Don't let your schooling interfere with your education.
~ Pete Seeger

Friday, June 13, 2008

Gender Identity Disorder

As the American Psychiatric Association works on revising the DSM, it's worth noting some curiosities about one of their entries, namely, GID.

The DSM IV is currently used as the guidebook to diagnose Gender Identity Disorder, the "mental disorder" used as a gatekeeper diagnosis for transpeople to get surgery and many other things needed for entry into society in their appropriate genders, such as the appropriate gender marker on their drivers licenses. It lists things like prevalence, which in the case of the DSM IV hasn't been updated since the 1960's. They cite male-to-female GID affecting about 1 in 30,000 individuals, and female-to-male affecting 1 in 100,000. That's 3,000 FTM's in the United States. I know at least five of them personally, right here in my town of 140,000. Lynn Conway, not surprisingly, takes issue with the APA's statistics.

What's really notable about GID, however, is that it is the only mental disorder I know of that has no recorded cases of anyone recovering. Zip. Zero. Ever. It's been around for as long as history, but nobody's ever been cured. It's had a name and professional treatment for almost 100 years, but nobody's ever been cured.

It can, however, be successfully treated - about 98% of the time – by surgery and drugs (Hormone Replacement Therapy).

To repeat:

Psychiatric/psychological treatment - 0% success rate.

Medical treatment - about 98% success rate.

Yet GID is listed as a mental disorder, not a genetic or hormonal disorder

P'raps it's time to remove GID from the DSM, and make it a medical diagnosis.

P'raps it's time to include HRT and surgery as regular treatment for GID in insurance plans. Time to treat it as the medical condition it is, rather than some kind of mental sickness to be gatekept by mental health professionals, with surgery as an optional treatment with costs to be born entirely by the patient.

P'raps it's time to look at the cost that transpeople pay for treatment and surgery (for just one example, click here), and the cost that society bears as a result, not just in broken lives but in HIV treatment, emergency room treatment for unsuccessful suicides, and incarceration.

Then maybe sharing the cost by paying for surgery through insurance won't seem so painful.

1 comment:

Anonymous said...


An interesting thought to include surgery on insurance. I've never heard this stance before, but I guess I never really thought about it as much as you have. I do find it interesting to list gender identity as a mental "disorder" but I can see how being in the wrong gender for your life can definitely feel "disorderly". I think it's hard to make blanket statements about gender in general, so I liked your post about "zie" and those words because it's so hard to define all people by gender when we are all so much more...


Thanks for the thoughts,

Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing. To keep our faces toward change and behave like free spirits in the presence of fate is strength undefeatable.
~Helen Keller

Reading List for Information about Transpeople

  • Becoming a Visible Man, by Jamison Green
  • Conundrum, by Jan Morris
  • Gender Outlaw, by Kate Bornstein
  • My Husband Betty, by Helen Boyd
  • Right Side Out, by Annah Moore
  • She's Not There, by Jennifer Boylan
  • The Riddle of Gender, by Deborah Rudacille
  • Trans Liberation, by Leslie Feinberg
  • Transgender Emergence, by Arlene Istar Lev
  • Transgender Warriors, by Leslie Feinberg
  • Transition and Beyond, by Reid Vanderburgh
  • True Selves, by Mildred Brown
  • What Becomes You, by Aaron Link Raz and Hilda Raz
  • Whipping Girl, by Julia Serano
I have come into this world to see this:
the sword drop from men's hands even at the height
of their arc of anger
because we have finally realized there is just one flesh to wound
and it is His - the Christ's, our