Transsexual Road Map Notes

Wednesday, June 22, 2011

“DSD” supporters on track to get intersex listed among DSM-V’s disorders

Anne Tamar-Mattis, an intersex activist with Advocates for Informed Choice, has embraced the problematic concept of DSD (Disorders of Sex Development). She has just published a piece in which she seems surprised that this short-sighted choice is about to usher in a new era of repathologization of the people her organization serves. She notes:

I am very concerned about the move to classify people with intersex conditions who reject their gender assignment as a subtype of the gender dysphoria diagnosis.

http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=5406&blogid=140&utm

For years, many of us have pointed out that Gender Identity Disorder (GID) and Disorders of Sex Development (DSD) are merely variations on a theme. Both turn traits into diseases. DSD is especially problematic because it conflates issues of function with issues of cosmesis, and it categorizes a wide range of naturally-occurring traits (even those not requiring medical intervention) as diseases to treat. DSD is a dangerous setback that erases decades of hard-earned rights and sets the stage for radical “cures,” including reparative therapy already used on trans youth, and in utero “solutions” that identify those who are “disordered” so they can be dealt with accordingly.

A commenter identified as a member of Organisation Intersex International sums up the contradiction perfectly:

With respect this contributor fails to see her own part in this. Calling Intersex people disordered and using pathologizing language is at the heart of the need to further pathologize us when we reject our birth assignments.

We not only do not have a gender identity disorder we likewise do not have a condition or a disorder of sexual development. We have anatomical differences that society finds so reprehensible the only acceptable explanation is a disease model. Your language is as problematic as that proposed by the writers of the DSM who incomprehensibly thought gender identity disorder was too stigmatising yet thought nothing of calling Intersex disorder of sex development. Recall the DSD terminology was invented by physicians who then and now seek to patrol the edges of human sex expression both physical and behavioural by categorising acceptable and unacceptable bodies and rectifying them to normalcy when they are thought to break those boundaries. The medical diagnose for Intersex is as stigmatising for us as the mental “condition” of GID is for Trans.

All pathologizing of difference is stigmatising and when used to describe people who have no illness , disease or reason for medical interventions save for societies discomfort with our bodies it is insultingly so.
In Australia we are able to have our cardinal documents changed in three states, on the basis of a mistaken assignment at the time of birth, simply by producing evidence of our intersex. Every country in the world would do well to follow this example and further respect our rights by including us in anti-discrimination and human rights law.

The notion that bodies that are not clearly male or female are somehow diseased and must be made, so far as possible, to conform to one or the other of those two stereotypes has to be scotched once and for all.

Those who argue that DSD, GID, and other pathologizing conceptualizations of human diversity are necessary usually claim it assists in getting subsidized healthcare. Trading our basic human dignity in order to save money on healthcare is a devil’s bargain. Reclassifying intersex people as diseased because their initial sex assignment does not match their personal conception of themselves will be the legacy of separatists who claim that intersex and trans rights issues need to proceed on separate paths. Thanks to DSD, its short-sighted supporters are about to find themselves in the same political boat as trans people, and it’s their own doing.

Disorders of Sex Development
http://www.intersexualite.org/AliceDreger.html

Monday, June 20, 2011

British Psychological Society joins critics of proposed DSM-V revisions

Lynn Conway notes: Despite significant criticism, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders continues to move toward codifying dangerous concepts for sex and gender minorities. The British Psychological Society had just joined in criticizing the entire DSM as being based on unsound methods, and recommends sweeping changes in its formulation. In a 26-page document, they write:

As stated in our general comments, we are concerned that clients and the general public are negatively affected by the continued and continuous medicalisation of their natural and normal responses to their experiences; responses which undoubtedly have distressing consequences which demand helping responses, but which do not reflect illnesses so much as normal individual variation.
We believe that classifying these problems as ‘illnesses’ misses the relational context of problems and the undeniable social causation of many such problems. For psychologists, our well-being and mental health stem from our frameworks of understanding of the world, frameworks which are themselves the product of the experiences and learning through our lives.

Of particular concern to sex and gender minorities, they write of two specific “disorders”:

Gender dysphoria
Of particular concern are the subjective and socially normative aspects of sexual behaviour. We are very concerned at the inclusion of children and adolescents in this area. There is controversy in this particular area – the concept of a ‘diagnosis’ of a ‘psychiatric disorder’ disputed.
Labelling people who need help as ‘ill’ may make supportive and therapeutic responses more difficult.

Paraphilias

Again, of particular concern are the subjective and socially normative aspects of sexual behaviour. It is a matter of record that homosexuality used to be considered a symptom of illness. The Society would not be able to support considering sexual differences as symptoms of illness.
We, finally, have severe misgivings about the inclusion of “Paraphilic Coercive Disorder” in the appendix. Rape is a crime, not a disorder. Such behaviours can, of course, be understood, but we disagree that such a pattern of behaviour could be considered a disorder, and we would have grave concerns that such views may offer a spurious and unscientific defence to a rapist in a criminal trial.

If you’d like to comment on this fiasco, APA has extended time for commentaries to July 15, according to Vibe Grevsen at LGBT Danmark.

