Kelley Winters

Ask the APA to Remove "Transvestic Disorder" Diagnosis from the DSM-5

Filed By Kelley Winters | March 16, 2010 1:00 PM | comments

Filed in: Living, Transgender & Intersex
Tags: APA, DSM V, gender identity disorder, gid, transgender, transsexual, Transvestic Disorder, Transvestic Fetishism

The International Foundation for Gender Education (IFGE) has posted an online petition calling for removal of the Transvestic Disorder diagnosis (302.3) from the pending Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Please help put an end to this defamatory and hurtful psychiatric label by adding your name and spreading the word to your organizations, friends and contacts.

The American Psychiatric Association (APA) released draft diagnostic criteria for the DSM-5 last month, and a period of public review and comment ends April 20th. Their proposal includes the diagnostic category Transvestic Disorder, previously called Transvestic Fetishism, which classifies crossdressing by birth-assigned males as mental illness.

This diagnosis perpetuates false stereotypes of sexual deviance that are used to deny human dignity and civil justice to gender variant and transgender people. It punishes feminine gender expression that does not conform to masculine conventions. It pathologizes harmless consensual sexual expression and sexualizes gender expression that is not necessarily sexually motivated.

The Transvestic Disorder category is not limited to crossdressers or male-identified people. It also targets transsexual women with a specifier of "autogynephilia," a deeply offensive label to many transwomen, implying that all transsexual women transition for sexual reasons rather than harmony with gender identity.

Please ask the the American Psychiatric Association DSM-5 Task Force, Board of Trustees and elected leadership to reject the proposed Transvestic Disorder category and remove this gender nonconformity diagnosis from the DSM-5.


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Normally, I'm not big on online petitions, although this one is independent and verified. So effort is made to address the usual shortcomings.

/signed.

It should be of interest to the Bilerico readership that the present proposed wording of this diagnosis has been extended to include gay and bisexual men, who in the past were explicitly excluded.

Is this true? That's interesting.

didn't think that autogynophilia covered all transsexual women, Kelley; isn't it limied to a group separate from the GID and the Gender incongruence people?

There is a problem in how AG is typically applied, and the proposed revisions do little to clarify the overlap between Gender Incongruence (was GID) and Transvestic Disorder (was TF). This leaves it up to the discretionary bias of the therapist. For a bit more about TD / TF: http://dentedbluemercedes.wordpress.com/2010/03/01/the-little-case-study-that-autogynephilia-forgot/

Either way, isn't it still used by clinicians to weed out the trans people who don't fit their particular gender standards? It covers whoever they want it to cover.

I think Mercedes is right. Since the DSM-IV in 1994, GID and TF were written to overlap. A specifier of "with Gender Dysphoria" was added to TF to specifically include TS women. This specifier was replaced with the AGP specifier in the proposed new criteria.

However, Jamie also raises an important point, that the stereotype of fetishism is used to deny transition treatment, even though the diagnoses are not written that way. The IRS tried to use this against Rhiannon O'Donnabhain in her recent tax court case.

More reasons why this offensive diagnosis must be removed from the DSM-5.

"IFGE" stands for "International Foundation for Gender Education." Just thought you'd like to know.

OMG, my mistake typing federation instead of foundation. Thanks for pointing this out, Monica. I made the correction.

Yes....it's probably past time that the APA should include as a diagnosis anything sexual that is between two consenting adults or a single behavior that is not harming others. The internet has allowed us to understand how prevalent all sorts of previously thought to be aberrant sexual behaviors are. Let's move beyond the silliness and instead teach doctors the breadth of normal sexuality.

Elena Kelly | March 17, 2010 11:24 AM

While I do not believe that who I am is a psychiatric disorder, I am hesitant to have these removed from the DSM until the Harry Benjamin SOC are updated. As it stands now, the treatment (hormones, surgery, etc.) cannot commence without a diagnosis. If there is nothing to diagnose, insurance could stop paying, and we could end up a lot worse off.

