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MsLinus
05-06-2008, 06:36 PM
Hopefully this location in the forums makes sense. I just came across, via the EGALE (Canadian LGBTIQ mailing list/group), this message and was curious as to what others think (I'm quoting the message as I received it and she encourages to cross-post this to as many communities/forums as possible; I've also bolded a section of importance to some here):



A short time ago, I'd discussed the *movement to have "Gender Identity Disorder" (GID, a.k.a. "Gender Dysphoria") removed from the DSM-IV or reclassified* http://dentedbluemercedes.wordpress.com/2008/04/05/destigmatization-versus-coverage-and-access-the-medical-model-of-transsexuality/ ,
and how we needed to work to ensure that any such change was an improvement on the existing model, rather than a scrapping or savaging of it.

*Lynn Conway reports* http://ai.eecs.umich.edu/people/conway/TS/News/News.html#508 that on May 1st, 2008, the American Psychiatric Association *named its work group members appointed to revise the Manual for Diagnosis of Mental Disorders in preparation for the DSM-V* http://www.psych.org/MainMenu/Newsroom/NewsReleases/2008NewsReleases/dsmwg.aspx .
Such a revision would include the entry for GID.

On the Task Force, named as Sexual and Gender Identity Disorders *Chair*, we find *Dr. Kenneth Zucker* http://www.tsroadmap.com/info/kenneth-zucker.html ,
from Toronto's infamous *Centre for Addictions and Mental Health (CAMH, formerly the Clarke Institute)* http://www.tsroadmap.com/info/clarke-institute.html .
Dr. Zucker is infamous for *utilizing reparative (i.e. "ex-gay") therapy to "cure" gender-variant children* http://ai.eecs.umich.edu/people/conway/TS/News/Drop%20the%20Barbie.htm .
Named to his work group, we find Zucker's mentor, *Dr. Ray Blanchard* http://www.tsroadmap.com/info/ray-blanchard.html , Head of Clinical Sexology Services at CAMH and creator of the theory of *autogynephilia* http://www.tsroadmap.com/info/autogynephilia.html , categorized as a paraphilia and defined as "a man's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman."

Drs. Blanchard, Zucker, *J. Michael
Bailey* http://www.tsroadmap.com/info/j-michael-bailey.html (whose work has even gone so far as to touch on
*eugenics* http://ai.eecs.umich.edu/people/conway/TS/Bailey/Greenberg-Bailey/Homosexual%20Eugenics.pdf )
and
a small cadre of others are proponents of dividing the transsexual population by sexual orientation ("homosexual transsexuals"
vs. "autogynephilic") and have repeatedly run afoul of the *World Professional Association for Transgender Health (WPATH, formerly HBIGDA)* http://www.wpath.org/ , and openly defied the Standards of Care that WPATH maintains (modeled after the original SoC developed by Dr. Harry Benjamin) in favor of conversion techniques. Blanchard and Bailey supporters also include *Dr. Alice Dreger* http://www.tsroadmap.com/info/alice-dreger/alice-dreger.html ,who re-stigmatized treatment of intersex, controversial sexologist *Dr. Anne Lawrence* http://www.tsroadmap.com/info/anne-lawrence-experiences.html , and *Dr. Paul McHugh* http://www.tsroadmap.com/info/paul-mchugh.html , who had set out in the begining of his career to close the Gender Clinic at Johns Hopkins University and has been one of our most vocal detractors.

*An additional danger that gay and lesbian communities need to be cognizant of is that if Zucker and company entrench conversion therapy in the DSM-V, then it is a clear, dangerous step toward also legitimizing ex-gay therapy and re-stigmatizing homosexuality.*

I am not familiar with others named to the Work Group. It would be worthwhile looking into any history with WPATH that they might have, to know if we have any positive advocates on board, or just more stigmatizing adversarial clinicians. They may be appointed primarily to address other listings categorized as "Sexual and Gender Identity Disorders," I don't know. They are:

- Dr. Irving M. Binik, McGill University, Montreal, Canada
- Dr. Peggy T. Cohen-Kettenis, VU University Medical Center, Amsterdam

- Dr. Jack Drescher, New York Medical College, St. Luke's-Roosevelt Hospital Center, NY
- Dr. Cynthia Graham, Isis Education Centre, Warneford Hospital, Oxfordshire, UK
- Dr. Richard B. Krueger, NY State Psyciatric Institute and Columbia University, NY
- Dr. Niklas Langstrom, Karolinka Institutet, Stockholm, Sweden
- Dr. Heino F.L. Meyer-Bahlburg, Columbia University, NY
- Dr. Robert Taylor Segraves, MetroHealth Medical Center, Cleveland

The APA press release states that for further information regarding this, to contact Rhondalee Dean-Royce (*rroyce@psych.org* rroyce@psych.org ) and Sharon Reis (*sreis@gymr.com* sreis@gymr.com ), though it's possible that they may govern the press release only, rather than have any involvement in the decision to appoint Zucker. The *APA* http://www.psych.org/ itself is headquartered at 1000 Wilson Boulevard, Suite 1825, Arlington VA, 22209. Their Annual General Meeting is currently being held (May 3-8, 2008) in Washington, DC.

I'm poorly situated (Western Canada, with no travel budget) to lead the drive for this, which I see as a very serious danger to the transgender community. So I am calling on the various Transgender and GLBT organizations to band together to take action on this, and will assist in whatever way that I and *AlbertaTrans.org* http://www.albertatrans.org/ can.

I am also calling upon our allies and advocates in the medical community and affiliated with WPATH to band together with us and combat this move which could potentially see WPATH stripped of its authority on matters regarding treatment of transsexuals.
Mercedes Allen, May 5, 2008
Weblog: http://dentedbluemercedes.wordpress.com/
Alberta Transgender Resources: http://www.albertatrans.org/
Has anyone heard of the potential revisions??

unndunn
05-06-2008, 07:05 PM
Hopefully this location in the forums makes sense. I just came across, via the EGALE (Canadian LGBTIQ mailing list/group), this message and was curious as to what others think (I'm quoting the message as I received it and she encourages to cross-post this to as many communities/forums as possible; I've also bolded a section of importance to some here):

Has anyone heard of the potential revisions??

The DSM is pretty much always gearing up for revisions. I scanned over the info quoted in your OP and it surprised me. I don't have time tonight to really go through it, but in general the DSM has become more and more open minded re- sexuality and IDs. It would really surprise me if things turned in the other direction. I would suggest going directly to the APA site and reading the info there. Here are some links:
American Psychiatric Association (http://www.psych.org/)

http://www.psych.org/MainMenu/Newsroom/NewsReleases/2008NewsReleases/dsmwg.aspx (http://www.psych.org/MainMenu/Newsroom/NewsReleases/2008NewsReleases/dsmwg.aspx)

I know several of the Yale folks who have been appointed to other work groups and they are highly respected in their field(s). Unfortunately I don't know any of the members of the sexual identity work group.


Unn/clinical nurse specialist in psych for 20 years

iamkeri1
05-06-2008, 07:06 PM
I can't answer your question about the DSMIV. I thing gender disphoria or any reference to trans issuea should be removed altogether since I see them as birth defects rather than mental illness. Why a perfectly sane person has to go to a psychologist and get a diagnosis prior to surgery, I don't understand, and have never understood.

A child born without an arm or a jawbone does not have to go through psychological therapy prior to surgical correction and I don't think that someone born without the sexual organs of their choice should have to do it either.

I acknowledge the difficulty of the transition (if one chooses transition) and therapy should be available upon request. but to be forced to participate as a basis for SRS makes no sense. Why would you perform surgery on someone you just diagnosed as crazy? The whole process is crazy, but in 99.9 percent of the cases the person seeking the SRS is NOT crazy...they just have to say they are to get the surgery they need.

