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New, New, NEW Gender DysphoriaTM! Completely repackaged! (Offer void where prohibited; children under 18 must have approval of parents. Offer cannot be combined with other offers such as Transvestic Disorder and Autogynephilia.)

(So in case you haven't heard, after years of strenuous work and lavish Big Pharma junkets, the American Psychiatric Association has officially decided to rename "Gender Identity Disorder" as "Gender Dysphoria".)

http://www.wisconsingazette.com/...

Advocates have spent years lobbying the American Psychiatric Association to rewrite or even remove categories typically used to diagnose transgender people, arguing that terms such as “Gender Identity Disorder” and “Transvestic Fetishism” promote discrimination by broad-brushing a diverse population with the stigma of mental illness.

“The label of mental defectiveness really places a burden on trans people to continually prove our competence in our affirmed roles,” Kelley Winters, a Colorado scholar who has helped lead the push for changes, said.

See  Third Swing: My Comments to the APA for a Less Harmful Gender Dysphoria Category in the DSM-5 for Kelley Winters' critique of the APA's relabeling game.

the proposed criteria are unreasonably reliant on gender stereotype nonconformity. Five of eight proposed subcriteria for children are strictly based on gender role nonconformity... Behaviors and emotions considered ordinary or even exemplary for other (cisgender) children are mis-characterized as pathological for gender variant youth. This sends a harmful message that equates gender variance with sickness. As a consequence, children will continue to be punished, shamed and harmed for nonconformity to assigned birth roles.
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Comment Preferences

  •  As I recall... (3+ / 0-)
    Recommended by:
    atana, 2thanks, rhubarb

    ...before it was called Gender Identity Disorder, it was called Gender Dysphoria.

    The dudes in charge of the DSM gender section want to maintain control of the children.  It's where they make their money.

    •  plus ça change... /nt (2+ / 0-)
      Recommended by:
      rserven, 2thanks
    •  As someone with ADHD (2+ / 0-)
      Recommended by:
      atana, rserven

      I sometimes sit and steam about the DSM, too. ADHD is a disorder only to the extent that it makes people fit in poorly in typical schools and jobs. I maintain that ADHD is adaptive and useful . . . merely a difference. I rather suspect that gender identity is somewhat the same deal. There must be a reason for the continuum of masculine to feminine identification. I know very few people who seem wholly one or the other. I know that it can be confusing and cause much "dysphoria" but is that a reason to pathologize it? The forthcoming DSM has more diagnoses than ever, which reeks, in my opinion. Not every variance from the typical is a disorder.

      Sometimes a .sig is just a .sig

      by rhubarb on Thu Jul 26, 2012 at 12:01:59 AM PDT

      [ Parent ]

      •  But ADHD is *extremely* lucrative (0+ / 0-)

        Big Pharma sucks in many billions of $ per year thanks to prescriptions of ADHA to children. The manufacturers of these drugs pay DSM committee members generous "consultants fees" and take them on extravagant vacations ("professional retreats").

        In short, they lobby the MDs and buy their support for broadened DSM diagnoses and therefore more drug sales.

        The American Psychiatric Association sells its "scientific" support to the highest corporate (or political) bidder.

    •  I was diagnosed as being Gender Dysphoric in 1977 (0+ / 0-)

      Quite possibly at that time the insurance companies had as yet added Gender Dysphoria to their list of non-covered "illnesses".

      This was very fortunate for me as my health insurance at that time considered the expenses for my treatment for doctor's visits, prescriptions, SRS and hospital expenses included under my coverage.

      I just wish that they would have covered electrolysis... ;)

      I like it when a flower or a little tuft of grass grows through a crack in the sidewalk. It's so fuckin' heroic. - Saint George Carlin

      by mzinformed on Tue Jul 31, 2012 at 06:50:58 PM PDT

      [ Parent ]

  •  The biggest problem with the DSM (2+ / 0-)
    Recommended by:
    rserven, atana

    is that it defines diseases/disorders on the basis of lists of alleged symptoms.  It's not just a problem in this instances, but across the board.

    In DSMIII+ even a perfectly healthy, happy, high-functioning individual can be defined as pathological if there's a symptom match.  This was an important shift between DSM II and DSM III, and its heart was in the right place -- psychiatrists wanted to wrestle power out of the hands of psychoanalysts, and to make diagnosis more "scientific" -- in short, they wanted to stake a claim for a set of agreed-upon standards of measurement, so that efficacy of treatment could be ascertained by objective measures.  Progressive psychiatrists and clinical psychologists were all for this, because it would force quacks and purveyors of outdated models (like Freudianism) to submit their work to the same sort of double-blind studies that less arcane researchers employed.

    But this all went to hell in the area of stress & personality disorders, which are virtually impossible to categorize on the basis of symptoms because the symptom set is so wide and variable and there's so much crossover between diagnoses.  The model of DSM III+ has been to sort patients into "categories": you're either Disordered (you fit into the category because you meet a certain set of standardized requirements/criteria), or you ain't.  And of course symptom lists are always influenced by social norms, so that people who don't feel "sick" are told they are sick, and treated like they're sick.  

    There's been some talk of replacing this categorical (operational) model with dimensional models -- those would admit the complexity of a patient's identity by scoring them on a wide range of measures, and viewing them as possessing more or less traits across a whole span of categories.  Unfortunately, these scales aren't very well developed in psychiatry, though there's a lot of ongoing research.  

    It's important to remember that diagnoses primarily exist for the convenience of clinicians, who need to make yes or no decisions about treatment (or, in the best case, who offer their clients information and make clear treatment options so clients can say yes or no).  Guidelines also benefit patients in many instances, by preventing doctors from using idiosyncratic treatments that aren't proven effective.  But these days, guidelines are inseparable from the insurance industry, as well.  For example, "elective" surgeries are almost never covered by insurance.  So, within this system, in order to cover surgery for trans individuals, they need to be defined as "sick."  So even medical professionals who do not personally see gender variance as any sort of illness will need to define it as such if their patients are going to be able to afford life-improving treatments. "Dysphoria" is seen as an improvement on "Disorder" by progressive physicians because "Dysphoria" implies a reaction to a condition, which will disappear when the condition changes (i.e., when the gender change is complete): it's a time-limited condition, not an illness.  "Disorder", on the other hand, says there's something inherently wrong with the person, and implies the need for a "cure."

    We need to radically restructure the mental health care system, and until then these minor upgrades are all we're going to get.

    "If you fake the funk, your nose will grow." -- Bootsy Collins

    by hepshiba on Thu Jul 26, 2012 at 03:52:50 AM PDT

    •  Most trans individuals in the US (0+ / 0-)

      have to pay out-of-pocket for all surgeries and treatments as I did, so this is not primarily an insurance issue in the US.

      "Diagnosis" is actually a strategy to protect surgeons against malpractice suits in a US legal and medical system hostile to gender transition. Many people have circumvented the DSM/SOC system by going outside the US for their surgeries -- particularly by going to Thailand.

      In fact, the old, punative "diagnostic" rules on access to hormones were relaxed solely because the Internet made access to hormones from offshore pharmacies easy -- something the AMA and Big Pharma are still trying to end, much as Hollywood is trying to end Internet file sharing. Similarly, what progress we have made politically has been because the Internet allowed us to organize in ways that were previously impossible. None of the progress, such as it has been, in gender rights has been a result of the medical or psychological professions: they have tried to block us every step of the way.

      The "minor upgrade" in DSM-V leaves children in the hands of the conversion therapists who run the DSM committees.

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