoria” remains in the DSM — and in the “Sexual and Gender Identity Disorders” category (although that name may change too), if I recall correctly, of a manual that governs mental health. The parallel being drawn to when homosexuality was removed from the DSM wildly overstates this change.
And because it has not been completely removed (something I’ve previously cautioned about the risk of doing too hastily, regarding both the DSM and ICD volumes), peoples’ medical processes are not affected in any way. The panic I’ve heard from some people wondering if their medical treatment will be hindered is unfounded.
There is something to see here, though:
There is a positive in this, though, in that people are finally paying attention to the problems associated with another DSM category: Transvestic Disorder (formerly Transvestic Fetish). When the alarm was raised about Drs. Ray Blanchard and Ken Zucker having administrative roles in the DSM revision, that protest lost some steam when the APA announced that Zucker would be in an oversight position rather than hands-on, and Blanchard would be working on a separate category not related to GID (Paraphilias). Some of our allies decided we were making much ado about nothing. Now, people are perhaps realizing the problem with that arrangement, in that it gave Blanchard full license to develop Transvestic Disorder (TD / TF).
A few trans advocates (including Kelley Winters, Julia Serano, and myself) have cautioned about the problems with regard to TD / TF and what could happen if that diagnosis is expanded in scope while GID diminishes or is eliminated. Well, indications thus far are that Transvestic Disorder has certainly been expanded, and evolved to encompass Ray Blanchard’s theory of “autogynephilia” as a subcategory (plus the addition of “autoandrophilia,” to make it an equal-opportunity pathology). All that anyone really needs to do to technically qualify for this diagnosis, as Serano notes, is to be “sexually active while wearing clothing incongruent with their birth-assigned sex.”
This diagnosis sexualizes and invalidates, and frankly, it has become a wide, sweeping pathology encompassing a significant amount of non-harmful behaviour.
Backgrounder: The Little Case Study That Autogynephilia Forgot
(Crossposted to The Bilerico Project)
By Kelley Winters
December 5, 2012
Reposted with permission.
On December 1, the Board of Trustees for the American Psychiatric Association approved the final draft of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The most controversial DSM revision in more than three decades, the DSM-5 has drawn strong concerns, ranging from overdiagnosis and overmedication of ordinary everyday behaviors to poor diagnostic reliability in field trials. The transgender-specific categories of Gender Identity Disorder (GID) and Transvestic Fetishism (TF) have been especially contentious, beginning with the 2008 appointment of Drs. Kenneth Zucker and Raymond Blanchard of the Toronto Centre for Addiction and Mental Illness (CAMH) to lead the workgroup for sexual and gender identity disorders. They were key authors of the prior DSM-IV gender diagnoses and leading proponents of punitive gender conversion/reparative psychotherapies (no longer considered ethical practice in the current WPATH Standards of Care).
There are two major issues in transgender diagnostic policy. The first is a false stereotype that stigmatizes gender identities or expressions that differ from birth sex assignment with mental disease and sexual deviance. The second is access to medically necessary hormonal and/or surgical transition care, for those trans and transsexual people who need them. This access requires some kind of diagnostic coding, but not the current “disordered gender identity” label, which actually contradicts rather than supports medical transition care. It is necessary to address both issues together, to avoid harming one part of the trans community to benefit another.
Some of the proposed gender-related revisions in the DSM-5 are positive, however they do not go nearly far enough. The Gender Identity Disorder category (intended by its authors to mean “disordered” gender identity) is renamed to Gender Dysphoria (from a Greek root for distress) Though widely misreported today as “removal” of GID from the classification of disorders, this name change is in itself a significant step forward. It represents a historic shift from gender identities that differ from birth assignment to distress with current sex characteristics or assigned gender role as the focus of the problem to be treated. This message is reinforced by the August 2012 Public Policy Statement from the American Psychiatric Association affirming the medical necessity of hormonal and/or surgical transition care. Moreover, the sexual/gender disorders workgroup has stated a desire to move gender diagnoses away from the sexual dysfunctions and paraphilias group. (At this time of writing, it is not yet clear where they will be classified in the DSM-5.)
