LOS ANGELES — The American Psychiatric Association has eliminated
“gender identity disorder” from its Diagnostic and Statistical Manual of
Mental Disorders.
For decades, the manual has classified all transgender people as
having a mental disorder. The new DSM, which will be called the DSM-5,
has been revised to refer to “gender dysphoria,” specifically focusing
on people who feel “a persistent discomfort with gender role or
identity” and not including people who are content with being
transgender.
The APA board of trustees finalized the revision last month, but the
change went largely unnoticed while most headlines focused on the APA’s
controversial revisions to its policies regarding autism.
The elimination of the GID diagnosis will have far-reaching ramifications for many transgender people.
In addition to being the guide that mental health professionals use
to diagnose their patients, the DSM has been employed by insurance
companies and other organizations to set their policies regarding
transgender people.
Dr. Tanya Jacob, a Los Angeles psychologist with a specialty in LGBT
patients, is one of many mental health professionals praising the
change.
“I think that it’s a great sign that society is beginning to accept
the fact that a person’s gender does not always correlate naturally with
their biological sex,” Dr. Jacob told Phoenix Nation. “Much of
the so-called ‘dysphoria’ of a transgendered person is based off of
society, not necessarily themselves. Gender itself is a societal
construct, it’s an expression, and one that most people, transgendered
or not, don’t fall completely on either side of.”
The elimination of the GID diagnosis has not met with universal
approval from transgender rights advocates. The diagnosis of GID is used
to justify insurance coverage for gender reassignment surgery, hormone
treatments and other medical procedures related to gender transition.
Some transgender rights advocates fear that without the GID diagnosis,
insurance companies will class these procedures as cosmetic or elective
and deny coverage.
Other transgender rights advocates feel that the DSM revision doesn’t
go far enough. Kelley Winters, founder of the Gender Identity Disorder
Reform Advocates group, objects to the DSM-5 retaining the Transvestic
Disorder diagnosis in the sexual disorders chapter. Transvestic Disorder
covers people who experience psychological distress related to
cross-dressing.
“This punitive and scientifically capricious category maligns many
gender variant people,” Winters wrote on the group’s blog, “including
transsexual women and men, as mentally ill and sexually deviant, purely
on the basis of nonconforming gender expression.”
The APA did not declassify homosexuality as a mental disorder until
1973, and the change did much to increase the acceptance of gay people
worldwide.
Transgender advocates have been pushing for the elimination of GID
from the DSM for years. They finally saw some progress last summer, when
the APA released new health guidelines for transgender patients and a
new position statement supporting transgender care and civil rights,
citing the importance of protecting transgender people from “significant
discrimination, prejudice, and the potential for victimization from
violent hate crimes, as well as denial of many basic civil rights,
protections, and access to health care, to the severe detriment of their
mental health.”
The DSM-5 is due to go into effect this May.
(Original article posted here.)
