APA Selects Group Members to Revise Transgender/Transsexual in DSM-V
And they’ve picked some real doozies. From the Bilerico Project:
Editors’ note: Frequent guest blogger Mercedes Allen looks at who’s in charge of deciding the fate of Gender Identity Disorder in the DSM-IV.
A short time ago, I’d discussed the movement to have “Gender Identity Disorder” (GID, a.k.a. “Gender Dysphoria”) removed from the DSM-IV or reclassified, and how we needed to work to ensure that any such change was an improvement on the existing model, rather than a scrapping or savaging of it.Lynn Conway reports that on May 1st, 2008, the American Psychiatric Association named its work group members appointed to revise the Manual for Diagnosis of Mental Disorders in preparation for the DSM-V. Such a revision would include the entry for GID.
On the Task Force, named as Sexual and Gender Identity Disorders Chair, we find Dr. Kenneth Zucker, from Toronto’s infamous Centre for Addictions and Mental Health (CAMH, formerly the Clarke Institute). Dr. Zucker is infamous for utilizing reparative (i.e. “ex-gay”) therapy to “cure” gender-variant children. Named to his work group, we find Zucker’s mentor, Dr. Ray Blanchard, Head of Clinical Sexology Services at CAMH and creator of the theory of autogynephilia, categorized as a paraphilia and defined as “a man’s paraphilic tendency to be sexually aroused by the thought or image of himself as a woman.”
Drs. Blanchard, Zucker, J. Michael Bailey (whose work has even gone so far as to touch on eugenics) and a small cadre of others are proponents of dividing the transsexual population by sexual orientation (”homosexual transsexuals” vs. “autogynephilic”) and have repeatedly run afoul of the World Professional Association for Transgender Health (WPATH, formerly HBIGDA), and openly defied the Standards of Care that WPATH maintains (modeled after the original SoC developed by Dr. Harry Benjamin) in favor of conversion techniques. Blanchard and Bailey supporters also include Dr. Alice Dreger, who re-stigmatized treatment of intersex, controversial sexologist Dr. Anne Lawrence, and Dr. Paul McHugh, who had set out in the begining of his career to close the Gender Clinic at Johns Hopkins University and has been one of our most vocal detractors.
An additional danger that gay and lesbian communities need to be cognizant of is that if Zucker and company entrench conversion therapy in the DSM-V, then it is a clear, dangerous step toward also legitimizing ex-gay therapy and re-stigmatizing homosexuality.
Big warning signs, yeah.
Mercedes also added contact info for the APA to object to this mishandling:
The APA press release states that for further information regarding this, to contact Rhondalee Dean-Royce (rroyce@psych.org) and Sharon Reis (sreis@gymr.com), though it’s possible that they may govern the press release only, rather than have any involvement in the decision to appoint Zucker. The APA itself is headquartered at 1000 Wilson Boulevard, Suite 1825, Arlington VA, 22209. Their Annual General Meeting is currently being held (May 3-8, 2008) in Washington, DC.
I’m poorly situated (Western Canada, with no travel budget) to lead the drive for this, which I see as a very serious danger to the transgender community. So I am calling on the various Transgender and GLBT organizations to band together to take action on this, and will assist in whatever way that I and AlbertaTrans can.
I am also calling upon our allies and advocates in the medical community and affiliated with WPATH to band together with us and combat this move which could potentially see WPATH stripped of its authority on matters regarding treatment of transsexuals.
May 5, 2008 at 8:02 pm
What, Jerry Springer wasn’t available?
I really hope there’s something that can be done about this.
They don’t fucking get it, do they? It’s not the future of a diagnosis category. It’s the future of *people*.
May 5, 2008 at 8:09 pm
I find it peculiar that the APA would pick those who are known to be controversial in the field for their supposed insight and “science”, rather than picking people with firsthand knowledge of what the community wants and needs.
It is as dubious as picking Scientologists to preside in a psychiatrics convention, and makes about as much sense.
Does someone in the APA have an axe to grind here?
May 5, 2008 at 9:25 pm
[...] 2) Via Mercedes Allen : Dented Blue Mercedes & cross posted to The Belerico Project & Questioning Transphobia [...]