Also, If Gender Disphoria were seen as a birth defect, repairing it would have to be covered by health insurance plans.
Keri

D-Man-Walking
05-06-2008, 07:07 PM
This is the first I've heard of it.

DapperButch
05-06-2008, 07:40 PM
The DSM is pretty much always gearing up for revisions. I scanned over the info quoted in your OP and it surprised me. I don't have time tonight to really go through it, but in general the DSM has become more and more open minded re- sexuality and IDs. Unn/clinical nurse specialist in psych for 20 years



Right. They are always revising and the DSM has become more open as time has gone on.


Having a gender identity diagnosis in the DSM is a double edged sword. On the one hand, having it listed as a diagnosis means that being transgendered is a "disorder". However, it is the fact that it is a "disorder" that some insurance companies (some Aetna contracts, for example), are beginning to pay for SRS surgery.

So, the question is...is it worth it to be seen as having a mental health diagnosis in order to get your surgeries paid for?

There was no downside to homosexuality being removed from the DSM long ago...but this one...

unndunn
05-06-2008, 08:23 PM
Having a gender identity diagnosis in the DSM is a double edged sword. On the one hand, having it listed as a diagnosis means that being transgendered is a "disorder". However, it is the fact that it is a "disorder" that some insurance companies (some Aetna contracts, for example), are beginning to pay for SRS surgery.

So, the question is...is it worth it to be seen as having a mental health diagnosis in order to get your surgeries paid for?

There was no downside to homosexuality being removed from the DSM long ago...but this one...

I think that's a great point and a really valid question. My guess would be that part of the problem is that the stigma of mental illness pervades every aspect of things that are included in the DSM. No one really complains (that I know of) about what is considered a medical diagnosis because it legitimizes what people are already experiencing. Fibromyalgia is a good example of that. However, when it comes to the DSM so many people look at it as black mark or a life sentence or something. When you really sit down and read it, with all of the preface info and introductions, it makes a lot of sense. Just because a condition/diagnosis/syndrome is in the DSM doesn't mean that it's just in your head or not real. A lot of psych. diagnoses are biologically based and more and more research is being done all the time. I'm tired and rambling so I should stop. But I would really encourage people to really take a look at it, and what is written about each condition that is listed. Read the fine print, read the intros, read the qualifiers and criteria and I think you'll find that it's not as bad as you think.

butchgorilla
05-07-2008, 12:05 PM
Yes, the DSM is always being revised, and I know that one of the diagnoses under fire is GID. I don't believe that it will be removed for the next revision - I just don't think we're there yet. Like someone else mentioned, it is a double-edged sword diagnosis. It does allow some folks to go through SRS and have insurance cover it. On the other hand, there are a lot of hoops that must be jumped through on the way, and it does put psychologists (I am one) in the position of gatekeeper - basically being able to decide to gets to go through and who can't. No, that's not right. I'm not necessarily against someone needing to go through therapy who is undergoing the process - it's not an easy journey and having another source of support is a good thing. However, I don't believe that the decision to transition should be anyone's but the individual. I'm not sure what the future of this diagnosis will be; will be interesting to see whether and how it is revised in the next edition.

There is no reason to fear that reparative therapy will someone get back into the mix. The American Psychological Association has taken a very firm stance against any sort of reparative therapy, so there is really no chance that will end up back in it.

At this point, anyone who is considering transitioning needs to find someone who is knowledgeable - a therapist I mean. Fortunately more of us are starting to specialize (I hope to have my own LGBT practice one of these days) so folks who actually have a clue about it are beginning to be around.

It makes no sense to me that I could have my chest enhanced, and could get a reduction to a point, but I can't get the surgery I want (double mastectomy). As I said, it does make sense to have supportive therapy throughout the process, and you need to be working with an endocrinologist for sure to make sure the hormones are safe for you. But hopefully one of these days the "gatekeeping" will go away, and we can elect to have the procedures we desire without having to obtain a diagnosis. Only time will tell.

butchgorilla
05-07-2008, 12:38 PM
Yes, the DSM is always being revised, and I know that one of the diagnoses under fire is GID. I don't believe that it will be removed for the next revision - I just don't think we're there yet. Like someone else mentioned, it is a double-edged sword diagnosis. It does allow some folks to go through SRS and have insurance cover it. On the other hand, there are a lot of hoops that must be jumped through on the way, and it does put psychologists (I am one) in the position of gatekeeper - basically being able to decide to gets to go through and who can't. No, that's not right. I'm not necessarily against someone needing to go through therapy who is undergoing the process - it's not an easy journey and having another source of support is a good thing. However, I don't believe that the decision to transition should be anyone's but the individual. I'm not sure what the future of this diagnosis will be; will be interesting to see whether and how it is revised in the next edition.

There is no reason to fear that reparative therapy will someone get back into the mix. The American Psychological Association has taken a very firm stance against any sort of reparative therapy, so there is really no chance that will end up back in it.

At this point, anyone who is considering transitioning needs to find someone who is knowledgeable - a therapist I mean. Fortunately more of us are starting to specialize (I hope to have my own LGBT practice one of these days) so folks who actually have a clue about it are beginning to be around.

It makes no sense to me that I could have my chest enhanced, and could get a reduction to a point, but I can't get the surgery I want (double mastectomy). As I said, it does make sense to have supportive therapy throughout the process, and you need to be working with an endocrinologist for sure to make sure the hormones are safe for you. But hopefully one of these days the "gatekeeping" will go away, and we can elect to have the procedures we desire without having to obtain a diagnosis. Only time will tell.

joectigger
05-09-2008, 05:49 PM
The APA has released a statement to activists who have emailed and called concerning the APA Diagnostic Statistical Manual. Activists have been very concerned over some people appointed to the committee who are very transphobic and who would likely keep the label "Gender Identity Disorder" even though moden research shows transgender people are just as healthy as everyone else in the population and are NOT disordered! The Gender Identity Disorders task force, is chaired by Peggy T. Cohen Kettenis, Ph.D. who is rumored to be TG friendly.

This being said our work is not done, Dr. Kenneth Zucker head of the entire Sexual and Gender Identity Disorders committee is very transphobic and believes in "reparative therapy" for transgender children.

"APA STATEMENT ON GID AND THE DSM

May 9, 2008

The American Psychiatric Association has received inquiries about the DSM-V process, particularly concerns raised about the Sexual and Gender Identity Disorders Work Group.

The APA has a long-standing mission to provide guidelines for the diagnosis and treatment of mental disorders, based on the most current clinical and scientific knowledge. Through advocacy and education of the public and policymakers, the APA also affirms it commitment to reducing stigma and discrimination.

The DSM addresses criteria for the diagnosis of mental disorders. The DSM does not provide treatment recommendations or guidelines. The APA is aware of the need for greater scientific and clinical consensus on the best treatments for individuals with Gender Identity Disorder (GID). Toward that end, the APA Board of Trustees voted to create a special APA Task Force to review the scientific and clinical literature on the treatment of GID. It is expected that members of the Task Force will be appointed shortly.

There are 13 DSM-V work groups. Collectively, the work group members will review all existing diagnostic categories in the current DSM. Each work group will be able to make proposals to revise existing diagnostic criteria, to consider new diagnostic categories, and to suggest deleting existing diagnostic categories.

All DSM-V work group proposals will be based on a careful, balanced review and analysis of the best clinical and scientific data. Evidence accumulated from work group members and hundreds of additional advisors to the DSM-V effort will be considered before final recommendations are made.

