Monday, May 19, 2008

Why Kenneth J. Zucker Should Resign as Sexual and Gender Identity Disorders Chair


Dr. Shelley Janiczek Woodson notes:

Why Kenneth J. Zucker Should Resign as Sexual and Gender Identity Disorders Chair
By Shelley Janiczek Woodson, Ph.D.

The American Psychiatric Association (APA) recently announced the names of members of work groups who will review information to be used in the development of the fifth edition of the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM-V).  Kenneth J. Zucker, Ph.D. was appointed Sexual and Gender Identity Disorders Chair. Dr. Zucker is best known for his work in “treating” hundreds of gender-variant children with “reparative therapy,” a “curative” approach to Gender Identity Disorder that is variously considered to be treatment of choice, ill advised or tantamount to child abuse by professionals in the mental health and human service fields. 

How was Dr. Zucker chosen for this position?  According to APA President Carolyn B. Robinowitz, M.D., “The work group members were chosen for their expertise in research and clinical care.” By these criteria, Dr. Zucker is a good choice.  While I strongly disagree with a number of conclusions Dr.  Zucker draws from his research data, and I contend that the phrases “reparative therapy” and “clinical care” do not belong in the same sentence, I think it illogical to conclude that Dr. Zucker is not an expert in the field of disorders of gender identity.  He is an expert insomuch as he possesses special skills and knowledge in the area, acquired from training and experience. 

It is notable that ethical qualities and expertise are separate issues.  Recall that in 1946, twenty-three German physicians were prosecuted for participating in war crimes and crimes against humanity.  These doctors used their expertise to conduct experiments on prisoners without their consent, and to design and execute a “Euthanasia” Program, systematically killing people they believed to be “unworthy of life.” At the time, these physicians were considered to be leaders in their field, experts.

My position regarding the appointment of Dr. Zucker is that, even though he is a well-known expert in the field of disorders of gender identity, he should recuse himself from participating as a work group or task force member.  To put it simply, he should recuse himself because he has a dog in the fight. 
The APA reports having made a significant effort to avoid conflicts of interest in the development of DSM-V.  For example, all work group and task force members were required to disclose any relationships they may have with people or organizations that have an interest in psychiatric diagnoses and treatments. “We have made every effort to ensure that DSM-V will be based on the best and latest scientific research, and to eliminate conflicts of interest in its development,” explained Dr. Robinowitz.

In fairness, it could be argued that any mental health professional working with and/or studying transgender people has some inherent level of conflict of interest in the revision or elimination of the controversial diagnosis of Gender Identity Disorder.  I, for example, am a bisexual psychologist who specializes in transgender issues; I am married to a transgender person.  The difference between a psychologist like myself and Dr. Zucker is that I do not have a vested professional and financial interest in recommending the continued pathologizing of transgender people through the DSM system, nor do I have a vested interest in de-pathologizing transgender people for that matter.  My professional identity and my financial livelihood do not depend upon the continuation of this diagnosis.  For Dr. Zucker, there is a clear conflict of interest, exactly the sort of conflict of interest that the APA claims to have so diligently worked to avoid. 

Dr. Zucker has a dog in the fight.  And what a fight it is, with some psychologists and psychiatrists viewing gender identity disorders as serious mental illnesses and a growing number asserting that there is no disorder here at all, rather there is dis-ease with people who do not fit into an artificial binary gender system.  Add the voices of a large transgender community, and a fight for human rights waged against a very powerful organization might actually become a fair one. 

For his part, Dr. Zucker contends that “transexuality” is a “bad outcome.” He further warns parents of gender-variant children of the “relation between GID and a later homosexual sexual orientation.” For Dr. Zucker, homosexuality is yet another “bad outcome.” I assert that, if one is in the business of “curing” transgender people, and business is booming, then the removal of Gender Identity Disorder from the DSM is most certainly, for them, a very “bad outcome.” Dr. Zucker advises parents of gender-variant boys: “The Barbies have to go.” My advice to the APA: “Dr. Zucker has to go.”

This is talk, not advice. See Terms of Use for details.
Posted by Andrea James on 05/19 at 05:51 AM
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Friday, May 16, 2008

Update on the DSM-V Issue from Dr. Marshall Forstein


Via quench zine, Dr. Marshall Forstein notes:

Before people get overly hysterical about the Gender Identity Work group for the DSM, some things need to be made clear.

The letter you are asking us to sign onto is inaccurate in many ways and does not help our cause. Let me clarify what I know as someone who has worked with the American Psychiatric Association for many years.