It's important to understand that there are two gender diagnoses in the DSM: GID (changed to Gender Incongruence in the DSM5) and Transvestic Fetishism (changed to Transvestic Disorder). This petition is to remove the second, Transvestic Disorder, which pathologizes crossdressing and gender nonconformity to a male birth-assignment, is not called out by the Standards of Care, and plays no role in enabling access to medical transition care. In fact, it is commonly used as an excuse to deny hormonal/surgical care to TS women. This diagnosis simply hurts nonTS and TS transwomen alike and in my view should be simply removed from the DSM.

Reform of the GID diagnosis to reduce barriers to medical transition care for those who need it and also to reduce stigma of mental illness and sexual deviance is a separate, parallel effort.

Pam Daniels Pam Daniels | March 18, 2010 2:18 AM

Being trans is not a mental illness, period! All variations of sexual orientation and gender identity are NORMAL, PERIOD! The human race evolved this way!

We suffer depression to one degree or another because some 1600 years ago an impossible binary standard was established!

Some 1600 years ago religion arbitrarily decided that anyone who isn’t a gender congruent hetero male or a gender congruent hetero female was abnormal. This artificial and arbitrary standard became part of human culture and eventually public law over the centuries. That arbitrary, artificial standard was then and still is dead wrong!

All variations of sexual orientation and gender identity are in fact normal! Psychiatry used this artificial and arbitrary binary standard to manufacture mental illnesses that never existed!

We as individuals find out for ourselves who we are and everyone else must accept that fact and each other!

We are undoing 1600 years of disinformation!

When children grow up they must be allowed to be whomever they are and nurtured as such! Birth certificates should indicate what genetic biology we’re born with, male, intersexed or female but then we as individuals decide when we’re old enough, whenever that is, what our own individual sexual orientation is and what our own individual gender identity is, PERIOD!

Just as Copernicus and Galileo forced the religious based culture of their time to realize that the earth and planets orbited the sun we too must force psychiatry and society to realize all variations of sexual orientation and gender identity are normal.

Sign this petition and help put an end to the ridiculously impossible binary standard we’ve been forced to live with!

In the meantime we must force the health care industry to help us with therapy and counseling to get through the fear we’ve been forced to live with until children are allowed to grow up and be who they are naturally!

We are not now, nor have we ever been mentally ill because we’re born LGBT OR GENDER CONGRUENT HETERO, PERIOD!

Pam Daniels Pam Daniels | March 18, 2010 2:19 AM

Being trans is not a mental illness, period! All variations of sexual orientation and gender identity are NORMAL, PERIOD! The human race evolved this way!

We suffer depression to one degree or another because some 1600 years ago an impossible binary standard was established!

Some 1600 years ago religion arbitrarily decided that anyone who isn’t a gender congruent hetero male or a gender congruent hetero female was abnormal. This artificial and arbitrary standard became part of human culture and eventually public law over the centuries. That arbitrary, artificial standard was then and still is dead wrong!

All variations of sexual orientation and gender identity are in fact normal! Psychiatry used this artificial and arbitrary binary standard to manufacture mental illnesses that never existed!

We as individuals find out for ourselves who we are and everyone else must accept that fact and each other!

We are undoing 1600 years of disinformation!

When children grow up they must be allowed to be whomever they are and nurtured as such! Birth certificates should indicate what genetic biology we’re born with, male, intersexed or female but then we as individuals decide when we’re old enough, whenever that is, what our own individual sexual orientation is and what our own individual gender identity is, PERIOD!

Just as Copernicus and Galileo forced the religious based culture of their time to realize that the earth and planets orbited the sun we too must force psychiatry and society to realize all variations of sexual orientation and gender identity are normal.

Sign this petition and help put an end to the ridiculously impossible binary standard we’ve been forced to live with!

In the meantime we must force the health care industry to help us with therapy and counseling to get through the fear we’ve been forced to live with until children are allowed to grow up and be who they are naturally!

We are not now, nor have we ever been mentally ill because we’re born LGBT OR GENDER CONGRUENT HETERO, PERIOD!