The Sexual and Gender Identity Disorders Work Group, chaired by Kenneth J. Zucker, Ph.D., will have 13 members who will form three subcommittees:

* Gender Identity Disorders, chaired by Peggy T. Cohen-Kettenis, Ph.D.
* Paraphilias, chaired by Ray Blanchard, Ph.D.
* Sexual Dysfunctions, chaired by R. Taylor Segraves, M.D., Ph.D.

Each subcommittee will pursue its own charge, provide ongoing peer review, and consult with outside experts. The DSM-V is expected to be published in 2012."
(This was a response given to Jessica L. off of Susans.org Forums)

http://queersunited.blogspot.com/2008/05/apa-has-released-statement-to-activists.html

unndunn
05-09-2008, 05:56 PM
The APA has released a statement to activists who have emailed and called concerning the APA Diagnostic Statistical Manual. Activists have been very concerned over some people appointed to the committee who are very transphobic and who would likely keep the label "Gender Identity Disorder" even though moden research shows transgender people are just as healthy as everyone else in the population and are NOT disordered! The Gender Identity Disorders task force, is chaired by Peggy T. Cohen Kettenis, Ph.D. who is rumored to be TG friendly.

This being said our work is not done, Dr. Kenneth Zucker head of the entire Sexual and Gender Identity Disorders committee is very transphobic and believes in "reparative therapy" for transgender children.

"APA STATEMENT ON GID AND THE DSM

May 9, 2008

The American Psychiatric Association has received inquiries about the DSM-V process, particularly concerns raised about the Sexual and Gender Identity Disorders Work Group.

The APA has a long-standing mission to provide guidelines for the diagnosis and treatment of mental disorders, based on the most current clinical and scientific knowledge. Through advocacy and education of the public and policymakers, the APA also affirms it commitment to reducing stigma and discrimination.

The DSM addresses criteria for the diagnosis of mental disorders. The DSM does not provide treatment recommendations or guidelines. The APA is aware of the need for greater scientific and clinical consensus on the best treatments for individuals with Gender Identity Disorder (GID). Toward that end, the APA Board of Trustees voted to create a special APA Task Force to review the scientific and clinical literature on the treatment of GID. It is expected that members of the Task Force will be appointed shortly.

There are 13 DSM-V work groups. Collectively, the work group members will review all existing diagnostic categories in the current DSM. Each work group will be able to make proposals to revise existing diagnostic criteria, to consider new diagnostic categories, and to suggest deleting existing diagnostic categories.

All DSM-V work group proposals will be based on a careful, balanced review and analysis of the best clinical and scientific data. Evidence accumulated from work group members and hundreds of additional advisors to the DSM-V effort will be considered before final recommendations are made.

The Sexual and Gender Identity Disorders Work Group, chaired by Kenneth J. Zucker, Ph.D., will have 13 members who will form three subcommittees:

* Gender Identity Disorders, chaired by Peggy T. Cohen-Kettenis, Ph.D.
* Paraphilias, chaired by Ray Blanchard, Ph.D.
* Sexual Dysfunctions, chaired by R. Taylor Segraves, M.D., Ph.D.

Each subcommittee will pursue its own charge, provide ongoing peer review, and consult with outside experts. The DSM-V is expected to be published in 2012."
(This was a response given to Jessica L. off of Susans.org Forums)

http://queersunited.blogspot.com/2008/05/apa-has-released-statement-to-activists.html

thanks for posting that Joe. I think it's a really good sign. It sounds like there are a lot of checks and balances in place to prevent one person or school of thought from making the decisions. Hopefully there are some postivite, structurally sound studies out there that will back up the push for changing the criteria for GID.

joectigger
05-09-2008, 06:10 PM
thanks for posting that Joe. I think it's a really good sign. It sounds like there are a lot of checks and balances in place to prevent one person or school of thought from making the decisions. Hopefully there are some postivite, structurally sound studies out there that will back up the push for changing the criteria for GID.


I'm hopeful also.

I found this site tonight too

http://www.gidreform.org/index.html

Lots of information including the diagnostics in the most recent DSM, as well as a list of people and groups that are "calling for reform of the classification of gender diversity as a mental disorder."

joectigger
05-10-2008, 08:17 AM
Please sign the petition asking the APA to remove from the DSM-V Sexual disorders committee 2 of the more outrageous members who promote junk science and reparative therapy


Objection to DSM-V Committee Members on Gender Identity Disorders

http://www.thepetitionsite.com/petition/412001300

butchgorilla
05-10-2008, 01:48 PM
Joe,

Thank you so much for posting this link. As much as I have confidence that we won't go backwards - reparative therapy and such - having certain folks on the task force is simply inappropriate. While I don't really expect GID to be removed just yet, it is imperative that we have folks working on who will do it just service.

-Kayden

Sassy_thong
05-10-2008, 01:51 PM
Please sign the petition asking the APA to remove from the DSM-V Sexual disorders committee 2 of the more outrageous members who promote junk science and reparative therapy


Objection to DSM-V Committee Members on Gender Identity Disorders

http://www.thepetitionsite.com/petition/412001300


Signed !!!

joectigger
05-11-2008, 05:26 AM
Thanks Butchgorilla and Sassy! (y)

People are also stressing the need for actual physical letter writing in this case as well. From an online activist blog:

We can join together and write letters to APA stating our concerns and disputes with having a Biased staffing of a committee to determine the criteria for GID. Here is the address to send letters:

APA
1000 Wilson Blvd, Suite 1825
Arlington, Virginia 22209

We need to send letters and lotz of them to APA. We need to address the seriousness of staffing the committee to determine the GID criteria with a biased committee membership.

Why for example are there not any Social Workers on that committee; there was one on the committee for the DSM IV?

This person makes an excellent point about the need for a social worker on this committe. If the deck is stacked against, how can this subject get truly looked at for revision?

~jolynn~
05-19-2009, 09:02 PM
LINK (http://www.youtube.com/watch?v=z0__63nNP1g&eurl=http%3A%2F%2Fwww%2Epamshouseblend%2Ecom%2F&feature=player_embedded)

...

AtLast
05-19-2009, 09:30 PM
Zucker would be the most objectionable member making these decisions. He is not TG friendly at all in terms of viewing it as anything but a pathology!! And he carries a lot of weight within the APA.

An area that is very tied into this whole matter has to do with insurance companies. They carry a lot of weight with the APA as they are who reimburstment comes from. Government sponsored insurers also use the DSM to determine reimbursement.

One of the problems here is how the GID diagnosis is changed (or eliminated) and how this will effect payment for services for TG people. There exists a catch-22 in all of this.


If the diagnosis is changed to for example a v-code, insurance companies will not pay for therapy and other services.

Obviously, the GID criteria pathologizes TG people and attaches negative stigma. Also, the APA is a VERY political professional organization with a lot of clout. The process for choosing which research will be used in formulating diagnostic criteria in the DSM is very much an old boys network. An old, white, straight boys network!

I am not hopeful that the changes made will be of much benefit to TG people. The biases within this system plus the insurance industries billions of research dollars as well as reimbursement allowances have stacked this deck for many, many years.

joectigger
05-19-2009, 09:47 PM
http://ifge.org/Article386.phtml

FOR IMMEDIATE RELEASE: 18 May 2009

Washington DC - The International Foundation for Gender Education has issued the following resolution calling on the American Psychiatric Association (APA) to reform its Diagnostic and Statistical Manual of Mental Disorders. IFGE will be participating in a demonstration this evening at the APA's annual conference in San Francisco, where this resolution will be presented. We urge everyone to join us in calling for an end to the APA's pathologising of gender non-conforming behaviour.

