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.....)
Posted on
Thu, May 21, 2009
by B.J. Caldwell
filed under