April 5, 2012
Table of Contents
Diagnostic and Statistics Manual for Mental Disorders (DSM) 2-3 Problems with the Current Diagnostic Criteria for GID
Support of Keeping the GID Diagnosis in DSM-V
Therapists Role in Transgendered Issues
Although Gender Identity Disorder (GID) and homosexuality has been in the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) for many years, I was personally unaware of the controversy that surrounded it. I realized that I needed to educate myself in the issues and changes that have occurred in the DSM regarding GID and homosexuality over the years. The APA is in the process of revising its DSM and part of that process has been to create a Work Group on Sexual and Gender Identity Disorders (WGSGSID). The Work Group is one of 13 groups participating in the DSM-V revision process (Drescher, 2010). There has been a high level of concern from the lesbian, gay, bisexual, and transgender (LGBT) community in regards to the status of the category of GID in the DSM (Drescher, 2010). Activists argued that it is wrong to label expressions of gender variances as symptoms of a mental disorder. Advocates for the removal of the GID compare it to the removal of homosexuality in 1973 (Drescher, 2010). According to the World Professional Association for Transgender Health, people experiencing “strong cross-gender identification and a persistent discomfort with their sex or a sense of inappropriateness in the gender role of that sex” were diagnosed with transexualism in the DSM-III. In 1994, the DSM IV changed that diagnosis to GID. (Drescher, 2010). Removing GID from the DSM would be a major step in destigmatizing the lives of transgendered people, however it would come at a price and this will be reviewed in this paper. Individuals that identify as gay, lesbian, bi-sexual or transgendered do not believe that they have a disorder and are mentally ill. The inclusion of gender nonconformity among disorders creates stigma for transgendered individuals in society. In 1973, homosexuality was declassified in the DSM (second edition), however, transgender identity and expression still remains. In this paper I will discuss issues of gender identity, how they are defined in the DSM, and the controversy that surrounds them. History of Gender Identity Disorder (Transgender)
I’ve always learned that to understand the issues of today we must look at history. And so we don’t repeat the misfortunes of yesterday we must learn from them. So, for this section I have researched a brief history of Gender Identity Disorder and how it became a psychiatric classification.
Under diagnostic codes in the DSM, transvestic fetishism, formerly transvestism, (TF) means to wear the clothing of the opposite sex. This term was created and used by Magnus Hirshfeld in 1910. Transsexualism, also termed by Hirchfeld in 1923, first appeared in the DSM-III (1980) as a diagnostic category.
Currently in the DSM, heterosexual men can be diagnosed with TF if they meet only two criteria: they have sexual fantasies about cross-dressing and those fantasies cause “impairment in social, occupational, or other important areas.”
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) development timeline began almost ten years ago with a series of meetings and conferences that summarized the findings that had accumulated in the scientific literature since the publication of DSM-IV and then developed research agendas for DSM-5 (Narrow & Cohen-Kettenis, 2010). There are no restraints on the amount of change that can occur in formulating the DSM-5, provided that the changes are based on sound research findings and will enhance its clinical usefulness (Narrow & Cohen-Kettenis, 2010).
The DSM-5 Task Force is composed of...