do you belong in the DSM if you are trans?
try to consider what you can't
There's been a lot of talk lately about a long time issue, taking trans issues out of the DSM. The DSM is the Diagnostic Statistical Manual. There have been 4 official editions of this book since 1952 and the 5th official edition is due to be out sometime within the next few years. This is the book that psychiatrists use to diagnosis their patients with a mental illness. France just recently removed gender identity disorder from their version of the DSM and now trans people everywhere are trying to decide if we want that for us too.
I'm not sure if i have an answer, but i do have some thoughts. I do think of myself as being more of an expert on this topic than most people i have talked with for a few reasons. 1. i have actually read the DSM4 and even the DSM3. If you haven't read the books, you are more likely to take the diagnosis of GID out of context. I have read it/studied it many times and i will continue to do so. 2. I have not only been diagnosed with Gender Identity Disorder, but i have at least 15 other official diagnoses from this book in my medical charts. Now, if your reaction to that last statement was something like "all that tells me is that you are crazy, not that you are qualified to have a strong opinion", then you might not like what i have to say.
The reason i felt compelled to write this was not to persuade you to pick a side. I'm tired of people picking sides. There are no black or white issues. It is all grey area and as long as we clutch to a side we not only make no progress, we start wars. It is good to have strong opinions. We should share them, but we should also be able to listen to others opinions without judgment. If you can't change your mind, you can't change a damn thing. I change my mind all the time. I'm about to give a strong opinion that i know is going to make many trans people uncomfortable. I am doing it for that very reason. I do not believe what i am about to say is set in stone. But i do think that if just hearing this makes you angry enough to resent me, then you should consider what that means.
I am frustrated with minorities right now. I love minorities. I am part of a whole lot of them. I am transgender, intersex, queer, i have been diagnosed with mental illness and spent half my life in and out of psych wards, i am unemployed, i am lower class/poor, i have been homeless, etc. I love all the minority groups that i belong to, but i also love all the other groups as well. ALL of them. It still boggles my mind to witness people in the LGBTQ community say they hate black people or Muslims or fat people or whatever. I just think "ARE YOU SERIOUS???" How can you fight for the equality of your people while hating other minorities? There is no equality unless we are ALL equal. And that INCLUDES those who we do not understand or agree with. Luckily, MOST of the people i know who are fighting for equality of LGBTQ people also recognize other minorities as being worthy of equality as well. To a point anyway. Too often they get caught up on the words that are used and how words offend people. Words ARE offensive, no doubt, but eventually we all need to grow up a little, get a sense of humor, grow some thicker skin, etc, because words are just words. How people act, even how they use the words, is a different matter. One of the biggest prejudices held by people fighting for equality is prejudice against ignorance. There are many people who have no interest in learning, no interest in opening their minds, and who in fact love to excel in the art of being ignorant. They are everywhere and especially love to "troll" the internet and let their hate and ignorance be seen by all. Some of them may actually be incapable of learning, and in that case, you can only do so much for them, but most ignorant people are capable of more than they realize. If you know how to talk to them without sounding like a snotty know it all liberal, you really can open the minds of most ignorant close minded people. But too many people in the fight for equality are far too rude and condescending and over educated to get anywhere with the "other side", as it is seen. Ignorance can in most cases be overcome, but if we act like we are too smart for them, using words they do not understand to tell them why they are being stupid, they are gonna hate us, and they do, and that is the biggest reason.
People in the fight for equality still judge others way too much too. Just because you disagree with something or even consider it morally wrong, if you cannot see how others might see you in the same light, we are screwed in this fight for equality. I'm tired of people thinking that they are better than drug addicts or gang members or prostitutes or members of the military just because they didn't have to face those particular choices in life. Most people get into those situations when they are young or desperate or are just plain born into it. If you didn't have to make that kind of choice it doesn't make you better, it makes you privileged. If you did get faced with the choice and you found a way to escape it, maybe you were lucky, maybe you were stronger...it still doesn't make you better.
And then there is the hatred for the oppressors. So many people in the LGBTQ community hate the christians and hate the republicans and hate the wealthy and hate the police, etc etc. I'm sorry, but that just isn't gonna get us anywhere. Yes, it is true that a lot of people in those groups do hate us, and they have far more power than we do, and that makes their hate stronger... They ARE stronger in numbers and status and they have the ability to hold us down. This is why HATING their groups is dangerous to US. Not all of them actually hate us, but if we hate them because they belong to those groups, they aren't gonna wanna help us either. We need to stop hating them just because some of them are trying to oppress us. Oppressing minorities is not the overall goal for police work, for christianity, for republicans, for the wealthy, etc. But as long as we keep bashing them and hating them, no matter how small of a minority we might be, we are not gonna be helping them to open their eyes and see us as equals. They will gladly just keep hating us back.
