Section Links:
- Introduction
- Gender Identity Disorder (GID) Criteria
- Research
- Problems with the removal of GID
- Sources
Introduction
"Gender Identity Disorder (GID) was entered into the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980, then called Transsexualism. The category was renamed Gender Identity Disorder in 1994 (sometimes called Gender Dysphoria). GID classifies transgenderism and all other atypical gender identities as a mental illness. Transvestic Fetishism (TF) is the diagnostic category in the DSM of cross-dressing, usually heterosexual, males. It is considered a sexual fetish and paraphilia. Depending on sources, it may or may not be portrayed as a potentially dangerous sexual deviancy that will escalate to violent behavior. Diagnosing atypical gender identity makes a statement that there is something inherently wrong with queer gender and it needs to be 'fixed.' GID is applied not only to adults but also to children and is often used as a method of anticipating homosexuality in adulthood. "Treatment" of gender-variant people is determined by the Harry Benjamin Standards of Care (commonly called The Standards of Care). These 'standards' limit people's freedom of choice and agency and are applied in heteronormative ways and pathologize normal behavior." (Stringer, 2007)
This is a brief overview of GID and the issues surrounding it. For more information, please visit the following links and resources:
ADVOCATING FOR GENDER IDENTITY
Gender Identity Disorder: What To Do?
Gender Identity Disorder (GID) Criteria
DSM-IV-TR: Gender Identity Disorder in Adolescents and Adults, 302.85 (Also Listed internationally as ICD – 10)
Section: Sexual and Gender Identity Disorders
SubSection: Gender Identity Disorders
- A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex). In adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction that he or she has the typical feelings and reactions of the other sex.
- Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex. In adolescents and adults, the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.
- The disturbance is not concurrent with a physical intersex condition.
- The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- Specify if (for sexually mature individuals) Sexually Attracted to Males, ... Females,... Both, ... Neither.
DSM-IV-TR: Gender Identity Disorder in Children, 302.6
Section: Sexual and Gender Identity Disorders
SubSection: Gender Identity Disorders
- In children, the disturbance is manifested by four (or more) of the following:
- repeatedly stated desire to be, or insistence that he or she is, the other sex
- in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing
- strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex
- intense desire to participate in the stereotypical games and pastimes of the other sex
- strong preferences for playmates of the other sex
- In children, the disturbance is manifested by any of the following:
- in boys, assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games and activities;
- in girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing.
- The disturbance is not concurrent with a physical intersex condition.
- The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if (for sexually mature individuals) Sexually Attracted to Males, ... Females,... Both, ... Neither.
DSM-IV-TR: Transvestic Fetishism, 302.3
Section: Sexual and Gender Identity Disorders
SubSection: Paraphilias
- Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.
- The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Specify if: With Gender Dysphoria: if the person has persistent discomfort with gender role or identity.
- Based off Societal Gender Expectations & Stereotypes
- Most children with GID do not grow up to become transgendered
- Diagnostic categories are over inclusive making classification complicated.
- Conflicting and ambiguous language make it easy to confuse cultural nonconformity with mental illness
- Reinforces false, negative stereotypes of gender variant people
- GID was entered into the DSM in 1980, 7 years after homosexuality was removed.
- Imposing Value Judgments: "Something is Wrong with You."
- Fails to legitimize the medical necessity of sex reassignment surgeries (SRS) and procedures
The premise that transgenderism is a mental illness is the same as the outdated notion that homosexuality is a mental illness.
“Under the premise of disordered gender identity, self-identified trans-women and trans-men lose any rightful claim to acceptance as women and men, but are reduced to mentally ill men and women respectively.” - Katherine Wilson
"The result is that a widening segment of gender non-conforming youth and adults are potentially subject to diagnosis of psychosexual disorder, stigma and loss of civil liberty." - Kelley Winters
Research
There are not scores of studies in this area. Some of the more prevalent research and writings include the following.
Harry Benjamin, The Transsexual Phenomenon (1966)
- Existence “psychological sex” as well as anatomical sex
- Suggests likelihood of biological causation
- Childhood conditioning and “possible imprinting”
- Describes trans-people as “miserable and maladjusted” as well as mentally ill
Ken Zucker, head of the Child and Adolescent Gender Identity Clinic at the University of Toronto's Clarke Institute of Psychiatry
- has done research where biologically male children with GID have some girlish physical features and biologically female children with GID have some boyish physical features.
- Introduces the idea that maybe transgenderism emerges because your physical features cause people treat you more like the 'other' sex.
- PROBLEMS
-
- Describing what is “girlish” or “boyish” is left to interpretation and also stereotyping.
- Discounts all of those children who do not look or have stereotypical physical aspects of, the opposite gender.
- Promotes stereotypical gender expectations
- Zucker is known for his "reparative therapy" for children diagnosed with GID
Richard Green, M.D., J.D. Sexologist specializing in homosexuality and gender variance and the founding president of the International Academy of Sex Research
- homosexuality and transgenderism have the same underlying biological causes, regardless of sexual orientation
Zhou, Hofman, Gooren and Swaab "A sex difference in the human brain and its relation to transsexuality" (1997)
- neurological difference of the BSTc (bed nucleus of the stria terminalis) volumes in the brains of transgendered people.
- A female-sized BSTc was found in male-to-female transsexuals.
- A female brain structure in genetically male transsexuals
- Supports the hypothesis that gender identity develops as a result of an interaction between the developing brain and sex hormones
- The size of the BSTc was not influenced by sex hormones in adulthood and was independent of sexual orientation
- PROBLEMS
- Small sample size
- no findings explaining the status of genetics, gonads, genitalia or hormone level of transgendered people
Problems with the removal of GID
- Deletion of GID from the DSM and ICD may cause problems with transition in relation to hormones and reassignment surgeries.
- May remove legitimacy of transgenderism
SOLUTION:
- If transgenderism is accepted as an innate state of being and classified as a physical condition, not a mental illness, transition methods can still be made available.
- More likely for insurance to cover transition, which is now very rare and very unlikely.
Sources
Adapted from a presentation created by JAC Stringer.
To schedule a presentation for a classroom/event please email us at info@genderqueercoalition.org.
Wilson, Katherine K., Hammond, Barbara E. Ph.D. Myth, Stereotype, and Cross-Gender Identity in the DSM-IV http://www.transgender.org/gidr/kwawp96.html Winters, Kelley, Ph.D. GID Reform Advocates Retrieved April 5th, 2006 from the World Wide Web: http://www.transgender.org/gidr/index.html Vitale, Anne PhD, January 27, 2003. The Gender Variant Phenomenon--A Developmental Review. Gender and Psychoanalysis, An Interdisciplinary Journal, Vol. 6 No. 2, Spring 2001, pp 121-141. GenderPsychology.org. 1998 to 2004. Gender identity disorder DSM-IV and ICD-10. Retrieved March 1st, 2006 from the World Wide Web: http://www.genderpsychology.org/transsexual/icd_10.html, http://www.tsroadmap.com/info/kenneth-zucker.html