Trans identity no longer a ‘disorder’ in influential psychiatric diagnosis manual

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Humiliating. Dishonest. Stigmatizing. These are just some of the words I’ve heard used to describe the practice of forcing trans people to receive a diagnosis of “gender identity disorder” before they can gain access to certain trans-related medical care, procedures, and treatments, or even before they can legally transition.

That’s why I’m optimistic about the latest move by the American Psychiatric Association to drop “gender identity disorder” from the new diagnosis manual in favor of “gender dysphoria”. The new term is apparently meant to indicate “emotional distress over one’s gender” rather than confusion or disturbance. The term “Asperger’s syndrome” was also dropped.

This is an important victory for trans activists, not only symbolically but logistically. The term has long been used to blame and stigmatize those with a diagnosis, even as many systems were set up to require a diagnosis for crucial treatment. You may remember that Sgt Bradley Manning’s diagnosis was used against her  during her trial, and she was forced to endure charges that gender identity disorder made her “mentally unstable” and led to leaking classified information.

Many are celebrating this as a victory on par with the moment that “homosexual” from the DSM. While I agree that it’s a step forward, I echo the concerns of many activists who believe that requiring any psychiatric diagnosis before granting access to certain medical care for trans folk is a backwards way of looking at the issue that stigmatizes trans people and unnecessarily classifies them as “sick” or problematic.  While I understand the point of view of those who want to keep the diagnosis structure to ensure medical access to transition for trans people, I feel like dropping the hugely stigmatizing term “disorder” is a step in the right direction and hopeful that this latest move will ultimately prove to be part of a sea change in transgender rights that will make the world a more just and humane place for everyone.

Brooklyn, NY

Lori Adelman is Executive Director of Partnerships at Feministing, where she enjoys creating and curating content on gender, race, class, technology, and the media. Lori is also an advocacy and communications professional specializing in sexual and reproductive rights and health, and currently works in the Global Division of Planned Parenthood Federation of America. A graduate of Harvard University, she lives in Brooklyn.

Lori Adelman is an Executive Director of Feministing in charge of Partnerships.

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  • rhian

    Sadly I think if the diagnosis is removed altogether, then the already limited insurance coverage for transition-related care will become outright nonexistent. I can only see two ways out: 1) this care becomes classified as preventive care that does not require an existing diagnosis, like contraception or cancer screening or 2) we have a real overhaul of our healthcare system that no longer requires every service provided to be justified to an insurance company. But yes, this is an important step.

  • daria

    this is a step forward but having it in the DSM is still stigmatising and hopefully it will go the way of the homosexuality entry. and none of the ASDs are going to be dropped- they’re going to be merged under one diagnosis, including asperger disorder.

  • Tae Phoenix

    I don’t think that being trans is a mental illness, and it shouldn’t be classified as such.

    That said, a lot of conditions in the DSM are perfectly healthy responses to trauma. It’s reasonable to suggest that the stressors and trauma associated with being assigned the wrong gender at birth (let alone being discriminated against the way trans people are in our culture) would give even the most mentally stable person a good chance of developing a mood disorder like depression or PTSD.

    So perhaps rather than creating a special disorder for trans people in the DSM, the health care community could treat transition care as a preventative measure for conditions that could result from not receiving that care. Transition care could be looked at much the same way as we look at offering reconstruction surgery for breast cancer patients after a mastectomy. In both cases we are preventing mental trauma by using medical science to make people physically whole and treat them with dignity.

    A side note: nothing in the DSM should be stigmatized any more than cancer is stigmatized. Mental illness is nothing to be ashamed of.

  • Molly Rothschild

    This is a good step forward, but when will it become normalized for the media to treat gender issues in the same way?
    check out this petition to take a stand