We really need to stop hating, stop seeing this as an us vs them thing cuz it is all grey area.
Now to finally get to the topic of the DSM, I think that gender identity disorder belongs in the DSM as much as any other "mental illness" because gender identity disorder is "crazy". Technically, it is even a "delusion". If you are born into a body that is both hormonally and sexually female, but you know in your HEAD that you are male, that is just as much of a delusion as a person who is carrying on a conversation with an invisible man. When you see a person carrying on a conversation with an invisible man, do you laugh? Some of you do, but probably most of you are nice enough not to go that far. Do you feel UNCOMFORTABLE in their presence? I bet most people do whether you will actually admit that or not is another thing, but you probably DO feel VERY uncomfortable when you are in the same room as a person who is talking to an invisible man. Why does it make you so uncomfortable? That is worth exploring on a personal level, but if you think that a person talking to an invisible man is crazy, and that such a person should be listed in the DSM, then you should try to accept that if you are trans, you are not all that different than them.
Here's why. Do YOU see the invisible man? No. If you did, you wouldn't be so uncomfortable. To you, talking to invisible men is "crazy". You see no scientific evidence, nothing in your physical perception of the world that could make you believe that there is really someone "there" if you cannot see it. It is in their head. There is something WRONG with their brain because they see something you don't. If you are trans and that is how you feel, then there is something WRONG with your brain too. Scientific evidence, physical evidence, shows that you are female or male (unless scientific evidence says you are both, aka intersex, in which case this varies a little) If you say you KNOW you are the opposite of what you physically appear to be, that makes you "crazy". It is a delusion because there is no real evidence except how you feel inside and what you "perceive" as your actual sex. It is a BRAIN issue. Brain issues are what the DSM is all about. The DSM does not understand ANY diagnosis. It lists the symptoms and the basic criteria to help a doctor be able to tell if this is something you might be dealing with or experiencing. The criteria changes all the time. People change all the time. No one is going to be exactly what the DSM might conclude them to be. You will always be more than that. It is a guideline. Is it a guideline that actually helps people or does it ultimately do more harm? As much as i love the book, i think it does do a lot more harm because too many people, including the well educated doctors who use it, do not really understand what is going on in your brain that makes you believe something or feel something that others do not. The brain is still a huge mystery.
The topic of gender identity in the DSM has been an issue for as long as there has been a DSM. Homosexuality is out of the DSM, and has been officially since 1994. The world of psychiatry was made to see homosexuality from another perspective. As homosexuals have grown more accepted in the world, doctors have decided it is not a disease. There are still many who have not reached a point of understanding, and they usually see homosexuals as "sinners". Some still think it is a disease that can be cured and some just call it sinning. But the GLB community has come far in their fight for equality and they have helped many people to understand that love is love and love is a good thing and i do agree with that. Still, on a scientific level, the act of gay sex could be seen as "crazy". It is not generally seen that way anymore. People can see it is about love and that everyone has different sexual desires, but the fact is that if 2 genetic men or 2 genetic females have sex with one another, they cannot create a life. If you are of the belief that the purpose of sex is to create a life, then gay sex is "crazy". But we have come a long way. We have had a sexual revolution and there are very few people out there who REALLY only have sex to make babies, including doctors. The minority now are the people having sex for the sole purpose of creating babies. Because of this shift in thinking and understanding, more people, including the doctors who diagnose, can fathom the idea of gay sex and gay love as a natural thing.
Trans people are grouped in with the GLB's, and that has helped us in many ways. A lot of GLB's still resent having anything to do with the T's and there are T's who feel the same. Shut up and get over it. For real. We are supposed to be working together. No, we are not the same thing. Being trans and being gay are 2 very different issues and really have very little to do with eachother. There are gay trans people, but there are gay racial minorities, gay christians, gay people with physical disabilities. There are trans fat people, trans jews, trans people with mental illness. In other words, groups people identify as overlap all the time and we all need to work together. The GLB community working together with the T community over the years has been a very special thing. We all know we aren't the same, but it has done us all a lot of good to work together.
However, because the GLB's have come so far in the sexual revolution, some want to leave the T's behind and get the power they always wanted and some of the T's resent being treated like that. It has caused some turmoil and political upsets. I think we need to stick together.
And when it comes to the DSM, i think the only reason gender identity disorder is even being considered as something that doesn't belong in a book about mental illness, is that it has been linked so strongly to the gay movement. Because we worked together, people who accept the gay community can at least kind of accept the trans community. They are more able to rethink the trans "delusion" because it is linked to something they already better understand.