1- there are TWO professional associations: Both unfortunately go by A P A

a) one is the American Psychiatric Association [this is a MEDICAL society of physicians who specialize in psychiatry]

b) the other is the American Psychological Association [this is a non- medical society of psychologists who are not medical doctors but have a PhD or PsyD or EdD in psychology, either clinical or research or academic or all.]

The American PSYCHIATRIC Association is the organization that publishes the DSM. This is a guide to diagnosis and NOT to Treatment.

Dr. Zucker, although not my preferred choice to head the work group on Gender and Sexuality, does not decide himself what the American Psychiatric Association publishes in the next DSM. In fact, there is a lengthy, and complicated process of peer review based on PUBLISHED scientific literature- in fact, the way we got homosexuality OUT of the DSM [1973] was to force the scientific program committee to produce evidence that homosexuality was an illness, and then in 1989 we removed ego-dystonic homosexuality because there was no evidence to support it and we suggested that there was also ego-dystonic heterosexuality that was a phase of people coming to understand their inner nature.

Sexual orientation is NOT even an issue for the DSM committee to consider. Transgender Identity is a bit more complicated, especially in childhood. The DSM work group will struggle with these issues in coming up with criteria for what to diagnose as a true gender identity disorder. I WANT TO EMPHASIZE THAT TREATMENT RECOMMENDATIONS ARE NOT A PART OF THIS ENDEAVOR.

Any treatment recommendations that the American Psychiatric Association makes are the result of significant process of creating EVIDENCED based research.

I am currently the Chair of the Work group on Practices Guidelines on HIV Psychiatry for the American Psychiatric Association, and so am intimately aware of the process. Guidelines go through rigorous research review for controlled studies in order to make recommendations. Hundreds of people review these guidelines before publication, and the same will be true of the criteria set forth by the work group on the DSM gender identity subcommittee.

EVEN if there is literature out there that disturbs those of us who are comfortable with the concepts of transgender identity, unless it meets peer review by legitimate journals ( i.e. non religious based periodicals) it will not be considered in the development of criteria for diagnosis or treatment.

I hope that what I have written makes us pause a bit before we do something to alienate even our supporters and friends in the American Psychiatric and the American Psychological Association who have been very pro-gay and pro-trans in their deliberations so far. There will always be a vocal minority that claim otherwise, but the process is vetted by many people committed to scientific integrity and evidence.

I have alerted the Association of Gay and Lesbian Psychiatrists to the announcement of Dr Zucker’s appointment and we will be addressing the implications of this within the psychiatric and psychological professional groups. I will also be talking with the Medical Director of the American Psychiatric Association and the Director of the Research group that oversees the DSM to convey the concerns that people have about the “transphobia” that may emerge.

In good conscience, however, I cannot sign a petition that is inaccurate and misleading - it may do far more harm than good. Clarity of the scientific evidence, asking the right questions of the committee, and addressing the criteria that will be put forth for review before it is ever considered ready for publication is the only way we will be taken seriously.

Please let me know how I can help to keep the issues clear.
Marshall Forstein, M.D.
Associate Professor of Psychiatry
Harvard Medical School Director, Adult Psychiatry Residency Training
The Cambridge Hospital
The Cambridge Health Alliance

Thanks to quench zine for publishing this.

This is talk, not advice. See Terms of Use for details.
Posted by Andrea James on 05/16 at 11:27 AM
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CAMH Clarke Institute to control funding for trans health services again


Looks as if 8 to 10 people in Ontario willing to subject themselves to CAMH Clarke Institute’s onerous and humiliating “gender program” will be able to qualify for subsidized services. From the article:

[Health Minister George] Smitherman says people wanting the procedures must first go through “very, very sustained psychological evaluations” and must get approval from the Centres for Addiction and Mental Health.

A Toronto Star article indicated that between 1969 and 1984, 90% of all people seeking transsexual health services (over 900 people) were turned away at The Clarke. (Newbery 1984) This created a system where applicants must compete to be the most suitable clients in the eyes of the gatekeepers. This allowed the gatekeepers to choose people who best exemplified their pet theories about “male gender dysphorics, paedophiles, and fetishists,” as the current key gatekeeper Ray Blanchard describes them. (Freund & Blanchard, 1993) As with any parole board situation like this, patients do everything they can to provide the evaluators with the answers they want to hear, which has led CAMH Clarke Institute employee Maxine Petersen to assert that “most gender patients lie.” (Bailey 2003)

“Evaluations” in the past at CAMH Clarke Institute have included penile plethysmography, a controversial lie detector for the genitals that measures intensity of erections. The device was developed to catch draftees who were lying about being gay to avoid conscription and is mainly used on sex offenders today.