On the negative side, the proposed diagnostic criteria for Gender Dysphoria still contradict social and medical transition and describe transition itself as symptomatic of mental illness. The criteria for children are particularly troubling, retaining much of the archaic sexist language of the DSM-IV that pathologizes gender nonconformity rather than distress of gender dsyphoria. Moreover, children who have socially transitioned continue to be disrespected by misgendering language in the diagnostic criteria and dimensional assessment questions. There is very plainly no exit from the diagnosis for those who have completed transition and are happy with their bodies and lives. In other words, the only way to exit the GD label, once diagnosed, is to follow the course of gender conversion/reparative therapies, designed to shame trans people into the closets of assigned birth roles. While supportive care providers will continue to make the diagnosis work for their clients, intolerant clinicians will exploit contradictory language in the diagnostic criteria to deny transition care access and promote unethical gender conversion treatments.
A worse problem in the DSM-5 is the Transvestic Disorder (formerly Transvestic Fetishism) category. It is punitive and scientifically capricious— designed to punish nonconformity to assigned birth roles. It has been expanded to stigmatize even more gender-diverse people and should be removed entirely from the DSM.
Despite retention of the unconscionable Transvestic Disorder category, I believe that the Gender Dysphoria category revisions in the DSM-5 will bring some long-awaited forward progress to trans and transsexual people facing barriers to social and medical transition. I hope that much more progress will follow. In the longer term, I would like to see a non-psychiatric classification in the International Statistical Classification of Diseases and Related Health Problems (ICD, published by the World Health Association) for access to medical transition treatments for those who need them.
Copyright © 2012 Kelley Winters, Ph.D., GID Reform Advocates
From Daily Kos: http://www.dailykos.com/story/2012/12/04/1167167/-Liberation-Day
Tue Dec 04, 2012
On Saturday, December 1, 2012 the board of trustees of the American Psychiatric Association approved the changes in the Diagnostic and Statistical Manual of Mental Disorders, which will now be known as the DSM-5 (as part of the dumbing down of America, it was apparently found necessary to stop using Roman numerals).
Among other changes, such as the revamping of the autism disorder spectrum, the new version of the manual no longer classifies people who are transgender or gender non-conforming as mentally disordered. Additionally compulsive hoarding will now be in a category of its own and PTSD will be moved into its own chapter, with more sensitivity to children and adolescents.
Until now, the term “gender identity disorder” has been used to diagnose people who are transgender. For conservatives, this has provided rhetorical carte blanche to describe the entire trans committee as disordered, delusional, and mentally ill. In some cases, this diagnosis has even been used to discriminate against trans people, with claims that they are unfit parents or employees, as examples. On the other hand, insurance companies have been more willing to cover the expenses associated with transition under this language, because treatment for a disorder is considered medically necessary, rather than cosmetic.
The final editing process will take place until December and the new manual will be released at the APA annual meeting in San Francisco in May and take effect then.
This does not mean that transgender people are totally excluded from the DSM-V. We will henceforth be diagnosed as having gender dysphoria…which is what I recall from pre-DSM-IV days. Gender dysphoria concerns the “emotional distress that can result ‘from a marked incongruence between one’s experienced or expressed gender and assigned gender.” This new classification allows for affirmative treatment of the distress without the stigma of a disorder.
In July the APA called for new guidelines to ensure the best course of treatment for transgender patients. In August the APA took a stand on the necessity of transgender civil rights:
Continue reading at: http://www.dailykos.com/story/2012/12/04/1167167/-Liberation-Day
BY Riki Wilchins
December 06 2012
She was a lovely 13-year-old girl, with long blond hair, bright hazel eyes and the budding bosom and hips of the woman she would soon be. Her smile betrayed none of the self-consciousness that I had when I was young and began—as a transsexual—dressing in feminine clothing. I assumed she was a friend of the young transsexual woman I was there to meet. While I searched for our assumed mutual friend, I ignored this young woman because it was simply impossible to see her as anything but a woman.
Never having passed as female as I’d grown older I’d finally given up trying. Besides, it seemed somehow counter-revolutionary, as the new transgender politics is increasingly built around exactly the kind prominent social visibility and defiant non-passing that my doctors at the Cleveland Clinic assured me would signal the failure of my gender transition surgery.