But when trans people say things like "We NEED to be taken out of that book because there is NOTHING WRONG with how we think and if we are in that book no one will EVER take us seriously", i think that is acting kind of elitist. Just like the gays who want to leave the trans behind in order to get the power, saying stuff like that is leaving behind so many others who also deserve understanding. If you think that trans people should not be linked with people who's brains do not work like most, you are missing a valuable opportunity.
I know i keep using the example of invisible men seers for mental illness although i am well aware that mental illness includes all kinds of thinking, emotions, compulsions, delusions, etc. Some mental illnesses are much better understood today, like depression and bipolar, etc. However, even if you don't understand those illnesses, being in the same room as a depressed person doesn't generally make people uncomfortable. Seeing someone with a delusion, seeing something that goes against all that makes sense to the majority of humankind however, does make most people uncomfortable. Trans people are in that category. Trans people make most people uncomfortable. We absolutely do. Most people do not understand us AT ALL and just being in our presence makes them as uncomfortable as if they were with a person talking to an invisible man. WE need to be able to see that, and acknowledge that. And if locking us up and drugging us for OUR "delusions" is wrong, it is just as wrong to do it to the person talking to the invisible man. If a person is endangering themselves or others, that is different. But just BEING "crazy" is no reason to be treated as less than anyone else, and trans people should be fighting for equality along side of the "crazy" people as the GLB's did for us.
One last thing to consider is that doctors have figured out that in the case of trans people, feeding into our "delusions" and letting us transition to what we say we are, is the best way to treat us. Before transition, most trans people are full of self hate. We hate our bodies and the way we are forced to live what we consider a lie and once we are allowed to live as who we feel we are, most of us stop hating ourselves and learn to love life. It isn't that simple for everyone of course, but the fact is that gender identity disorder is the only "delusion" diagnosis where doctors have even tried BELIEVING the "delusion" as a way of treating it. And for the most part, it is no longer even acceptable to lock someone up, drug them, give them electric shock therapy, etc, in order to treat them for being trans anymore. And as trans people, we should consider sticking it out and fighting for those who do get locked away and drugged and tortured just because they are not understood. Fighting to be seen as "different" from "crazy people" is choosing to leave them behind. And it is not the way to equality.
Peace
There's been a lot of talk lately about a long time issue, taking trans issues out of the DSM. The DSM is the Diagnostic Statistical Manual. There have been 4 official editions of this book since 1952 and the 5th official edition is due to be out sometime within the next few years. This is the book that psychiatrists use to diagnosis their patients with a mental illness. France just recently removed gender identity disorder from their version of the DSM and now trans people everywhere are trying to decide if we want that for us too.
I'm not sure if i have an answer, but i do have some thoughts. I do think of myself as being more of an expert on this topic than most people i have talked with for a few reasons. 1. i have actually read the DSM4 and even the DSM3. If you haven't read the books, you are more likely to take the diagnosis of GID out of context. I have read it/studied it many times and i will continue to do so. 2. I have not only been diagnosed with Gender Identity Disorder, but i have at least 15 other official diagnoses from this book in my medical charts. Now, if your reaction to that last statement was something like "all that tells me is that you are crazy, not that you are qualified to have a strong opinion", then you might not like what i have to say.
The reason i felt compelled to write this was not to persuade you to pick a side. I'm tired of people picking sides. There are no black or white issues. It is all grey area and as long as we clutch to a side we not only make no progress, we start wars. It is good to have strong opinions. We should share them, but we should also be able to listen to others opinions without judgment. If you can't change your mind, you can't change a damn thing. I change my mind all the time. I'm about to give a strong opinion that i know is going to make many trans people uncomfortable. I am doing it for that very reason. I do not believe what i am about to say is set in stone. But i do think that if just hearing this makes you angry enough to resent me, then you should consider what that means.
