DSM-5 Coming in 2013: "Gender Incongruence" Proposed to Replace "Gender Identity Disorder"
01/03/10 13:00 Filed in: GID
The diagnosis of mental disorders have very real and profound effects on the people who are diagnosed. The stigma that accompanies a psychiatric diagnosis has harmful effects on self-concept and wellbeing, civil liberties, access to healthcare, and can lead to denial of health care coverage for pre-existing conditions. (See more about stigma in Notes below). Persons who experience and express gender outside traditional cultural norms for their birth sex have been harmed by the DSM’s pathologizing diagnosis of Gender Identity Disorder and are advocating for reform. The issue of diagnosis is controversial among the trans community and healthcare professionals alike. Some advocate for the complete removal of any diagnosis related to gender expression on the basis that diversity in gender expression does not reflect an underlying mental disorder. Others do believe that experiencing and/or expressing gender outside traditional cultural norms for their birth sex reflects normal development gone awry. Still others believe that diagnosis plays an important role in recognizing the complex issues that gender identity issues can have on physical and mental health and accessing medically necessary healthcare. We need diagnostic language that preserves the dignity of the person, does not stigmatize, and supports access to needed healthcare.
In 1973, the Board of Directors of the American Psychiatric Society decided to remove homosexuality from it’s Diagnostic and Statistical Manual of Mental Disorders
where it was listed under the section “Sexual Deviations” as “Homosexuality” along with Fetishism, Pedophilia, Transvestism, Exhibitionism, Voyeurism, Sadism, and Masochism. Public Radio International aired a program “The story of how the American Psychiatric Association decided in 1973 that homosexuality was no longer a mental illness” today on This American Life, and its available for free now on iTunes.
The DSM-II text includes the following description of the category “Sexual Deviations”. As you read, think about how the pathologizing of gay men and women has contributed to stigmatization, institutional discrimination, and hate crimes in our culture to this very day, and consider how important DSM diagnosis reform is to trans children, teenagers and adults.
“This category is for individuals whose sexual interests are directed primarily toward objects other than people of the opposite sex,toward sexual acts not usually associated with coitus, or toward coitus performed under bizarre circumstances as in necrophilia, pedophilia, sexual sadism, and fetishism. Even though many find their practices distasteful, they remain unable to substitute normal sexual behavior for them. This diagnosis is not appropriate for individuals who per-form deviant sexual acts because normal sexual objects are not available to them.”
The American Psychiatric Association is preparing to publish the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013. As part of the revision process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are posted on the internet for public review and comment. These are initial drafts of the recommendations that have been made to date by the DSM-5 Work Groups. Viewers will be able to submit comments until April 20, 2010. Their website includes the DSM-5 proposed revisions to the GID diagnosis, in addition to the rationale for the proposed changes, an introduction of a severity rating, along with the current DSM-IV criteria for GID.
Review the proposed changes at the American Psychiatric Association’s website here: DSM-5 Development. Kelly Winters, a longtime advocate of reform of the existing DSM-IV criteria for GID, is the author of the website GID Reform Advocates. Her site contains a critique of the DSM’s current language and underlying attitudes toward diagnosis of persons who experience and express gender outside traditional cultural norms for their birth sex. She also has detailed information about the controversy within the trans community regarding, Kenneth Zucker PhD, the Chair of the DSM Sexual and Gender Identity Disorders Workgroup, the members of the Gender Identity Disorders Subcommittee.
Revised Diagnosis Proposed for the DSM-5
Gender Incongruence (in Adolescents or Adults)
A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2* or more of the following indicators:
1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics)
2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
3. a strong desire for the primary and/or secondary sex characteristics of the other gender
4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)
6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)
Subtypes
With a disorder of sex development
Without a disorder of sex development
What do you think about the pros and cons of the diagnosis “Gender Incongruence”? Do you have stories where diagnosis helped or harmed?
Thanks for visiting TransgenderSoul...
