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April 16, 2010
Kelley Winters, Ph.D.
GID Reform Advocates
www.gidreform.org
On February 10th, 2010, the American Psychiatric Association released proposed draft revisions for the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for public comment through April 20th. The DSM is regarded as the medical and social definition of mental disorder throughout North America and strongly influences international psychiatric nomenclature. The DSM-5 proposal includes the diagnostic category Transvestic Disorder, expanding a previous diagnosis of Transvestic Fetishism.
Authored by Dr. Ray Blanchard, of the Toronto Centre for Addiction and Mental Health (CAMH, the former Clarke Institute of Psychiatry), the proposed Transvestic Disorder diagnosis is:
- Punitive: It punishes gender expression that differs from expectations of male birth-assignment and enforces conformity to masculine social stereotypes.
- Sexist: The diagnostic category is limited to those assigned male at birth, holding them to a stricter standard of conformity than birth-assigned females. It labels behaviours and gender expression that are ordinary or even exemplary for birth-assigned women as pathological for others.
- Stigmatizing: Transvestic Disorder is classified as a “paraphilic” sexual disorder, grouped with diagnoses of such harmful behaviors as pedophilia and exhibitionism. The resulting stereotypes of sexual deviance deny human dignity and civil justice to gender variant and transgender people.
- Ambiguous: murky language implicates sexual expression “involving” crossdressing as diagnosable. Thus, both erotic and nonerotic gender expression among bigender, dual-gender and genderqueer people may be diagnosed as “disordered.”
- Victim-blaming: The second diagnostic criterion requires clinically significant distress or impairment, but fails to exclude distress resulting from societal intolernce. This would promote false-positive diagnosis of victims of prejudice. For example, suffering job discrimination would be inferred as symptomatic of mental disorder.
- Needlessly Pathologizing: This diagnosis primarily pathologizes erotic crossdressing, a harmless consensual sexual expression, that does not meet any definition of mental illness.
- Harmful to Closeted or Self-rejecting Crossdressers: This diagnosis pathologizes crossdressers who are distressed by internalized shame and societal prejudice, very much as the previous diagnosis of Ego-Dystonic Homosexuality in the DSM-III pathologized victims of social homophobia.
- Harmful to Transsexual Women: This 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, promoting an unfounded theory that transsexual women transition out of sexual fetishism rather than harmony with gender identity.
- Used to Deny Medical Transition Treatment for those who need it: For example, the predecessor Transvestic Fetishism diagnosis was cited by IRS attorneys against Rhiannon O’Donnabhainn in her recent landmark case in US Tax Court. They used the diagnosis to promote a false stereotype of fetishism to argue that corrective transition surgeries for transsexual women are not medically necessary.
Please add your name and voice before April 20th to the online petition to remove this defamatory Transvestic Disorder catagory from the DSM-5. It is sponsored by the International Foundation for Gender Education (IFGE) at dsm.ifge.org/petition/. You may also register and comment directly to the APA DSM-5 Task Force at www.dsm5.org. For more information, see the statement by Professionals Concerned With Gender Diagnoses in the DSM.
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