I am frustrated with minorities right now. I love minorities. I am part of a whole lot of them. I am transgender, intersex, queer, i have been diagnosed with mental illness and spent half my life in and out of psych wards, i am unemployed, i am lower class/poor, i have been homeless, etc. I love all the minority groups that i belong to, but i also love all the other groups as well. ALL of them. It still boggles my mind to witness people in the LGBTQ community say they hate black people or Muslims or fat people or whatever. I just think "ARE YOU SERIOUS???" How can you fight for the equality of your people while hating other minorities? There is no equality unless we are ALL equal. And that INCLUDES those who we do not understand or agree with. Luckily, MOST of the people i know who are fighting for equality of LGBTQ people also recognize other minorities as being worthy of equality as well. To a point anyway. Too often they get caught up on the words that are used and how words offend people. Words ARE offensive, no doubt, but eventually we all need to grow up a little, get a sense of humor, grow some thicker skin, etc, because words are just words. How people act, even how they use the words, is a different matter. One of the biggest prejudices held by people fighting for equality is prejudice against ignorance. There are many people who have no interest in learning, no interest in opening their minds, and who in fact love to excel in the art of being ignorant. They are everywhere and especially love to "troll" the internet and let their hate and ignorance be seen by all. Some of them may actually be incapable of learning, and in that case, you can only do so much for them, but most ignorant people are capable of more than they realize. If you know how to talk to them without sounding like a snotty know it all liberal, you really can open the minds of most ignorant close minded people. But too many people in the fight for equality are far too rude and condescending and over educated to get anywhere with the "other side", as it is seen. Ignorance can in most cases be overcome, but if we act like we are too smart for them, using words they do not understand to tell them why they are being stupid, they are gonna hate us, and they do, and that is the biggest reason.
People in the fight for equality still judge others way too much too. Just because you disagree with something or even consider it morally wrong, if you cannot see how others might see you in the same light, we are screwed in this fight for equality. I'm tired of people thinking that they are better than drug addicts or gang members or prostitutes or members of the military just because they didn't have to face those particular choices in life. Most people get into those situations when they are young or desperate or are just plain born into it. If you didn't have to make that kind of choice it doesn't make you better, it makes you privileged. If you did get faced with the choice and you found a way to escape it, maybe you were lucky, maybe you were stronger...it still doesn't make you better.
And then there is the hatred for the oppressors. So many people in the LGBTQ community hate the christians and hate the republicans and hate the wealthy and hate the police, etc etc. I'm sorry, but that just isn't gonna get us anywhere. Yes, it is true that a lot of people in those groups do hate us, and they have far more power than we do, and that makes their hate stronger... They ARE stronger in numbers and status and they have the ability to hold us down. This is why HATING their groups is dangerous to US. Not all of them actually hate us, but if we hate them because they belong to those groups, they aren't gonna wanna help us either. We need to stop hating them just because some of them are trying to oppress us. Oppressing minorities is not the overall goal for police work, for christianity, for republicans, for the wealthy, etc. But as long as we keep bashing them and hating them, no matter how small of a minority we might be, we are not gonna be helping them to open their eyes and see us as equals. They will gladly just keep hating us back.
We really need to stop hating, stop seeing this as an us vs them thing cuz it is all grey area.
Now to finally get to the topic of the DSM, I think that gender identity disorder belongs in the DSM as much as any other "mental illness" because gender identity disorder is "crazy". Technically, it is even a "delusion". If you are born into a body that is both hormonally and sexually female, but you know in your HEAD that you are male, that is just as much of a delusion as a person who is carrying on a conversation with an invisible man. When you see a person carrying on a conversation with an invisible man, do you laugh? Some of you do, but probably most of you are nice enough not to go that far. Do you feel UNCOMFORTABLE in their presence? I bet most people do whether you will actually admit that or not is another thing, but you probably DO feel VERY uncomfortable when you are in the same room as a person who is talking to an invisible man. Why does it make you so uncomfortable? That is worth exploring on a personal level, but if you think that a person talking to an invisible man is crazy, and that such a person should be listed in the DSM, then you should try to accept that if you are trans, you are not all that different than them.
Here's why. Do YOU see the invisible man? No. If you did, you wouldn't be so uncomfortable. To you, talking to invisible men is "crazy". You see no scientific evidence, nothing in your physical perception of the world that could make you believe that there is really someone "there" if you cannot see it. It is in their head. There is something WRONG with their brain because they see something you don't. If you are trans and that is how you feel, then there is something WRONG with your brain too. Scientific evidence, physical evidence, shows that you are female or male (unless scientific evidence says you are both, aka intersex, in which case this varies a little) If you say you KNOW you are the opposite of what you physically appear to be, that makes you "crazy". It is a delusion because there is no real evidence except how you feel inside and what you "perceive" as your actual sex. It is a BRAIN issue. Brain issues are what the DSM is all about. The DSM does not understand ANY diagnosis. It lists the symptoms and the basic criteria to help a doctor be able to tell if this is something you might be dealing with or experiencing. The criteria changes all the time. People change all the time. No one is going to be exactly what the DSM might conclude them to be. You will always be more than that. It is a guideline. Is it a guideline that actually helps people or does it ultimately do more harm? As much as i love the book, i think it does do a lot more harm because too many people, including the well educated doctors who use it, do not really understand what is going on in your brain that makes you believe something or feel something that others do not. The brain is still a huge mystery.