Resolution

Whereas people are naturally endowed with a wide diversity of gender expression, identities, and sexual orientations;

Whereas, the distress felt by gender non-conforming people is fundamentally due to social prejudice and heterosexism, and is not a characteristic of their identities;

Whereas diagnosis of psychological disorders has been used as a form of social control;

Whereas, the inclusion of normal variations of behavior as diagnostic criteria has been widely used to justify discrimination against gender non-conforming people by individuals, governments, and corporations; and has resulted in material harm to people;

Whereas, the principle responsibility of medicine is to "Do No Harm;"

Therefore, be it resolved that we find the American Psychiatric Association to have a responsibility to ameliorate this harm, and hereby call for the following remedies:

(1) We hereby call on the Board of Trustees of the American Psychiatric Association to issue a declaration stating that: Gender variance, and gender non-conforming behavior do not constitute a psychological disorder;

(2) We hereby call on the American Psychiatric Association to remove the diagnosis of so- called "Transvestic Fetishism," which explicitly pathologizes gender non-conforming behavior, from their Diagnostic and Statistical Manual;

(3) We hereby call for the reform of any diagnosis that can be made solely based on gender non-conforming behavior, specifically including “Gender Identity Disorder in Children.”

Resolved this day 15 May 2009 by the Board of Directors of The International Foundation for Gender Education


The International Foundation for Gender Education promotes acceptance for transgender people everywhere through education. Founded in 1978, IFGE is the largest transgender advocacy organisation with members worldwide. Providing educational outreach for the emancipation of all gender variant people from restrictive gender norms, IFGE is a non-profit educational corporation with offices in Waltham, MA and Washington, DC and is recognised by the I.R.S. as a 501c(3) charitable organisation.

IFGE
272 CARROL ST NW
WASHINGTON DC 20012
1202 207 8364

~jolynn~
05-20-2009, 08:20 AM
GID Reform Now Protest At Annual APA Meeting - Speaker Madeline Deutch, M.D. (http://www.pamshouseblend.com/diary/11064/gid-reform-now-protest-at-annual-apa-meeting-speaker-madeline-deutch-md)

by: Autumn Sandeen (http://www.pamshouseblend.com/user/Autumn%20Sandeen)

Wed May 20, 2009 at 10:00:00 AM EDT


Mila Pavlin of Trans-Ponder (http://trans-ponder.com/) has posted the first video from the GID Reform Now (http://gidreformnow.com/) protest at the American Psychiatric Association 2009 Annual Meeting. She edited the video as well.

Here is the approximately 7-minute speech (http://www.youtube.com/watch?v=s2k52g9yRJU) of Madeline (http://professionals.gidreform.org/aboutus.html)Deutch, M.D. (http://www.doctormaddie.com/), that she made to the approximately 150 protesters at the event. A transcription of a large portion of the speech begins below the video.


My name is Madeline Deutch, M.D., and I am a queer, transgender woman. And I'm here to tell Dr. Zucker and the rest of the world that my identity is not pathological. My identity does not belong miscategorized in your book. We live in a society based on individual liberties and informed consent. Each individual should be allowed to make decisions about how to live their own life. It is true that transgender people do, in many cases, suffer from other conditions, such as anxiety, depression, panic disorder, etc. But, the question is how much of that is due a stresses of being a transgender person in a transphobic world? My answer: Most, if not all of it.
I look at the world around me, and I see a world full of personality disorders, behavioral disorders, and psychotic disorders, which are undiagnosed, untreated, or unattended to. But no one forces these people into a psychotherapeutic environment. It is time to stop forcing the same on transgender people. It is time to change society, and change the system, rather placing the social, financial, and psychological burden on transgender people.
This reminds me of a Martin Luther King Jr. quotation (http://www.quotationspage.com/quote/25717.html):

True compassion is more than flinging a coin to a beggar; it is not haphazard and superficial. It comes to see that an edifice that produces beggars needs restructuring.
Resuming the transcript:

Transgender persons who transition have been shown to have [satisfaction and success rates] in up to 99% in some outcome studies. I challenge you Dr. Zucker, Dr. Blanchard, Dr. Lawrence, or anyone else to find other conditions with such his satisfaction and success rates after treatment. We live in a world where you can walk down any city street, and buy a McDonalds' Big Mac, A pack of cigarettes, a case of beer, and a box of Twinkies. You can do this regardless of your health status, if you have diabetes, or if you have recently have had open heart surgery at the expense of Medicare tax dollars.
In fact, a McDonalds was recently opened in the food court at one of the most prestigious hospitals in the country -- the Cleveland Clinic. Imagine that: In Ohio, transgender people are so pathologied, in part of as the result of the DSM-V categorization, that they are not allowed to change their birth certificate -- ever! Yet, if you have open heart surgery in Ohio, at the expense of taxpayers, you may stop by the hospital cafeteria on your way out for a big make and fries.
We need to change these double standards; we need to change the system.
This reminds me of another Martin Luther King Jr. quotation (http://www.quotationspage.com/quote/32718.html):

Freedom is never voluntarily given by the oppressor; it must be demanded by the oppressed.

The argument that we need to be in the DSM for insurance purposes are often flawed. As I mentioned, earlier, tobacco, alcohol, fast foods are all for sale on any block in this or any other city. Kaiser Permanente, has an extensive smoking cessation support program. Literally, billions of Medicaid and Medicare dollars are spent annually on treating the...effects of these harmful habits. So why do we continue to allow the sale of toxic substances and then pay billions of dollars in medical costs, yet refuse to cover the relatively low cost of transgender healthcare, even though its been shown to be effective. It's time to change the system. If you worry about insurance will not cover this, then we should work to change perception, and work change the system, not create more categories, restrictions, exclusions, and pathologisation of whatever subgroups we feel are not yet deserving of basic civil rights, workplace protections, and healthcare...
This time, a Bayard Rustin quotation (http://www.brainyquote.com/quotes/authors/b/bayard_rustin.html):

When an individual is protesting society's refusal to acknowledge his dignity as a human being, his very act of protest confers dignity on him.
I only transcribed about half of the speech. I would hope that you would listen to the rest of what Dr. Deutch has to say about the DSM and how Gender Identity Disorder (GID). If you're lesbian, gay, or bisexual, and come out since 1973, you likely haven't experienced the pathologization of your LGBT experience -- you haven't had the majority culture oppress your community as a group because of your identity. This is exactly what is still happening to trans people, and will continue if GID isn't reformed for DSM-V.

But you should listen and remember that your trans brothers and sisters -- like me -- deserve more than pathologization of our lives. And, if DSM-V still pathologizes us for being trans -- well, trans people like me deserve better. We deserve basic civil rights, employment and housing protections, and adequate healthcare that recognizes the realities of our lives without pegging us for the rest of our lives as being disordered.

www.pamshouseblend.com (http://www.pamshouseblend.com) (full video of speech can be found here)

hollylewya
05-20-2009, 06:16 PM
Thank you, Jolynn for posting the transcript

The speech was very moving

Here it is without the link

s2k52g9yRJU


Hope Others Will Watch It...Shit Needs To Change,
Dylan

~jolynn~
05-20-2009, 06:19 PM
It is a great speech and I think really clarified some issues involved.

Thank you for posting the video sans linkage -- I was trying to figure out how to do that and gave up!

DapperButch
05-20-2009, 07:56 PM
Zucker would be the most objectionable member making these decisions. He is not TG friendly at all in terms of viewing it as anything but a pathology!! And he carries a lot of weight within the APA.

An area that is very tied into this whole matter has to do with insurance companies. They carry a lot of weight with the APA as they are who reimburstment comes from. Government sponsored insurers also use the DSM to determine reimbursement.

One of the problems here is how the GID diagnosis is changed (or eliminated) and how this will effect payment for services for TG people. There exists a catch-22 in all of this.


If the diagnosis is changed to for example a v-code, insurance companies will not pay for therapy and other services.

