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Gender dysphoria replacing gender identity disorder in DSM

BY NATASHA BARSOTTI – The American Psychiatric Association (APA) will replace the term gender identity disorder in the upcoming fifth edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM), a move that activists have lobbied the APA to make for years, contending that that term characterizes transgender people as mentally ill.

Instead, the term gender dysphoria will be used to refer to people who experience "a marked incongruence between one's experienced/expressed gender and assigned gender," according to an Associated Press report.

"We know that there is a whole community of people out there who are not seeking medical attention and live between the two binary categories," psychiatrist Jack Drescher, an APA subcommittee member, said in the report. "We wanted to send the message that the therapist's job isn't to pathologize."

Retired surgeon Dana Beyer also told AP that shifting the emphasis from a disorder that "by definition all transgender people possess to a temporary mental state that only some might possess" signals real progress. "A rightwinger can't go out and say all trans people are mentally ill, because if you are not dysphoric, that can't be diagnosed from afar."

Like gay people before them, transgender people have seen APA language applied to their disadvantage. 

According to AP, advocate Kelley Winters, who was among those who helped push for the change, also notes that the "disordered" label saddles transgender people with the burden of proving their competence.

But for some, the change in terminology is a catch-22 of sorts. While a person's gender identity could conceivably no longer be used against them in court proceedings (for example, having children taken away because of a diagnosis of mental illness), trans people could also face the loss of insurance benefits that cover hormone treatments and gender reassigment surgery.

Shannon Minter, legal director of the National Center for Lesbian Rights, notes that while the gender identity disorder diagnosis has been used against trans people, it has also been of benefit to others. 

"We rely on it even in employment discrimination cases to explain to courts that a person is not just making some superficial choice . . . that this is a very deep-seated condition recognized by the medical community."

In tandem with lobbying for use of less loaded terminology, activists and mental health professionals are pushing for a revision of symptoms so that a diagnosis isn't applied to people whose anxiety or discomfort derives from prejudice, to adults who have transitioned successfully, or to children based on gender stereotypes.

Homosexuality was diagnosed in the DSM as an illness until 1973, but it took another 14 years to remove the conditions related to homosexuality from the manual.



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