Rachael
NOTES:
*Erving Goffman in his book, Stigma: Notes on the Management of Spoiled Identity, reminds us that the term stigma was originated by the Greeks to refer to the bodily signs designed to expose something unusual or bad about the moral status of the signifier. The signs were cut or burnt into the body and advertised that the bearer was a slave, criminal, or traitor, a blemished person, ritually polluted, to be avoided especially in public places. The term stigma is then an attribute of a person that is deeply discrediting. A person with a stigma is reduced from a whole person to a deviant, to someone who cannot be trusted, someone dangerous, someone fundamentally tainted, a foreigner, an outsider
In 1973, the Board of Directors of the American Psychiatric Society decided to remove homosexuality from it’s Diagnostic and Statistical Manual of Mental Disorders
where it was listed under the section “Sexual Deviations” as “Homosexuality” along with Fetishism, Pedophilia, Transvestism, Exhibitionism, Voyeurism, Sadism, and Masochism. Public Radio International aired a program “The story of how the American Psychiatric Association decided in 1973 that homosexuality was no longer a mental illness” today on This American Life, and its available for free now on iTunes.
The DSM-II text includes the following description of the category “Sexual Deviations”. As you read, think about how the pathologizing of gay men and women has contributed to stigmatization, institutional discrimination, and hate crimes in our culture to this very day, and consider how important DSM diagnosis reform is to trans children, teenagers and adults.
“This category is for individuals whose sexual interests are directed primarily toward objects other than people of the opposite sex,toward sexual acts not usually associated with coitus, or toward coitus performed under bizarre circumstances as in necrophilia, pedophilia, sexual sadism, and fetishism. Even though many find their practices distasteful, they remain unable to substitute normal sexual behavior for them. This diagnosis is not appropriate for individuals who per-form deviant sexual acts because normal sexual objects are not available to them.”
The American Psychiatric Association is preparing to publish the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013. As part of the revision process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are posted on the internet for public review and comment. These are initial drafts of the recommendations that have been made to date by the DSM-5 Work Groups. Viewers will be able to submit comments until April 20, 2010. Their website includes the DSM-5 proposed revisions to the GID diagnosis, in addition to the rationale for the proposed changes, an introduction of a severity rating, along with the current DSM-IV criteria for GID.
Review the proposed changes at the American Psychiatric Association’s website here: DSM-5 Development. Kelly Winters, a longtime advocate of reform of the existing DSM-IV criteria for GID, is the author of the website GID Reform Advocates. Her site contains a critique of the DSM’s current language and underlying attitudes toward diagnosis of persons who experience and express gender outside traditional cultural norms for their birth sex. She also has detailed information about the controversy within the trans community regarding, Kenneth Zucker PhD, the Chair of the DSM Sexual and Gender Identity Disorders Workgroup, the members of the Gender Identity Disorders Subcommittee.
Revised Diagnosis Proposed for the DSM-5
Gender Incongruence (in Adolescents or Adults)
A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2* or more of the following indicators:
1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics)
2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
3. a strong desire for the primary and/or secondary sex characteristics of the other gender
4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)
6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)
Subtypes
With a disorder of sex development
Without a disorder of sex development
What do you think about the pros and cons of the diagnosis “Gender Incongruence”? Do you have stories where diagnosis helped or harmed?
Thanks for visiting TransgenderSoul...
Rachael
NOTES:
*Erving Goffman in his book, Stigma: Notes on the Management of Spoiled Identity, reminds us that the term stigma was originated by the Greeks to refer to the bodily signs designed to expose something unusual or bad about the moral status of the signifier. The signs were cut or burnt into the body and advertised that the bearer was a slave, criminal, or traitor, a blemished person, ritually polluted, to be avoided especially in public places. The term stigma is then an attribute of a person that is deeply discrediting. A person with a stigma is reduced from a whole person to a deviant, to someone who cannot be trusted, someone dangerous, someone fundamentally tainted, a foreigner, an outsider
0 Comments