Obviously, the GID criteria pathologizes TG people and attaches negative stigma. Also, the APA is a VERY political professional organization with a lot of clout. The process for choosing which research will be used in formulating diagnostic criteria in the DSM is very much an old boys network. An old, white, straight boys network!

I am not hopeful that the changes made will be of much benefit to TG people. The biases within this system plus the insurance industries billions of research dollars as well as reimbursement allowances have stacked this deck for many, many years.

Hi, AtLast.

I posted about this last May, on this thread. Yes, it is truly a double edged sword. Remove it from the DSM and insurance won't pay (and more and more insurance companies are paying, at this point), but if defined as being a mental illness, than insurance will pay, yet you have the stigma of having a "mental illness".

V code....bah...no insurance will take any of those! But, THAT is a whole nother discussion!

hollylewya
05-20-2009, 08:24 PM
Hi, AtLast.

I posted about this last May, on this thread. Yes, it is truly a double edged sword. Remove it from the DSM and insurance won't pay (and more and more insurance companies are paying, at this point), but if defined as being a mental illness, than insurance will pay, yet you have the stigma of having a "mental illness".

V code....bah...no insurance will take any of those! But, THAT is a whole nother discussion!

Actually, it's more likely to be covered by health insurance if it IS removed from mental illness status. 1. More medical doctors consider it a medical necessity. 2. There's way more coverage for medical issues than mental health issues. 3. Medical doctors have more sway with insurance companies than psychs, so if more med doctors than psych doctors make a hoopla about it, the insurance companies are more likely to listen.

And...not enough insurance companies cover diddly...in fact ALL of them have a waiver written in against trans status (even the ones who cover it)


Dylan

Toughy
05-20-2009, 09:13 PM
And...not enough insurance companies cover diddly...in fact ALL of them have a waiver written in against trans status (even the ones who cover it)

not enough insurance companies cover diddly............about many damn issues........especially those that have any hint of 'mental illness'.

I see this as a way to build coalitions with many groups who are fucked over by health insurance........

What about coalition building around mental and physical health conditions that insurance companies decide not to cover?

Is there room to find that common ground and change the lives of those deemed 'not insurable' by those who make profit from the health issues of most of the US?

iamkeri1
05-20-2009, 09:20 PM
It is my opinion that GID should be treated as a birth defect and treated by way of SRS or other options to the extent that, and IF it is desired by the person seeking treatment.

GID is a physical condition, not a mental illness. Theoretically it is caused by hormonal disturbance in the womb somewhere between the 6th and 12th week of gestation.

Individuals with this "condition" should be afforded access to the treatment which seems best to them. Some might choose surgical treatment of their condition corresponding to that provided to individuals born with a heart valve disorder or talipes equinovarus (club foot.) Another medical choice for them might be provision to them of workable protheses and the supportive physical/occupational therapy to be able to use it/them well (similar to the treatment provided for amputees or to individuals born with missing limbs.) A third alternative might be counseling for the individual with GID to help them deal with the cruelties of a world which finds gender disorders laughable.

NOT a mental illness. (but if it was, these individuals should still be afforded the type of treatment most in line with their needs and wants.)
Smooches,
Keri

MountainGirl
05-20-2009, 09:24 PM
If you don't get the show "In The Life" where you live...
you can watch it online. Here is a teaser of a really good show they did on this topic. Most activists are really worried about Kenneth Zuckerman being in charge of the gender portion. The episode is called "Revising Gender".

_FONpqUc6Kc

Here is a link to the site, where you can watch the whole episode.

http://www.inthelifetv.org/html/episodes/72.html

AtLast
05-21-2009, 12:35 AM
It is my opinion that GID should be treated as a birth defect and treated by way of SRS or other options to the extent that, and IF it is desired by the person seeking treatment.

GID is a physical condition, not a mental illness. Smooches,
Keri

I lean toward it being totally removed from the DSM. And, most certainly removing disorder from it entirely. There are many medical conditions that bring people into therapy or counseling for various things such as depression, anxiety, various adjustment disorders, etc. These would be covered for the patient (via insurance reimbursement) and other services would be available (ie., cancer support groups are covered in HMO's and some PPO's- gender related support groups etc. can be done in the same way). This would lift transgendered folks out of this mental illness trap. And the treatments and surgeries desired could be discussed and decided upon between the patient and the specific physician/surgeon needed just like other medical conditions. I don't get advise about my knee surgery from my therapist! I talk to the knee surgeon.

An aside- a worrisome one is that Kenneth Zucker's (DSM GID committe) treatment model for TG children contradicts some very solid biophysiological and neurological research and in my opinion do great psychological harm to these children.

butchgorilla
05-21-2009, 10:36 AM
I very much agree that Zucker's position on the committee is frightening - I only hope the other members have enough sway to go against him successfully.

There has been discussion stating that it should be removed completely, and that it could then be covered as a medical condition and therefore might receive better coverage. However, I don't think this is realistic at this point. Even though there may be some medical doctors who would support this, right now the number is far too small. I fear that if GID were completely removed from the DSM that transgender individuals would be left with no insurance options for quite some time.

Also, remember that the DSM does not establish treatment, and that's an important factor here. Right now the first step in the accepted course of treatment is counseling - that won't change if it is removed, at least not quickly. So now TG folks might be able to get insurance to cover the medical aspects, but if doctors stick to the "accepted treatment" and this is an area where few will stray at this point, then TG folks still have to cover initial psychological treatment without insurance coverage.

I conceptualize folks who are transgender as having both psychological and physical components to the condition. Psychological does not mean they are crazy, it does not mean they are pathological, it simply means that gender identity is a mental as well as a physical condition. I do think it is appropriate for individuals to be in therapy as a part of transitioning, if nothing else just to deal with the adjustment issues. Which brings me to my final point. At this time, I would like to see GID renamed to something like Gender Identity Adjustment - that seems a more accurate name. The criteria DO need to be changed - I won't go into that here, that's another post.

Finally, several have mentioned that it should be removed from the DSM so that it will lose the stigma of a mental illness. I don't think this is a valid argument, in that the stigma attached to anything in the DSM is a social construct. I would love to not have to face the stigma of having Major Depressive Disorder. My disorder is very much a physical condition - I have a severe neurotransmitter imbalance in my brain. So technically I could argue that mine is a medical condition and so should be removed so I don't have to deal with stigma. But the reality is, there is an emotional component to my condition. Unfortunately, to remove the stigma will require a change in social perception.

AtLast
05-21-2009, 11:46 AM
I very much agree that Zucker's position on the committee is frightening - I only hope the other members have enough sway to go against him successfully.

There has been discussion stating that it should be removed completely, and that it could then be covered as a medical condition and therefore might receive better coverage. However, I don't think this is realistic at this point. Even though there may be some medical doctors who would support this, right now the number is far too small. I fear that if GID were completely removed from the DSM that transgender individuals would be left with no insurance options for quite some time.

Also, remember that the DSM does not establish treatment, and that's an important factor here. Right now the first step in the accepted course of treatment is counseling - that won't change if it is removed, at least not quickly. So now TG folks might be able to get insurance to cover the medical aspects, but if doctors stick to the "accepted treatment" and this is an area where few will stray at this point, then TG folks still have to cover initial psychological treatment without insurance coverage.

I conceptualize folks who are transgender as having both psychological and physical components to the condition. Psychological does not mean they are crazy, it does not mean they are pathological, it simply means that gender identity is a mental as well as a physical condition. I do think it is appropriate for individuals to be in therapy as a part of transitioning, if nothing else just to deal with the adjustment issues. Which brings me to my final point. At this time, I would like to see GID renamed to something like Gender Identity Adjustment - that seems a more accurate name. The criteria DO need to be changed - I won't go into that here, that's another post.

