http://www.transgendersoul.com/index.htmlHot News!enrachael.stclaire@me.comCopyright 2010 Rachael St.Claire2010-03-01T13:00:00-07:00 hourly 1 2000-01-01T12:00+00:00 Tue, 23 Feb 2010 01:00:07 -0700rachael.stclaire@me.comGID2010-03-01T13:00:00-07:00http://www.transgendersoul.com/page5/files/20c216ec00378f6562576a9fdd8305d2-1.html#unique-entry-id-1http://www.transgendersoul.com/page5/files/20c216ec00378f6562576a9fdd8305d2-1.html#unique-entry-id-1The 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






]]>rachael.stclaire@me.comTransgenderSoul Blog2010-02-23T13:00:00-07:00http://www.transgendersoul.com/page5/files/0abba47c84e5e073c27a899798a88b8f-0.html#unique-entry-id-0http://www.transgendersoul.com/page5/files/0abba47c84e5e073c27a899798a88b8f-0.html#unique-entry-id-0After almost 10 years publishing my website (www.transgenderSoul.com), I am transitioning my website to a fresh design using Rapid Weaver and re-investing my energy into providing a content rich website for transgender people, allies, and professionals seeking information about the psychology of transgender issues.

I am a psychologist not a website designer, so please bear with me as I switch over from old tired Windows FrontPage on my ancient PC Dell computer to fresh flexible Rapid Weaver on my iMac! I also moved my hosting service from a Windows platform to UNIX. The website is under construction so pardon my dust and the occasional missing link, link to nowhere, and random “Lorem ipsum dolor sit amet” dummy text.

I received my clinical psychology training from two universities, Ohio State University and Wright State University, with two different models for training clinical psychologists, the scientist-practicioner model and the practicioner-scholar model. I was trained to practice with patients using scientifically valid assessment and psychotherapy methods, tools, and techniques, to inform my patients of scientifically-based findings and approaches to their problems, to regularly stay up to date on recent research findings in the field and to evaluate the validity of clinical research as it applies to the practice of clinical psychology. Accessing and integrating scientific findings to inform healthcare decisions is an important tenet of practice that I will bring to the TransgenderSoul Blog

I will continue to focus on the psychology and mental health issues of people who identify as transgender, transsexual, and experience an incongruence between their physical birth sex and their gender identity, gender expression, and gender roles. I also have some ideas for new content that I hope will be valuable to the trans-community, including:

• educational resources for help along the journey to wholeness
• links to the best trans writing on the web
• reviews of scholarly articles and research, including those published by WPATH in the International Journal of Trangenderism
• news and developments within WPATH, especially those dealing with the Standards of Care
• new pages on workplace issues, including anti-discrimination law and gender transition in the workplace
• of course, listings of trans-affirming service providers in my hometown of Denver Colorado
• and a blog of commentary, opinion, and reporting on issues and events important to the trans community

Look for a new blog entry every Monday.

Until next time, be well, and thank you for visiting TransgenderSoul,

Rachael]]>