The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is scheduled for publication by the American Psychiatric Association in 2012. It will be the first major revision of American diagnostic nomenclature for mental disorder since 1994, and the DSM-V will likely impact the lives, civil liberties and medical care of all gender variant people through the 2020s.

The current diagnostic categories of Gender Identity Disorder (GID) and Transvestic Fetishism (TF) in the current DSM have long raised concern within the transgender community. Those who are distressed by their physical sex characteristics or ascribed social gender roles need diagnostic nomenclature that supports the legitimacy of transition and access to medically necessary treatment. At the same time, this nomenclature should respect the gender identity and expression of gender variant children, adolescents and adults and not impose stigma of mental illness or sexual deviance on femininity, masculinity or gender diversity in themselves.

There are two prevailing views of gender diversity in North American psychiatry and psychology. The emerging view is affirming and accepting. The older view is punitive, judging difference as disorder, something to be ashamed of. The current diagnostic categories of Gender Identity Disorder and Transvestic Fetishism in the DSM-IV and revision IV-TR predominantly reflect the punitive view of gender diversity. They go so far as to disrespect transitioned adults and youth with inappropriate pronouns and gender terms in the diagnostic criteria and supporting text.

The transgender community has expressed growing concern that the work group for Sexual and Gender Identity Disorders in the DSM-V Task Force of the American Psychiatric Association is not sufficiently representative of newer, respectful attitudes toward gender diversity that are widely held by practitioners who work with gender variant adults and youth today. Many transgender advocates and care providers hope to see more balance in this work group, more inclusion of clinical approaches described by Dr. Diane Ehrensaft on National Public Radio, “If we allow people to unfold and give them the freedom to be who they really are, we engender health. And if we try and constrict it, or bend the twig, we engender poor mental health.”

There was a protest held at the APA's 2009 General Meeting this month. Below is the  a video of a speech by Madeline Deutsch, MD to the crowd of about 150 protestors outside the meeting in SanFrancisco. (The Dr. Zucker she references -- negatively-- in her speech several times is the Psychologist-in-Chief and Head of the Gender Identity Service in the Child, Youth, and Family Program of the Centre for Addiction and Mental Health . He is also a Professor with the Departments of Psychiatry and Psychology at the University of Toronto. He also bears a striking resemblance to the character in the editorial cartoon above who is closing the book.....)