Finally, several have mentioned that it should be removed from the DSM so that it will lose the stigma of a mental illness. I don't think this is a valid argument, in that the stigma attached to anything in the DSM is a social construct. I would love to not have to face the stigma of having Major Depressive Disorder. My disorder is very much a physical condition - I have a severe neurotransmitter imbalance in my brain. So technically I could argue that mine is a medical condition and so should be removed so I don't have to deal with stigma. But the reality is, there is an emotional component to my condition. Unfortunately, to remove the stigma will require a change in social perception.


Really good points. I think I just want the simple, perfect solution to this (my idealism showing). But, what you say here brings out how complex this all is and the delicacy needed in making changes.

Absolutely the emotional component has to be addressed. But reimbursement for the related consequences for medical conditions are covered. I guess I feel that the many emotional/psychological consequences (like anxiety and depression) of GID should be treated in the same way as any other medical condition. For example, my polyosteoarthritis has it's physical components that an arthritis specialist trats, but because of the impact this disease has had on my life, bouts of depression are common. My psychological treatment here is covered by my insurance as is the medical doctor and those treatments.

Yes, social perception! I agree that the balance in these decisions is critical. Keeping my fingers crossed.

Adjustment would be much better, or syndrome, complex??? Gender identity issues are so varied, it would be helpful for the diagnostic criteria/identification/label to more accurately reflect this. Post-Traumatic Stress was originally a disorder in the DSM, then changed to Syndrome.... why the DSM has to be fluid and continually revised.

butchgorilla
05-21-2009, 12:14 PM
Yeah, it's pretty complex - no easy answers here. Your post made me think of something else to toss out, that being the role of psychotherapy in working with TG individuals.

Thank you so much for sharing about your polyosteoarthritis - you offer a wonderful example. So in your treatment you've got the benefits of a team - medical stuff addressed by the specialist, but access to mental healthcare as well because there is an emotional aspect to it. Therapists and social workers often are part of treatment teams in medical settings. I envision a similar approach. The therapist is not the gatekeeper, does not get to determine if the individual receives treatment. The therapist is one member of the team, composed at least of the endocrinologist, the surgeon, the PCP, and the therapist. Perhaps the treatment protocol does require a brief stint of therapy at the beginning (insurance companies typically will cover up to 8 sessions without asking questions), but the therapist has no say in whether or not treatment continues. Additionally, they are a part of the treatment throughout, not just the initial step. I guess I don't see a problem including therapy as part of the treatment as long as the gate-keeping is removed.


Really good points. I think I just want the simple, perfect solution to this (my idealism showing). But, what you say here brings out how complex this all is and the delicacy needed in making changes.

Absolutely the emotional component has to be addressed. But reimbursement for the related consequences for medical conditions are covered. I guess I feel that the many emotional/psychological consequences (like anxiety and depression) of GID should be treated in the same way as any other medical condition. For example, my polyosteoarthritis has it's physical components that an arthritis specialist trats, but because of the impact this disease has had on my life, bouts of depression are common. My psychological treatment here is covered by my insurance as is the medical doctor and those treatments.

Yes, social perception! I agree that the balance in these decisions is critical. Keeping my fingers crossed.

Adjustment would be much better, or syndrome, complex??? Gender identity issues are so varied, it would be helpful for the diagnostic criteria/identification/label to more accurately reflect this. Post-Traumatic Stress was originally a disorder in the DSM, then changed to Syndrome.... why the DSM has to be fluid and continually revised.

AtLast
05-21-2009, 01:15 PM
Yeah, it's pretty complex - no easy answers here. Your post made me think of something else to toss out, that being the role of psychotherapy in working with TG individuals.

Thank you so much for sharing about your polyosteoarthritis - you offer a wonderful example. So in your treatment you've got the benefits of a team - medical stuff addressed by the specialist, but access to mental healthcare as well because there is an emotional aspect to it. Therapists and social workers often are part of treatment teams in medical settings. I envision a similar approach. The therapist is not the gatekeeper, does not get to determine if the individual receives treatment. The therapist is one member of the team, composed at least of the endocrinologist, the surgeon, the PCP, and the therapist. Perhaps the treatment protocol does require a brief stint of therapy at the beginning (insurance companies typically will cover up to 8 sessions without asking questions), but the therapist has no say in whether or not treatment continues. Additionally, they are a part of the treatment throughout, not just the initial step. I guess I don't see a problem including therapy as part of the treatment as long as the gate-keeping is removed.


Yes! A team approach. And something does have to be done about the gate keeping.

Something that has always bothered me about any gate-keeping role (not just with gender issues and treatment) as a therapist is that it inserts a power dynamic in the therapeutic relationship that eradicates the entire process of therapy!! Trying to build a safe, empathic process with a patient with this in the mix does not work (or at least it doesn't with this therapist). And it really is proclaimed by entities such as the insurance industry. Most therapists feel very hindered by this role.

Unless a patient is incapable of decision-making, the therapist's role should not be as any kind of gatekeeper. The ultimate decisions that the patient makes about what they want to do in terms of their gender identity need to be their own. Yes, they need to get the best possible information and medical care, but they have to weigh these decisions themselves.

A therapist's (or counselor) role here is to assist in the individual putting these decisions together for themselves and dealing with all of the situations that arise for them in doing so. Things like how they are being treated within their family, a relationship, at work, etc. How can the therapist and patient work out the best ways for the patient to succeed here and build confidence throughout all of the processes they are dealing with. A therapist also needs to make certain that the patient knows about the services outside of therapy that is available (i.e., support groups, organizations, etc.). Therapy does not exist in a vacuum. Or, at least in my way of thinking. I do know, however, I am tainted/biased with an earlier background in social work, so i tend to take a comprehensive psychosocial approach.

Oh, and just for the record, I do not work with GID patients presently. This is not my specialty and my interest here has more to do with hopefully seeing positive changes made with the DSM.

joectigger
05-21-2009, 07:23 PM
Curious to know... do others here feel that France's recent decision to no longer declare transsexuality a mental illness will have an affect on things here in the US?

link (http://www.france24.com/en/20090517-transsexuality-no-longer-classified-mental-illness-france-day-against-homophobia)

hollylewya
05-21-2009, 07:52 PM
It's fun to me when butches seem to forget that according to the DSM, almost all butches 'suffer' from GID also. According to psychs following the DSM, almost ALL butches would be diagnosed with 'this disorder'.



Thus, According To Some, ALL Butches Should Be In Therapy For The Emotional Distress And The 'Social Stigma' They're All Suffering From,
Dylan...ends on prepositions sometimes

hollylewya
05-21-2009, 07:57 PM
Also, if we're using the 'therapy for those suffering from a social stigma', by that logic, we would have to include POC, women, the alternately-abled, queers, butches, flamers, drag kings, drag queens, the poor, the working poor, old people, ESL folks, immigrants, undocumented workers, migrant farm workers, and every other oppressed group as those who 'need therapy' to deal with their emotional distress and such


Dylan

joectigger
05-21-2009, 08:50 PM
Dylan your posts just now reminded me of Julia Serano's piece

Why feminists should be concerned about the impending revision of the DSM (http://www.feministing.com/archives/015254.html) <-- link

AtLast
05-21-2009, 09:08 PM
It's fun to me when butches seem to forget that according to the DSM, almost all butches 'suffer' from GID also. According to psychs following the DSM, almost ALL butches would be diagnosed with 'this disorder'.