Further reading:
Response to the American Psychiatric Association: DSM-5 Development”
My comment on the DSM-V proposals
http://www.tsroadmap.com/notes/index.php/site/comments/my_comment_on_the_dsm_v_proposals/

Sunday, June 05, 2011

More European rights groups oppose “gender identity disorder” in DSM-V

Vibe Grevsen notes:

We in LGBT Denmark have noted your passionate fight for reforming the gender identity disorder diagnoses in the next revision of APA DSM and we would like to share our thoughts with you!

At a Danish transgender conference this March 14 a strong wish to remove the gender identity diagnoses was expressed by the participants and supported by the attending politicians, who did however not belong to government parties. We would like to submit the document as a joint statement to the APA from as many organisations and individuals as possible and kindly ask you to review it. please have a look at this paper regarding the Gender Identity diagnoses:

http://www.grevsen.dk/TS/SPGV.pdf

We are submitting the document as a joint statement to the American Psychiatric Association on June, 15 and urgently need as many organizations as possible to support it.

If your organization wants to be listed in the document please reply to this mail before June, 10 including

- Name of organization
- Postal address
- Web address
- Logo or logo URL
and member count if you wish

Individual co-signatories are accepted too.

Thank you very much!
Vibe Grevsen
vibe@lgbt.dk

In addition, Kim at Menschenrecht und Transsexualität in Germany notes:

We had been at the UN in may. The UN followed our argumentation that the legal situation in Germany (psychiatric tests who are widely based on “gender identity disorder” in Germany, too) is a discrimination against personal integrity.

Maybe you find that useful for your work? (Recommendation no26)

http://www.institut-fuer-menschenrechte.de/fileadmin/user_upload/PDF-Dateien/Pakte_Konventionen/ICESCR/icescr_state_report_germany_5_2008_cobs_2011_en.pdf

Our main argumentation: to ensure acceptance in society and medical care based on who you are, governments had to accept transsexual people as sexual variance and accordingly give us the freedom to choose gender-markers in offical documents independent from the necessity of fulfilling gender-stereotypes or medical requirements. These “official” acceptance will ensure our rights in health and society.

The result in the CESCR-process (recommendation no26 for Germany) is based on this document, too:
http://atme-ev.de/index.php?option=com_rubberdoc&view=doc&id=209&format=raw&Itemid=53

Best,

Kim
ATME e.V. Aktion Transsexualität und Menschenrecht - Germany
http://atme-ev.de

Wednesday, January 05, 2011

26 suicide prevention experts call for end to trans pathologization in DSM-5 by 2013

Lynn Conway notes:

“A panel of 26 leading researchers, clinicians, educators and policy experts have released a comprehensive report on the prevalence and underlying causes of suicidal behavior in lesbian, gay, bisexual and transgender adolescents and adults. The report will be published as the lead article in the January 2011 issue of the Journal of Homosexuality. The article is currently available online and will appear in print on Jan. 19.

Titled “Suicide and Suicide Risk in Lesbian, Gay, Bisexual and Transgender Populations: Review and Recommendations,” the report makes sweeping recommendations for closing knowledge gaps about suicidal behavior in LGBT people, and calls for making LGBT suicide prevention a national priority . . .

The consensus panel called for revision of diagnoses pertaining to transgender people in the 5th edition of the Diagnostic and Statistical Manual (due out in 2013) to affirm that gender identity, expression and behavior that differ from birth sex is not indicative of a mental disorder.

Other recommendations focus on improving information about LGBT people by measuring sexual orientation and gender identity in all national health surveys in which respondents’ privacy can be adequately protected, and encouraging researchers to include such measures in general population studies related to suicide and mental health.”

http://www.afsp.org/index.cfm?fuseaction=home.viewPage&page_ID=4D087E92-D94D-8D97-57BF6BA564D8BBA3

http://www.informaworld.com/smpp/section?content=a931819675&fulltext=713240928

Sunday, October 17, 2010

Ten Reasons Why the Transvestic Disorder Diagnosis in the DSM-5 Has Got to Go

The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders is shaping up to be a disaster for all trans people, but the diagnosis poised to cause the most harm is getting the least coverage and protest, probably because those diagnosed under it are the least political of all forms of cross-gender expression.

Kelly Winters notes:

While the diagnostic category of Gender Identity Disorder (GID) has garnered most of the controversy, a second category of so-called Transvestic Fetishism (TF) has harmed transwomen, including transsexual women, as well as male-to-female crossdressers, dual gender and gender nonconforming people since the earliest days of the DSM. Trans and LGB advocates have been inexplicably quiet about the TF category, even after the APA proposed to expand the category in the DSM-5, renamed Transvestic Disorder, to implicate gender nonconforming people of all sexes and all sexual orientations.

The proposed DSM-5 diagnosis of Transvestic Disorder, even worse than its predecessor Transvestic Fetishism, labels gender expression not stereotypically associated with assigned birth sex as inherently pathological and sexually deviant. The diagnosis is punitive and scientifically capricious, serving to punish social and sexual gender nonconformity and enforce binary stereotypes of assigned birth sex. Here are ten reasons why the Transvestic Disorder diagnosis should be eliminated entirely from the DSM-5.

Ten Reasons Why the Transvestic Disorder Diagnosis in the DSM-5 Has Got to Go
http://www.gidreform.org/blog2010Oct15.html