Unisexual?

After having been a member of this forum for several months, I can only come to one conclusion: we seem to be quite a diverse community that defies labeling of any kind! Maybe one day society will drop this silly “requirement” that everything neatly “fit” into one category or another. I know how much I hate being “categorized” in any way! Reading this thread, there have been several terms put forth that are interesting and worth considering--perhaps most intriguing is the Angry Postman’s suggestion of “Pansexual.” I must admit, I don’t really know what the term means but I would like to explore it further. Of course, anything that helps to promote greater acceptance of the LGBT community is something I am for. Anything that helps to educate and promote understanding is progress.

One issue I have not seen discussed is the American Psychological Association’s DSM-IV classification of “Gender Identity Disorder.” As many of you know this is the “manual” used by Psychologists and Psychiatrists to make a clinical diagnosis. It was last updated in the mid-1990’s (again in 2000) and is undergoing “revision” to DSM-V with an expected final publication date of 2014. There are those that think that “GID” should either be dropped from DSM-V entirely, or those that think that it should be retained but with significant changes--focusing on the distress of the individual, NOT gender orientation. The following comes from www.psychiatryonline.org:

Darryl Hill, Ph.D., an assistant professor of psychology at Concordia University in Montreal, cited the lack of any scientific reliability or validity studies supporting the GID diagnostic criteria listed in DSM-IV as part of his argument for removing the diagnosis from the manual of mental disorders.

In fact, he insisted, GID is not a mental disorder at all. More than anything else, the criteria described reflect “the distress often experienced by parents” who have become “preoccupied with the negative aspects” of their son’s or daughter’s behavior as the child struggles to make sense of gender-related feelings, Hill maintained.

“Parents may inadvertently create” a problem in their children, he said, because they cannot come to grips with a child who does not easily fit into society’s approved gender roles and expectations.

“Psychoeducational approaches” directed at parents would do their children much more good than bringing them to therapy for a phantom disorder, Hill stressed. He urged a “parent-centered approach” to psychoeducation that encourages parents to accept their children “just the way they are,” even if the parents’ inclination is to try to have the children’s feelings and behaviors somehow shifted back to the mainstream. Educational programs need to concentrate on teaching parents ways to help them and in turn their children understand that children may be comfortable in “nonstereotypical” gender roles, but they are not “sick.”

Katherine Wilson, Ph.D., a founder of the San Diego-based organization GID Reform Advocates and former outreach director of the Gender Identity Center of Colorado, disagrees with Hill on the value of a diagnosis based on gender identity. She insisted that it should remain in DSM, but not as a disorder.

Wilson believes that to reduce stigma, what’s now labeled GID should be replaced with a diagnosis “unambiguously defined by distress” rather than by “gender nonconformity.” She took issue with the notion inherent in a psychiatric diagnosis of GID that cross-gender identity itself is not a legitimate mental and behavioral framework for some individuals, but rather a “perversion or defective development.”

Wilson said that DSM fails to acknowledge that “many healthy, well-adjusted transsexual people exist” or to distinguish between such individuals and those who would benefit from a medical treatment.

She would like to see GID replaced with a term such as gender dysphoria, which would describe someone who is persistently distressed with his or her physical sex characteristics or with the limiting gender-based roles that society often imposes on men and women.

The current diagnosis, Wilson said, “poorly serves transgender and especially transitioning individuals,” because it “contradicts the treatment goals for transsexuals who require sex-reassignment procedures.”

A diagnosis based on dysphoria rather than evidence of “strong and persistent cross-gender identification” would be an important element in the long process leading up to sex-reassignment surgery, she added. It should also “exclude consequences of societal prejudice or intolerance” that are labeled as “symptomatic of mental illness,” Wilson stated.

“Just as DSM reform reduced stigma surrounding same-sex orientation 30 years ago, reform of the gender identity disorder diagnosis holds similar promise today.” she said.

There are still those in the medical community who oppose removal or revision, most notably Dr. Robert Spitzer who chaired the DSM-III workgroup and Dr. Julian Fink, former APA president. Last May there was an organized protest in San Francisco as the APA met to consider determine how transgender people will be categorized in the next version of the Diagnostic and Statistical Manual of Metal Disorder (DSM-V). Here is a link to the site.

Disclaimer: I’m not a “real” doctor but I play one on TV… LOL! I have however discussed this issue with some of my colleagues in our Psych department and the consensus is that “GID” should be dropped entirely or significantly revised--a position I am in agreement with.