Thus, According To Some, ALL Butches Should Be In Therapy For The Emotional Distress And The 'Social Stigma' They're All Suffering From,
Dylan...ends on prepositions sometimes

Hell, according to the DSM, most everyone has mental disorder, especially in the hands of clinicians that view it as gospel. Yes, butches could fall into GID as it is now represented in the DSM - another reason for our community to take a look at this - it can stigmatize everyone of us within the mental health system! And then there are those that haven't a clue as to it's approprite use (or the multi-modal diagnosis as it pertains to treatment planning and efficacy). Personally, I blame managed health care and it's financial grip on mental health practitioners (and all medical doctors) for this. It is the single most significant factor in the development and cannonizing of the DSM!!! But, don't get me started on this.... that would really be a derail! And I hope that this thread along with media coverage and the outreach of organizations in our community get this DSM revision process out in the open. And if ever there were a need for transparency, this would be the process to reveal!

iamkeri1
05-21-2009, 09:49 PM
[quote=AtLast;3123014]Hell, according to the DSM, most everyone has mental disorder, especially in the hands of clinicians that view it as gospel. Yes, butches could fall into GID as it is now represented in the DSM - another reason for our community to take a look at this - it can stigmatize everyone of us within the mental health system!

Not too many years ago we all WERE stigmatized in the DSM...at least those of us who would accept the descriptor "homosexual" for ourselves. Whenever I use that word I remember a little incident that happened in the early seventies in the short time I lived in San Francisco. The three of us who had traveled out there together were at the grocery store. There was a group of boys (around age 10) hanging around in the parking lot, swearing their heads off, as children seem to when no adult is supervising them.

One boy hurled this long, stream of swearwords and curses at another boy. The boy, nonplussed, replied..."At least I ain't no Ho-mo-sex-u-al!!!! Talk about ROLF - we could barely get in the car we were laughing so hard.

iamkeri1
05-21-2009, 10:21 PM
Yeah, it's pretty complex - no easy answers here. Your post made me think of something else to toss out, that being the role of psychotherapy in working with TG individuals.

Thank you so much for sharing about your polyosteoarthritis - you offer a wonderful example. So in your treatment you've got the benefits of a team - medical stuff addressed by the specialist, but access to mental healthcare as well because there is an emotional aspect to it. Therapists and social workers often are part of treatment teams in medical settings. I envision a similar approach. The therapist is not the gatekeeper, does not get to determine if the individual receives treatment. The therapist is one member of the team, composed at least of the endocrinologist, the surgeon, the PCP, and the therapist. Perhaps the treatment protocol does require a brief stint of therapy at the beginning (insurance companies typically will cover up to 8 sessions without asking questions), but the therapist has no say in whether or not treatment continues. Additionally, they are a part of the treatment throughout, not just the initial step. I guess I don't see a problem including therapy as part of the treatment as long as the gate-keeping is removed.

The emphasized word above "gatekeeper", perfectly describes the role of the therapist in working with an individual wih GID, in a way that (I think) is unlike their role in any other treatment scenario. This is the main reason I would like to see GID come out of the DSM and into the physician's office. I have known individuals who were delayed for years by their therapist (and also by scores that was solidly in the "normal" range on psychological testing used to provided Diagnoses allowing surgery.) The "patient" should have control of their own treatment, as they do in most other situations
Smooches,
Keri

AtLast
05-21-2009, 11:57 PM
The emphasized word above "gatekeeper", perfectly describes the role of the therapist in working with an individual wih GID, in a way that (I think) is unlike their role in any other treatment scenario. This is the main reason I would like to see GID come out of the DSM and into the physician's office. I have known individuals who were delayed for years by their therapist (and also by scores that was solidly in the "normal" range on psychological testing used to provided Diagnoses allowing surgery.) The "patient" should have control of their own treatment, as they do in most other situations
Smooches,
Keri

Yes, some of us have commented about this in much the same way. It is also counter-therapeutic to have this dynamic within a therapy setting. For me, the most difficult part of my training when I was an intern was having to treat court ordered patients/clients. Usually this was to satisfy a condition of probation or could influence early release from jail. People put in this situation will say and do anything to convince the therapist to send in a good report to the court. Actually gaining insight into what has gotten them where they are does not usually happen. Now, the therapist's skills here are obviously important and I certainly know of many therapists that do fantastic work with these kinds of patients/clients. Thankfully, I had a very talented supervisor during this time and learned a lot. Forcing someone into treatment is not a good idea and is not therapy!

In a way cout-ordered therapy is similar to someone being told they cannot progress with various phases of their transition without a therapist opening that gate. Hummmm ... now what does that say about how we view GID? What is really sad here is that the person could very well have issues and concerns that they do want to work through in therapy but are impacted by this dynamic (as you bring up). Although, a therapist with a good background and skills in this area could get this turned around and be of benefit to this individual in the whole process. I am so glad that in CA (don't know about other states) it is required to take gender studies and human sexuality course work for licensure renewal. And you can't just take a course one year and have it satisfy future renewals as future courses will have updated research information.

Also, there are many forms of counseling and therapy along with self-help groups and organizations that are supportive networks that people can utilize. Although, I don't know how this is in other areas and I live close to SF. What is available here is probably not what a lot of people have available to them.

~jolynn~
05-22-2009, 04:18 AM
Dylan your posts just now reminded me of Julia Serano's piece

Why feminists should be concerned about the impending revision of the DSM (http://www.feministing.com/archives/015254.html) <-- link

That was a great article, Joe. Thanks.

These copied sections really exposed some valuable points for me:


Blanchard and other like-minded sex researchers have coined words like Gynandromorphophilia (attraction to trans women), Andromimetophilia (attraction to trans men), Abasiophilia (attraction to people who are physically disabled), Acrotomophilia (attraction to amputees), Gerontophilia (attraction to elderly people), Fat Fetishism (attraction to fat people), etc., and have forwarded them in the medical literature to denote the presumed "paraphilic" nature of such attractions. This tendency reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It's bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.


Another frightening aspect of Blanchard's proposal is that any sexual interest other than "genital stimulation or preparatory fondling" is now, by definition, a paraphilia. In his presentation, he claimed that paraphilias should include all "erotic interests that are not focused on copulatory or precopulatory behaviors, or the equivalent behaviors in same-sex adult partners." Copulatory is defined as related to coitus or sexual intercourse (i.e., penetration sex). So, essentially, all forms of sexual arousal and expression that are not centered around penetration sex may now be considered paraphilia.


...


"Curiously, women and gay men are free to wear whatever clothing they chose without a label of mental illness. This criterion serves to enforce a stricter standard of conformity for straight males than women or gay men. Its dual standard not only reflects the social privilege of heterosexual males in American culture, but promotes it. One implication is that biological males who emulate women, with their lower social status, are presumed irrational and mentally disordered, while biological females who emulate males are not. A second implication stereotypically associates femininity and cross-dressing with male homosexuality and serves to punish straight males who transgress this stereotype."
.

I'm finally reading Serano's, Whipping Girl and I already have so many places bookmarked...she really exposes and clarifies some issues and gives the reader a lot to think about.

butchgorilla
05-22-2009, 09:46 AM
Yes Dylan, many butches do meet the criteria for GID. However, although this has not always been the case, just meeting the criteria as spelled out in the DSM does not a diagnosis make. Not only must the person meet the criteria, but it must also be negatively affecting their life. Now, I do think the criteria do need to be changed to better emcompass it, but even as it stands, if it isn't causing a problem, then it isn't a disorder. I've been in therapy for over 20 years now. I have never been diagnosed with GID. It's never been a therapeutic issue for me.


It's fun to me when butches seem to forget that according to the DSM, almost all butches 'suffer' from GID also. According to psychs following the DSM, almost ALL butches would be diagnosed with 'this disorder'.



Thus, According To Some, ALL Butches Should Be In Therapy For The Emotional Distress And The 'Social Stigma' They're All Suffering From,
Dylan...ends on prepositions sometimes

For some of these individuals, therapy might be helpful. If they believe it would, then they can pursue it. No one has suggested that experiencing social stigma requires therapy. As I have endorsed therapy in GID as part of the team approach, it is for far more than simply social stigma. I've dealt with social stigma my whole life - but it's never been addressed in my therapy. Again, it's never been a therapeutic issue.


