Randall Ehrbar PsyD, Jamison Green MFA, Kelley Winters PhD and Lore Dickey MA, lead a roundtable discussion, "Gender Identity Disorder: Moving Toward DSM Reform," at the 2007 American Psychological Association Convention in August.
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GID Reform Advocates are medical professionals, caregivers,
scholars, researchers, students, human rights advocates, and members of the
transgender, bisexual, lesbian and gay communities and their allies who advocate
reform of the psychiatric classification of gender diversity as mental disorder.
What is GID?
"Gender Identity Disorder" (GID) is a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. The DSM is regarded as the medical and social definition of mental disorder throughout North America and strongly influences the The International Statistical Classification of Diseases and Related Health Problems published by the World Health Organization. GID currently includes a broad array of gender variant adults and children who may or may not be transsexual and may or may not be distressed or impaired. GID literally implies a "disordered" gender identity.
"Transvestic Fetishism" (TF) is another DSM diagnostic category that labels crossdressing by heterosexual males as sexual fetish and paraphilia. Deletion or reform of the TF diagnosis is also the focus of GID Reform Advocates.
Kelley's keynote speech at the February 2008 Colorado Gold Rush Convention on trans-solidarity in the face of maligning psychiatric nomenclature.Posted on lynnconway.com.
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Why reform transgender psychiatric classification?
Thirty-Four years after the American Psychiatric Association (APA) voted to delete homosexuality as a mental disorder, the diagnostic categories of "gender identity disorder" and "transvestic fetishism" in the Diagnostic and Statistical Manual of Mental Disorders continue to raise questions of consistency, validity, and fairness. Recent revisions of the DSM have made these diagnostic categories increasingly ambiguous, conflicted and overinclusive. They reinforce false, negative stereotypes of gender variant people and at the same time fail to legitimize the medical necessity of sex reassignment surgeries (SRS) and procedures for transsexual women and men who urgently need them. The result is that a widening segment of gender non-conforming youth and adults are potentially subject to diagnosis of psychosexual disorder, stigma and loss of civil liberty.
Sexual and Gender Diagnoses of the Diagnostic and Statistical Manual (DSM),
A Reevaluation , Ed., Dan Karasic, MD, and Jack Drescher, MD. (2005)
Order from the IFGE Bookstore
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Why are GID issues needlessly divisive?
The transgender community and civil rights advocates have long been polarized by fear that access to sex reassignment procedures would be lost if the GID classification were revised. This division over issues of psychiatric stigma versus access to SRS has allowed little dialogue and no progress on GID reform in over two decades. In truth, however, transsexual individuals are poorly served by a diagnosis that both stigmatizes them unconditionally as mentally deficient and undermines the legitimacy of sex reassignment procedures that have been easily dismissed as "elective" and "cosmetic" by insurers, governments and employers. GID reform is not a question of less stigma versus improved SRS access, it is a question of less stigma and improved SRS access. We need dialogue among people who wish to move beyond division and polarization to proposals for diagnostic reform that will lead to consensus and forward progress.
The vision of GID Reform
It is time for the medical professions to affirm that difference is not disease,
nonconformity is not pathology, and uniqueness is not illness
It is time for culturally competent psychiatric policies that recognize the legitimacy of cross-gender
identity and yet distinguish gender dysphoria as a serious condition, treatable with medical procedures.
It is time for diagnostic criteria that serve a clear therapeutic purpose, are appropriately inclusive, and
define disorder on the basis of distress or impairment and not upon social nonconformity.
It is time for medical policies which, above all, do no harm to those they are intended to help.
Are you an Advocate for Psychiatric Policy Reform?
Our Advocates page lists
individuals and organizations who support the reform of the current psychiatric
categories of TF and GID.
We'd love to hear from you or your organization. Please fill out our
web form. Do you have
an issue to share or paper to post here?
Let us know. Do you have a web site? Please help us with a link to this site.
About your hostess
Kelley Winters, Ph.D., formerly under pen-name Katherine Wilson,
is a writer on issues of transgender medical policy, founder of GID Reform
Advocates and an Advisory Board Member for the
Matthew Shepard Foundation
and TransYouth Family Advocates.
She has presented papers
on the psychiatric classification of gender diversity at the annual
conventions of the American Psychiatric Association, the American
Counseling Association and the Association of Women in Psychology.
Her articles have appeared in Psychiatry On-Line, the Journal of
Psychology and Human Sexuality, and the books,
Taking Sides: Clashing Views on
Controversial Issues in Sex and Gender, edited by Elizabeth Paul (2001) and
Sexual and Gender Diagnoses of the Diagnostic and Statistical Manual (DSM),
A Reevaluation , edited by Dan Karasic and Jack Drescher (2005).
Kelley may be reached at
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it is time for medical policies which, above all, do no harm to
those they are intended to help
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