Blanchard has stated that a trans woman who goes through their program, such as CAMH Clarke Institute employee Maxine Petersen, is in reality “a man without a penis.” (Armstrong 2004)

Most people seeking trans health services in Ontario choose better options such as Sherbourne Health Center or the youth-focused program at the 519, Trans Youth Toronto. See the Ottawa Transition Support site for other good alternatives to CAMH Clarke Institute.


Armstrong J. The Body within, the body without. Globe and Mail, 12 June 2004, p. F1.

Bailey JM. The Man Who Would Be Queen, p. 172

Freund K, Blanchard R. Erotic target location errors in male gender dysphorics, paedophiles, and fetishists. Br J Psychiatry 1993 Apr;162:558-63

Newbery L. Trans-sexuals happier after operation, MD says. Toronto Star, 27 November 1984, p. H2.


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Posted by Andrea James on 05/16 at 07:11 AM
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Thursday, May 15, 2008

Current TV: Silent T Party


Parisa Vahdatinia notes:

I’d like to share with you a video we just posted on that recounts the story of Kalil Cohen’s experience of being transgender in the LGBT community of LA and active involvement with ENDA. The video discusses the drawbacks of ENDA and lifestyle choices that Kalil must make in order to be accepted into the workplace.

Check it out:

Feel free to link or embed the video in your site and share it with your readers. Leave us a comment; we always love to hear the opinions of active voices in the LGBT community. Please let me know if you do use our video or any of our content you may find engaging.


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Posted by Andrea James on 05/15 at 09:30 AM
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Ray “man without a penis” Blanchard: I am not transphobic


Wow, that headline sounds like a personal attack, right? Pretty insulting, huh? Well, that exactly what Ray Blanchard said about me and women like me. But it’s OK, he’s a scientist.

Blanchard has the temerity to claim he is not transphobic and does not engage in attempts to modify people’s gender identity and expression or sexual behavior through coercive therapies, including aversion therapy and other techniques.

Maxine Petersen recently forwarded an email from Ray Blanchard defending his views. I’ll be dismantling his specious defense eventually, but a reader noted that Petersen (Blanchard’s coworker at CAMH) conveniently provided Blanchard’s CC list:

• Shelley McMain:  CAMH Clinical Psychologist and Head of the Borderline Personality Clinic of the Addictions Section in the Clinical Research Department.

Ken Zucker: CAMH reparative therapist who uses coercion therapy to deprive children of innappropriately-gendered toys and activities they love.

• Michael Torres: CAMH media relations spokesperson

Maxine Petersen: Bailey‘s “ace gender clinician” at CAMH who asserts “most gender patients lie.” A key proponent of the “male essence” narrative put forth by Blanchard et al. about “male gender dysphorics, paedophiles, and fetishists.”

Alice Dreger: J. Michael Bailey defender, currently part-time at Northwestern University, who will undoubtedly be defending the other CAMH Clarke cronies.

• Jack Drescher: Reparative therapy critic, ran for APA president in 2005, openly gay, member of the APA DSM-V committee Zucker chairs.

• press @ American Psychiatric Association media relations

• William Narrow: DC psychiatrist, associate director for diagnosis and classification in the APA Division of Research, will serve as the research director of the DSM-V revision.

It seems they understand they are facing a little public relations problem over at Jurassic Clarke. This list is mostly official and unofficial flacks for their reparative therapy clinic. Oh, and just for the record, Blanchard does support all kinds of reparative therapy to modify the behavior of “male gender dysphorics, paedophiles, and fetishists” (Blanchard 1993).

In Blanchard’s worldview, transsexual women are males whose condition is on a continuum with the other groups he studies: “Male gender dysphorics, paedophiles, and fetishists” are all part of the same nosological group in his worldview. (Blanchard 1993)

As for this post’s headline, I refer to Blanchard’s statement that a trans woman is in reality “a man without a penis”:

Toronto psychologist Ray Blanchard, one of Canada’s leading—and most controversial—gender experts, argues the transgender movement is rife with delusion. “This is not waving a magic wand and a man becomes a woman and vice versa,” he says. “It’s something that has to be taken very seriously. A man without a penis has certain disadvantages in this world, and this is in reality what you’re creating.” (Armstrong 2004)

If that ain’t transphobic and bigoted reductionism, I don’t know what is. More classic Blanchard quotes about his aversion therapies and other outrageous views soon.


Armstrong J. The Body within, the body without. Globe and Mail, 12 June 2004, p. F1.

Erotic target location errors in male gender dysphorics, paedophiles, and fetishists. Freund K, Blanchard R, Br J Psychiatry 1993 Apr;162:558-63


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Posted by Andrea James on 05/15 at 08:10 AM
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