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Gender dysphoria replacing gender identity disorder in DSM

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Gender dysphoria replacing gender identity disorder in DSM

BY NATASHA BARSOTTI – The American Psychiatric Association (APA) will replace the term gender identity disorder in the upcoming fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), a move that activists have lobbied the APA to make for years, contending that that term characterizes transgender people as mentally ill.

Instead, the term gender dysphoria will be used to refer to people who experience "a marked incongruence between one's experienced/expressed gender and assigned gender," according to an Associated Press report.

"We know that there is a whole community of people out there who are not seeking medical attention and live between the two binary categories," psychiatrist Jack Drescher, an APA subcommittee member, said in the report. "We wanted to send the message that the therapist's job isn't to pathologize."

Retired surgeon Dana Beyer also told AP that shifting the emphasis from a disorder that "by definition all transgender people possess to a temporary mental state that only some might possess" signals real progress. "A rightwinger can't go out and say all trans people are mentally ill, because if you are not dysphoric, that can't be diagnosed from afar."

Like gay people before them, transgender people have seen APA language applied to their disadvantage. 

According to AP, advocate Kelley Winters, who was among those who helped push for the change, also notes that the "disordered" label saddles transgender people with the burden of proving their competence.

But for some, the change in terminology is a catch-22 of sorts. While a person's gender identity could conceivably no longer be used against them in court proceedings (for example, having children taken away because of a diagnosis of mental illness), trans people could also face the loss of insurance benefits that cover hormone treatments and gender reassigment surgery.

Shannon Minter, legal director of the National Center for Lesbian Rights, notes that while the gender identity disorder diagnosis has been used against trans people, it has also been of benefit to others. 

"We rely on it even in employment discrimination cases to explain to courts that a person is not just making some superficial choice . . . that this is a very deep-seated condition recognized by the medical community."

In tandem with lobbying for use of less loaded terminology, activists and mental health professionals are pushing for a revision of symptoms so that a diagnosis isn't applied to people whose anxiety or discomfort derives from prejudice, to adults who have transitioned successfully, or to children based on gender stereotypes.

Homosexuality was diagnosed in the DSM as an illness until 1973, but it took another 14 years to remove the conditions related to homosexuality from the manual.



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Is this another example of
Is this another example of politics meddling with the truth?
We should take a moment and
We should take a moment and celebrate what is a big moment in LGBT history. However, with rampant depression, homelessness, addiction and overall poor health prevalent in the transgender community, we cannot celebrate but so much.

People are making more of
People are making more of this than it is. The change is merely cosmetic: whether as gender dysphoria or gender identity disorder, it will still be in the DSM, thus categorizing it as a mental illness, and will still be classified under a sexual and gender disorder heading. It's an improvement, but it certainly doesn't fix everything.

This report is accurate in that there can be negative consequences for total removal, though. There is a medical process for transsexed people, and where medical access and coverage exists, it's usually dependent on the diagnosis.

Kelley Winters (thanks for quoting her) is an excellent resource in understanding what is needed for a harm-reduction model: http://www.gidreform.org/

But I do want to caution folks who are thinking that everything's resolved, that there's still more that needs to be done, and needs to be navigated carefully.
It was about time.
It was about time. Classifying trans folks as 'mentally ill' is not based on the reality of their situation and does more harm than good. Indeed it's almost exclusively because of the prejudice and discrimination that most trans people face on a daily basis that they experience anxiety and depression, and some are forced into isolation. The depression caused by gender incongruity can be adressed by successfully going through the transition process.
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