- Focus of pathology on nonconformity to assigned birth sex in disregard to the definition of mental disorder, which comprises distress and impairment.
- Stigma of mental illness upon emotions and expressions that are ordinary or even exemplary for non-transgender children, adolescents and adults.
- Lacks clarity on gender dysphoria, defined here as clinically significant distress with physical sex characteristics or ascribed gender role.
- Contradicts transition and access to hormonal and surgical treatments, which are well proven to relieve distress of gender dysphoria.
- Encourages gender-conversion therapies, intended to change or shame one’s gender identity or expression.
- Misleading title of “Gender Identity Disorder,” suggesting that gender identity is itself disordered or deficient.
- Maligning terminology, including “autogynephilia,” which disrespects transitioned individuals with inappropriate pronouns and labels.
- False positive diagnosis of those who are no longer gender dysphoric after transition and of gender nonconforming children who were never gender dysphoric.
- Conflation of impairment caused by societal prejudice with distress intrinsic to gender dysphoria.
- Placement in the class of sexual disorders.
from "Top Ten Problems with the GID Diagnosis" at GID Reform Advocates.
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Issues with the Membership of the Sexual and Gender Identity Disorders Work Group
- It's important to have people with a wide range of view-points about gender dysphoric people and cross-dressers in order for the scientific process to work as well as possible.
- We're concerned that researchers and practitioners who work from a trans-affirmative stance are under-represented on the two sub-committees in question. Because of this, we ask that at least one person with such a perspective be added to each sub-committee and suggest specific
recommendations for nomination.
- The diagnostic category of Transvestic Fetishism (TF), in the Paraphilias section of the current DSM, equates crossdressing and expression of femininity by biological males with sexual fetishism and imposes unfair social stigma of perversion. The TF diagnosis does not allow for the existence of healthy, well-adjusted male-identified cross-dressers, and affirming views of gender expression diversity are not adaquately represented on the Paraphilias Subcommittee of the Sexual and GID Work Group.
- Other leading professional medical and mental health organizations have recently affirmed the social legitimacy of transitioned individuals and medical necessity of hormonal or surgical treatment for gender dysphoria. Portrayal of gender identity or expression that vary from birth sex as inherent mental pathology in the DSM is out of step with contemporary attitudes about gender diversity. For example:
- In June, 2008 the American Medical Association stated that "medical research demonstrates the effectiveness and medical necessity of mental health care, hormone therapy, and sex reassignment surgery as forms of therapeutic treatment..." for emotional pain caused by distress with one's assigned sex and sex characteristics.
AMA Resolution 122 called for health insurance coverage of these treatments for what it termed "a serious medical condition."
- The World Association for Transgender Health (WPATH) released a statement of Clarification on Medical Necessity for Sex Reassignment Surgery in July, 2008. It stated that "... sex reassignment, properly indicated and performed as provided by the
Standards of Care, has proven to be beneficial and effective in the treatment of individuals with transsexualism, gender identity disorder, and/or gender dysphoria." WPATH reaffirmed its position from the 2001
Standards of Care that medical procedures attendant to sex reassignment are not cosmetic, elective or experimental and urged insurance coverage of these medically necessary services.
- In August, 2008 the National Association for Social Workers approved a public policy statement on Transgender and Gender Identity Issues. The NASW advocated "civil rights of people of diverse gender expression and identity" and "repeal of laws and discriminatory practices, especially in employment." The statement noted that "A nonjudgmental attitude toward gender diversity enables social workers to provide maximum support and services to those whose gender departs from the expected norm."
- In August, 2008 the American Psychological Association issued a "Resolution on transgender, gender
identity, and gender expression non-discrimination," opposing discrimination on the basis of gender identity and expression and recognizing the "the efficacy, benefit and
medical necessity of gender transition treatments...." The APA called for "public and private insurers to cover these medically necessary treatments," and encouraged "legal and social
recognition of transgender individuals consistent with their gender identity and expression...."
- The American Psychological Association Task Force on Gender Identity, Gender Variance and Intersex Conditions stated in 2006, that “Many transgender people do not experience their transgender feelings and traits to be distressing or disabling, which implies that being transgender does not constitute a mental disorder per se.”
More background information and references may be found on our
References page.
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