Also, if we're using the 'therapy for those suffering from a social stigma', by that logic, we would have to include POC, women, the alternately-abled, queers, butches, flamers, drag kings, drag queens, the poor, the working poor, old people, ESL folks, immigrants, undocumented workers, migrant farm workers, and every other oppressed group as those who 'need therapy' to deal with their emotional distress and such


Dylan

AtLast is right on target as far as a gate-keeping role creating harmful imbalance within a therapeutic relationship. It encourages the client to say what they think the therapist wants to hear in order to get a letter. At my clinic we treat clients who are mandated to attend therapy after being found with alcohol or drugs on campus. I hate those clients - in 95% of the cases I don't think the therapy does any good because the clients are not invested in making any change. They say what they think I want to hear. Fortunately, in the letter I write all I have to confirm is that they attended the required number of sessions; I don't have to say anything about how effective I think the therapy was.

Right now I am working with a client with GID, MtF. In the future, I hope to continue to be part of this work, although hopefully in a team-like approach.

butchgorilla
05-22-2009, 09:53 AM
I meant to respond to this before.

Unfortunately I don't think this decision will have much impact on things in the US. There isn't a lot of consistency worldwide in terms of mental health. I hope I am wrong, but I doubt this will affect how the APA handles things here.


Curious to know... do others here feel that France's recent decision to no longer declare transsexuality a mental illness will have an affect on things here in the US?

link (http://www.france24.com/en/20090517-transsexuality-no-longer-classified-mental-illness-france-day-against-homophobia)

maverick73
05-22-2009, 11:07 AM
The DSM topic caught my eye...off topic, but in class today we were discussing the addition of PMS as a menatl illness(!) and a male classmate said " It says PMS is a disease in soome book called DV something..." I lamost fell over cuz, um, we're Soc. & Psych. seniors and the guy was a little unclear as to what the book even was!! Yikes! :l

AtLast
05-22-2009, 02:51 PM
That was a great article, Joe. Thanks.

These copied sections really exposed some valuable points for me:


Blanchard and other like-minded sex researchers have coined words like Gynandromorphophilia (attraction to trans women), Andromimetophilia (attraction to trans men), Abasiophilia (attraction to people who are physically disabled), Acrotomophilia (attraction to amputees), Gerontophilia (attraction to elderly people), Fat Fetishism (attraction to fat people), etc., and have forwarded them in the medical literature to denote the presumed "paraphilic" nature of such attractions. This tendency reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It's bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.


Another frightening aspect of Blanchard's proposal is that any sexual interest other than "genital stimulation or preparatory fondling" is now, by definition, a paraphilia. In his presentation, he claimed that paraphilias should include all "erotic interests that are not focused on copulatory or precopulatory behaviors, or the equivalent behaviors in same-sex adult partners." Copulatory is defined as related to coitus or sexual intercourse (i.e., penetration sex). So, essentially, all forms of sexual arousal and expression that are not centered around penetration sex may now be considered paraphilia.


...


"Curiously, women and gay men are free to wear whatever clothing they chose without a label of mental illness. This criterion serves to enforce a stricter standard of conformity for straight males than women or gay men. Its dual standard not only reflects the social privilege of heterosexual males in American culture, but promotes it. One implication is that biological males who emulate women, with their lower social status, are presumed irrational and mentally disordered, while biological females who emulate males are not. A second implication stereotypically associates femininity and cross-dressing with male homosexuality and serves to punish straight males who transgress this stereotype."
.

I'm finally reading Serano's, Whipping Girl and I already have so many places bookmarked...she really exposes and clarifies some issues and gives the reader a lot to think about.

Yes, thanks, Joe!! Thinking it would be good to keep bring these excerpts to the top of the thread for good exposure...???

Joe, or anyone, do you have links, etc. about all of the members on the DSM GID related revision committee? Kenneth Zucker is probably the most dangerous (my opinion), but thinking about the full range, here. I'll try looking up more articles too. And something on the revision process for the DSM, which is..... scary (for everyone!)...... this group will address more than the GID diagnosis and I think many leather folks would be interested. There is some really strange research utilized in this area, too. Decisions for the diagnostic criteria is based upon research... and we all know the politics that can behind research!!!

joectigger
05-22-2009, 05:32 PM
GID Reform Advocates website link (http://www.gidreform.org/dsm5.html) has a page on the DSM V and the right side of the page is the listing of the task force, work group and the sub committees.

darkgazer
05-22-2009, 06:10 PM
Zucker and Blanchard are demonic. The only real ally seems to be Peggy T. Cohen-Kettenis. But maybe I missed somebody.

handy1
05-22-2009, 06:53 PM
This thread is an eye opener, absorbing the knowledge....

Again
thankyou
handy1

butchgorilla
05-23-2009, 08:49 AM
I wanted to toss out another role that therapists can play when working with transgender clients that is important to remember - that of advocate for our clients. Using my client as an example, we've gone together to several offices on campus to go over policy and make sure we are backed by the administration. If she has difficulties with specific professors that may another time that I can advocate for her. Just another positive factor that therapists can add.

~jolynn~
05-23-2009, 07:31 PM
Brain Gender Identity -- A Presentation by Dr. Sydney Ecker MD FACS (http://aebrain.blogspot.com/2009/05/brain-gender-identity-presentation-by.html)

AtLast
05-25-2009, 10:13 PM
Brain Gender Identity -- A Presentation by Dr. Sydney Ecker MD FACS (http://aebrain.blogspot.com/2009/05/brain-gender-identity-presentation-by.html)

Ecker's presentation is really interesting. Thanks for the link! I am facinated by brain chemistry and chromosone research. I get so frustrated that the money is not available as it should be for this research. This is is so critical to the present and future DSM diagnostic categories for gender identitiy (and beyond). You can almost be assured of which researchers from what schools that will be the studies representing the DSM revisions. Ivy League, those from drug companies that have the biggest lobbying networks, foundations that donate libraries and building to educational institutions and hospitals.... the researchers that have published the most in the elite journals.

This article makes me want to go in and say... Please, check my brain out!

AtLast
05-25-2009, 10:18 PM
I wanted to toss out another role that therapists can play when working with transgender clients that is important to remember - that of advocate for our clients. Using my client as an example, we've gone together to several offices on campus to go over policy and make sure we are backed by the administration. If she has difficulties with specific professors that may another time that I can advocate for her. Just another positive factor that therapists can add.

I so agree. Usually, this kind of work is done by clinical social workers because it is part of their training fabric. You get up and go to places with clients and advocate! The hell with the couch! A big reason it is really terrible that over all, social workers have been left out of the DSM revision committees.

AtLast
01-30-2010, 12:44 PM
Bumping this thread because I have been thinking about the ramifications a lot during all of the health care reform debates. I think what becomes of it will be critical to what is established by revisions to the DSM. And have a far reaching impact on so many members right here!

Has anyone run across any new information? I am going to do some research to catch up, but it would be great to hear from others that are following this. Also, if anyone can post links for all of us to check out organizations that are queer positive and are addressing the DSM revisions, it would be appreciated. Feeling like I need to have more places to go to that relate specifically to folks here and the site has members from all over the world!!

DapperButch
02-12-2010, 01:00 PM
Here you go, AtLast. I just got alerted to this today through email at work.:

www.dsm5.org

butchgorilla
04-10-2010, 09:06 AM
For those of you who want to actively voice your opinion on what is going on with GID in the upcoming DSM edition, here is a link you might find useful.

http://professionals.gidreform.org/