The topic of gender identity in the DSM has been an issue for as long as there has been a DSM. Homosexuality is out of the DSM, and has been officially since 1994. The world of psychiatry was made to see homosexuality from another perspective. As homosexuals have grown more accepted in the world, doctors have decided it is not a disease. There are still many who have not reached a point of understanding, and they usually see homosexuals as "sinners". Some still think it is a disease that can be cured and some just call it sinning. But the GLB community has come far in their fight for equality and they have helped many people to understand that love is love and love is a good thing and i do agree with that. Still, on a scientific level, the act of gay sex could be seen as "crazy". It is not generally seen that way anymore. People can see it is about love and that everyone has different sexual desires, but the fact is that if 2 genetic men or 2 genetic females have sex with one another, they cannot create a life. If you are of the belief that the purpose of sex is to create a life, then gay sex is "crazy". But we have come a long way. We have had a sexual revolution and there are very few people out there who REALLY only have sex to make babies, including doctors. The minority now are the people having sex for the sole purpose of creating babies. Because of this shift in thinking and understanding, more people, including the doctors who diagnose, can fathom the idea of gay sex and gay love as a natural thing.
Trans people are grouped in with the GLB's, and that has helped us in many ways. A lot of GLB's still resent having anything to do with the T's and there are T's who feel the same. Shut up and get over it. For real. We are supposed to be working together. No, we are not the same thing. Being trans and being gay are 2 very different issues and really have very little to do with eachother. There are gay trans people, but there are gay racial minorities, gay christians, gay people with physical disabilities. There are trans fat people, trans jews, trans people with mental illness. In other words, groups people identify as overlap all the time and we all need to work together. The GLB community working together with the T community over the years has been a very special thing. We all know we aren't the same, but it has done us all a lot of good to work together.
However, because the GLB's have come so far in the sexual revolution, some want to leave the T's behind and get the power they always wanted and some of the T's resent being treated like that. It has caused some turmoil and political upsets. I think we need to stick together.
And when it comes to the DSM, i think the only reason gender identity disorder is even being considered as something that doesn't belong in a book about mental illness, is that it has been linked so strongly to the gay movement. Because we worked together, people who accept the gay community can at least kind of accept the trans community. They are more able to rethink the trans "delusion" because it is linked to something they already better understand.
But when trans people say things like "We NEED to be taken out of that book because there is NOTHING WRONG with how we think and if we are in that book no one will EVER take us seriously", i think that is acting kind of elitist. Just like the gays who want to leave the trans behind in order to get the power, saying stuff like that is leaving behind so many others who also deserve understanding. If you think that trans people should not be linked with people who's brains do not work like most, you are missing a valuable opportunity.
I know i keep using the example of invisible men seers for mental illness although i am well aware that mental illness includes all kinds of thinking, emotions, compulsions, delusions, etc. Some mental illnesses are much better understood today, like depression and bipolar, etc. However, even if you don't understand those illnesses, being in the same room as a depressed person doesn't generally make people uncomfortable. Seeing someone with a delusion, seeing something that goes against all that makes sense to the majority of humankind however, does make most people uncomfortable. Trans people are in that category. Trans people make most people uncomfortable. We absolutely do. Most people do not understand us AT ALL and just being in our presence makes them as uncomfortable as if they were with a person talking to an invisible man. WE need to be able to see that, and acknowledge that. And if locking us up and drugging us for OUR "delusions" is wrong, it is just as wrong to do it to the person talking to the invisible man. If a person is endangering themselves or others, that is different. But just BEING "crazy" is no reason to be treated as less than anyone else, and trans people should be fighting for equality along side of the "crazy" people as the GLB's did for us.
One last thing to consider is that doctors have figured out that in the case of trans people, feeding into our "delusions" and letting us transition to what we say we are, is the best way to treat us. Before transition, most trans people are full of self hate. We hate our bodies and the way we are forced to live what we consider a lie and once we are allowed to live as who we feel we are, most of us stop hating ourselves and learn to love life. It isn't that simple for everyone of course, but the fact is that gender identity disorder is the only "delusion" diagnosis where doctors have even tried BELIEVING the "delusion" as a way of treating it. And for the most part, it is no longer even acceptable to lock someone up, drug them, give them electric shock therapy, etc, in order to treat them for being trans anymore. And as trans people, we should consider sticking it out and fighting for those who do get locked away and drugged and tortured just because they are not understood. Fighting to be seen as "different" from "crazy people" is choosing to leave them behind. And it is not the way to equality.
Peace