May 6, 2008 at 5:51 am
[...] Story origionally seen at Questioning Transphobia. [...]
May 6, 2008 at 7:34 am
Jerry Springer would be a damn sight better than Zucker and Blanchard. I’d rather have a fucking ringmaster running the show than a “reparative therapist” who confuses denial with a cure.
May 7, 2008 at 9:40 pm
Someone who’s got a bit more information might want to contact the Task Force (http://www.thetaskforce.org). They strongly opposed the HRC’s sellout on an inclusive ENDA and generally seem far more supportive of transgender rights, not to mention the fact that anyone who is LGBT has reason to worry about Zucker & Blanchard influencing the DSM.
May 7, 2008 at 9:40 pm
Err, “a bit more information than I have”.
May 8, 2008 at 9:36 pm
Don’t forget that, beyond all of the other controversy he’s known for, J. Micheal Bailey has also said that he basically doesn’t believe women have a real sexual preference and that their entire sexuality is more or less dictated to them by the culture at large. Lesbians have a lot to be afraid of from him, as well.
May 9, 2008 at 12:26 pm
We gotta get trans men and transmasculine folk talking about this as well. I’m trying.
May 20, 2008 at 5:32 pm
Ahem. Correct me if I’m wrong, but you (American transsexuals, “you”) have fought long and hard to get transsexuality recognised as a disorder in need of a cure (even as your gay and lesbian peers were fighting their way out of the DSM). You totally surrendered your fate at the hands of your doctors. You have succeeded in convincing the world that you are poor delusional invalids, so now you have no credibility, you cannot be trusted and you are completely inconsequential. Of course they won’t let you decide what treatment is best for you!
You screwed up, din’you?
May 20, 2008 at 8:44 pm
Even if your interpretation is true, then what would you have everyone do? Cry over spilt milk or do something about it?
May 22, 2008 at 1:44 pm
Not knowing very much about this topic, or even about Jerry Springer, I would like to stick up for Springer. From listening to him from time to time on the radio, and knowing his personal history, I suspect he would be a very good reviewer, with the only problem seeing as he is not a psychiatrist.
I wish you well, there is a syndrome I would very much like to see fairly reviewed for inclusion in the DSM-V, that would be PAS.
June 5, 2008 at 3:34 am
Stassa,
First, I (nor anyone of my generation or the generations most likely to be affected by this change, those just born in recent years) had anything to do with whether or not GID had a place in the DSM. As well, I doubt that “placing it in the hands of doctors” eliminates anyone’s voice; indeed, a cornerstone to any form of medical treament in either physiological or mental terms is the ability of the patient to consent if able. None of the diagnostic criteria ever formulated for GID has ever included the inability to consent to treatment (indeed, conditions that render the patient non-credible in determining the pace and form of treatment are contra-indicated by all diagnostic criteria internationally, since GID is largely self-diagnosed and the only differential diagnostic criteria to be done is by elimination of symptoms, not by observation of symptoms).
Finally, this is not about being angry at competent ethical doctors making decisions about revamping diagnostic criteria. This is about the formal selection of incompetent and unethical doctors for that purpose. Blaming TS’s in the US for this is like blaming someone for taking their car to a garage run by a trusted mechanic after their car is stolen from that garage and taken to a chop shop.
June 5, 2008 at 7:08 pm
You are missing my point completely. There is no such thing as GID. You’ve made it up. You, being the doctors and patients in the US and also probably the UK, but also, by now, most of the Western world. You made it up because you needed to justify to yourselves and to your societies, your very real need to modify your physique to approach that of your opposite biological sex and to live in the gender role you prefer.
I am not imagining some secret conspiracy behind closed doors. But I have read the very real accounts of many, many transwomen who had to “jump through the hoops” and “get past the gatekeepers”- and freely admit that they made it by lying about the way they felt and their personal histories. I posit that the current narrative of the gender dysphoric transsexual, whose eligibility for medical intervention is measured by their despair with living in the “wrong body” and desire to “make things right”, is the product of decades of just those lying-while-jumping-through-the-hoops acrobatics.
