In 1973, homosexuality was largely removed from the DSM, or Diagnostic and Statistical Manual, the guide to diagnosis and classification of mental illnesses and personality and mood disorders for use by the psychological and psychiatric community. Initially, a vestigial diagnosis, “Ego-Dystonic Homosexuality”, was included in its wake but this too was ultimately shed in 1986.
This stood as a very significant step forward in the normalization and acceptance of homosexuality as a naturally occurring variance in human sexuality rather than a pathological disorder that required diagnosis and subsequent ethically, scientifically and medically dubious “treatment”. It was perhaps the first major success of the gay rights movement, and signified that progress was being made, that the fight was worth fighting.
Similar debates are now occurring within the transgender community regarding the inclusion of Gender Identity Disorder (or, alternately, Gender Dysphoria), in the current edition of the DSM. So much of the thinking goes, if declassification of homosexuality was such a significant achievement for gay rights, such a significant step in the direction of its normalization and acceptance, and was so deserved by the gay community, why does the trans community deserve any different? Are we, comparably, “sick” relative to the “healthy” nature of gay, lesbian and bisexual people?
But I’m not sure these two issues are comparable. I’m not sure it’s wise to assert that Gender Dysphoria is not a disorder. And I’m not sure that any theoretical, abstract benefits of removing it from the DSM would not be outweighed by massive and widespread harm, particularly to the least privileged members of our community, who are most dependent on asserting to the public, the medical community and those in power, that our access to things like hormones and surgery is a medical need, not a “cosmetic” dalliance or “lifestyle choice”.
There are five main points I’d like to address to make my argument on behalf of Gender Dysphoria. [Read more…]