While reading
Stryker's piece, the part about Gender Identity Disorder (GID) really resonated
with me. In the article, she defines it as "feelings of unhappiness or
distress about the incongruence between the gender-signifying parts of one's
body, one's gender identity, and one's social gender (a condition sometimes
called 'gender dysphoria')" She mentions in the piece that
"Generally, a person who wants to use hormones and surgery to change his
or her gender appearance, or who wants to change his or her legal bureaucratic
sex, has to be diagnosed with GID.”
This description
stuck with me as someone who is a psychology and women’s studies double major.
When learning about this disorder in abnormal psychology last year, I remember
feeling so awkward. Normally when something is not widely accepted or just not
PC, the professor will include it in the curriculum so that we know about it,
but also comment on the fact that it’s problematic. When we got to the GID
slide in class, the professor just discussed it at the same level of legitimacy
as the other sexual disorders (most of which are also problematic). My first
reaction was to cringe at labeling transgender as a mental illness, but it was
presented as truth. Now that I have done more research on the subject, I
understand where both sides are coming from.
Psychology thinks
that if they diagnose it, then insurance will pay for psychotherapy. The
insurance companies don’t, however pay for transition surgeries. In class I
learned that the recommended treatment for GID is surgical transition. Why
then, would this not be paid for like neurosurgery would be paid for in the
case of other types of mental illness? It seems like there isn’t much evidence
for why this is in the DSM IV as a disorder if the only reason it is in there
is to charge insurance companies that aren’t going to pay.
Is this
justification enough to label an entire community of people as diseased and
disordered? A good way to look at it is to compare it to homosexuality. Up
through the time of the DSM III (1980s) homosexuality was listed as a mental
illness. Today, it seems absurd that we would call it a mental illness. Maybe
in 40 years, we will be able to say the same thing about transgender or GID.
The writers
of the DSM V had a lot of pressure to eliminate this disease from the newest
edition of the book. They ultimately decided not to remove it entirely, but to
change it to Gender Dysphoria. They are very clear to point out that they don’t
want to stigmatize people with disorders. They also make it known that crossing
the lines of gender is not disordered. Only the feelings of dysphoria
associated with it are disordered. Something I have been thinking about is that
if people are being treated for the depressive symptoms that sometimes come
with transitioning, then why aren’t these people just treated for depression?
It is extremely common for people to seek counseling for minor bouts of
depression throughout their lives. Also, any client’s depression (or any other
mental illness) can be caused by societal or cultural influences or pressures.
By the DSM’s definition, being a woman is just as much of a diagnosable
disorder or cause for feelings of dysphoria as being transgender. If we start
looking at it more like homosexuality in its post DSM years, then we would see
that many people become depressed as a result of being homosexual in a heterosexist,
homophobic society, and by no means is this a reflection of their mental
health. Transgender people could move better through the mental health system
if they weren’t labeled with a diagnosis.
Many individual psychologists
understand this, or at least how harmful the stigma can be, and that treatment
gender dysphoria is not focused on fixing transgender people. I honestly
believe that generally, they treat clients with gender dysphoria no differently
than they would treat depressed women, women with eating disorders, or people
who are homosexual and depressed. Feelings of depression (or feelings at all)
in people who aren’t aligned as a masculine male who identifies as a man, and
is sexually attracted to women, are linked to gender and sexuality. That is
simply a part of being outside the norm. But this is all on the individual
level.
A discussion on morality in my
junior seminar lead me to begin believing that it is a lot harder for huge
structures and corporations to be moral, but the people working within those
structures are easily capable of being moral. The same goes for psychology. The
APA (American Psychological Association) is problematic in labeling sexual
disorders, but many individual psychologists reject that, and practice the way
that they see fit. Or they see the flaws in the APA system and use the DSM with
a grain of salt.
Attached below is a link to the DSM
V page about gender dysphoria. It explains thoroughly what the APA is trying to
accomplish by including it in the book. Whether we think that is a sufficient
definition is up for discussion, but I thought that at least I should let the
plead their case.
I also, included a poster from a protest of GID that has a website at the bottom. This could be an interesting source to pin against the DSM's defense of gender dysphoria because it protests GID. It would be interesting to see how the DSM answered the call for change in the DSM V, if they did at all.
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