I see this as a vicious circle: the gatekeepers keep updating their views on transsexuality based on what their patients tell them to convince them they are really transsexual. The patients keep adjusting their personal histories to what they believe the doctors expect of them. And the result is the various definitions of GID in the DSMs, past and present. It is also the root of the problems you now have with the Zuckers and Blanchards and their cohorts. It is not going to go away while you cling on to the notion of transsexuality as a medical condition, a psychiatric disorder, a mental illness and so on.
It will only go away when you actively and proudly claim your right to choose your gender, not because you are ill and suffer, but because there is no harm that can come to your societies from your doing so and because it is your human right to fully express and develop your personality as an individual. That, of course, depends on the exact wording of the relevant rights by your national laws. Meanwhile, the right to gender self-identification and legal recognition is defined in the Principles of Yogyacarta, as Principle 3, the right to recognition before the law.
In other words, wake the fuck up and cut the crap short. You’re not sick, I’m not sick and if we keep telling ourselves and everyone that we are sick, they’ll treat us all out of existence.
June 9, 2008 at 3:17 pm
What I’d like is for there to be diagnostic categories that are viewed as indicating the need for treatment/accomodations but which are not actually ‘disorders’. For example, the way giftedness is seen by the more enlightened ones in the education system.
June 9, 2008 at 10:08 pm
Stassa,
I see your point of view, but to deny that the medical field has any responsibility in this is ludicrous. When my sister wanted to get gastric bypass surgery, she had to deal with ‘gatekeepers’ of her own, who were much more stringent in their requirements than mine. She had to have several referring doctors, they all had to issue opinions regarding her mental state, her physical state, her fitness for the procedure. She had to take blood tests, urine tests, several other tests and batteries to ensure that she indeed understood the full implications of her decision, and that she could survive the procedure.
And that’s just with a procedure that much of American society believes is beneficial to the long-term health of an individual. Imagine how it would be even if you removed psychologists from this when most of American society (I don’t know what it’s like in Europe, since I haven’t lived there for about 17 years now) frowns on SRS.
The reason there are so many practices and procedures in the way is simply because one chooses to have a procedure doesn’t mean that doctors are removed from liability; they create standards of care to balance the needs of the patient versus the liability of the doctor. There are many people who are schizophrenic, have Munchausens or other problems where if SRS and hormones were on demand, then there would be lawsuits flying left and right. I wonder what would happen to the already-small number of surgeons who ARE willing to do SRS, under those conditions.
Generally, however, I have a personal policy about ‘gatekeepers’. If I find someone I’m paying good money to help me is obstructing me, I find someone else. It’s not exactly like there’s a shortage of therapists where I live. If I go to a doctor who refuses to take my letter and write a script for any non-medical reason, I’ll go find a doctor who will.
Asserting your right to recognition isn’t something one can assume; it’s something everyone (TS or not) has to actively pursue.
(By the way, I find your language use to be a continuation of the stigmatization of those who need mental health assistance. My mother has PTSD from multiple rapes while serving in the military; she’s not SICK, but PTSD is in the DSM. Needing help doesn’t make you a freak, it means you need help. Your composition reflects a perspective of ableist privilege. Please consider how you use language.)
June 13, 2008 at 3:04 pm
I certainly don’t think the doctors are not responsible for pathologising transsexuality! As about my “right to recognition”, I assume you mean my right to have my gender identity recognised. This is part of a fundamental human right, that of liberty of expression and development of the personality. It’s not something I have to claim or pursue- rather, something I must safeguard.
That I and others in the same situation as me, because of our gender identity have to “jump through the hoops” and accept that our condition is termed a personality disorder in order to get proper medical care, is a crime, fair and square. The medical establishment is as guilty of it as we ourselves- of course, we’re the eternal victims who can only ever fight to be recognised as ill. But I’m certainly not leaving the doctors out of it.
Btw…
Are you even aware that you are using someone else’s language and speaking someone else’s words? If you really have an accusation to level at me, what’s more, if you really think that my post somehow disrespects your mother, whom I wouldn’t know was raped if you hadn’t told me, publicly, on the internet, if you have something, anything, to say, say it with your own words. The expression “ableist privilege” is not something I consider an accusation- it’s just political shiboleth and I don’t give a shit about it. Oh and, if you really cared that your mother was raped, you wouldn’t be bandying her PTSD around as an “argument” to shut me up. So, no, you consider your use of language.