In fact, my political identity for 30 years has been built on the foundation of my being visibly transgender, from the day I donned a Transsexual Menace NYC t-shirt and flew to the Brandon Teena murder trial in Falls City, Nebraska.
Memorial vigils for slain transgender women, picketing HRC, books on gender theory and public fights with radical feminists, and being booted from the Michigan Womyn’s Music Festival on multiple occasions for not being a “born womyn” have made me who I am—inextricably intertwined with being publicly and very much a visible transsexual.
But what if all that were wiped away? Who would I be? What would I have become? With all the activism and writing that identity forced on me during the birth of transgender liberation, would I even be writing this today?
Unlike society’s unwritten rule, “prove you’re really a woman,” nature’s rule is “female, unless proven otherwise.” In that sense we are all born females in utero. It is only through the action of testosterone in the womb that about half of us develop into those “other females,” or men.
Androgen blockers, which prevent all the painful and irrevocable effects of puberty that I spent several years of my life trying to reverse – chest hair, beard, Adam’s apple, etc. – had made this blond 13-year-old into an entirely non-transgender transsexual. One whose gender, and social identity, will be always and completely female to every adult she knows or meets. With the right surgeon, she might not ever tell her husband or wife. She didn’t cross gender lines or even rub up against them. She fulfilled them fully and completely in a way I could never know.
In my adolescence, it was unthinkable to even mention being transgender to my parents or doctors, let alone seek treatment. And treatment, if it were forthcoming at all, would have inevitably meant a psychiatrist (not to mention probably having my father try to beat me into manhood – a project which, come to think of it, he pretty much started anyway).
With adolescents increasingly taking androgen blockers with the support of a generation of more protective, nurturing parents, public transsexuality is fading out. And I don’t mean only that in a generation or two we may become invisible in the public space. I mean rather that in 10 years, the entire experience we understand today as constituting transgender—along with the political advocacy, support groups, literature, theory and books that have come to define it since transgender burst from its closet in the early 1990s to become part of the LGB-and-now-T movement—all that may be vanishing right in front of us. In 50 years it might be as if we never existed. Our memories, our accomplishments, our political movement, will all seem to only be historic. Feeling transgender will not so much become more acceptable, as gayness is now doing, but logically impossible.
In other words, I may be a gender dinosaur.
By Laura Stone
Dec 5, 2012
A Conservative MP wants to amend an opposition private member’s bill on transgender rights to exempt sport organizations from discrimination if they ban athletes from competing.
Edmonton MP Brent Rathgeber wants NDP Randall Garrison’s Bill C-279 — which would make it illegal to discriminate against transgendered Canadians and to disseminate hate on the basis of someone’s gender identity or expression — to exclude all Canadian sport organizations from the gender identity “claim” if the organizations determine through eligibility criteria that a transgendered athlete cannot compete.
“I’m not saying that they couldn’t allow an individual to compete, I’m just saying that it wouldn’t be automatically discriminatory if they decided that it would be inappropriate,” Rathgeber said.
In an interview, Rathgeber explained why sports groups should be exempt from the bill.
“What I’m envisioning, a male for example, my size or possibly bigger, who actually goes through gender reassignment surgery, and then wants to compete in, let’s say women’s wrestling or women’s shot put,” said the MP, who is well above 6 feet tall.
“That would be wrong and I think a person my size would be at an advantage competing in women’s sport if the sport deals with strength or stamina, (and) I think it is generally accepted that men have more strength and stamina,” he said.
“Conversely, a sport that requires flexibility and agility, I think generally speaking women are at an advantage, and I think it would be equally inappropriate for a person who’s gone through that to be able to compete against people who are formally of the opposite sex.”
Rathgeber also wants the bill to include a medical diagnosis of “gender dysphoria” because the terms identity and expression are too broad.
“It is my position that legal recognition of the preferred gender should not require infertility or compulsory medical treatment which may seriously impair the autonomy, health or well-being of the individuals concerned. Any requirement of a medical diagnosis should be reviewed with a view to eliminating obstacles to the effective enjoyment by transgender persons of their human rights, including the right to self-determination. Moreover, divorce should not be a necessary condition for gender recognition as it can have a disproportionate effect on the right to family life.” says Council of Europe Human Rights Commissioner Nils Muižnieks in a letter to Irish Minister for Social Protection Juan Burton.