12/8/12

APA DSM-5: The D word Switcharoo

The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association APA, contains descriptions, symptoms, and other criteria for diagnosing mental disorders.

These criteria for diagnosis provide a common language among clinicians and mental health professionals who treat patients with mental disorders. The APA is currently developing the latest edition, DSM to be published May 2013

There are extremes in all communities and ours is no exception. Being radical it seems right that I occupy the one on the far side advocating for our removal lock, stock and barrel from the DSM-5.

I'm also open to others opinions and since it's such a hot button issue, one I felt needed our attention I created a Facebook event that was joined by five thousand people for conversation. Some against some for our removal and some in the middle, but all respected.

Did those of us who wanted our removal succeed?  No, most likely we failed despite my best efforts at getting local people out from behind their keyboards. That was somehow my fault. Not the gay communities.  We didn't take to the street at key moments and gain the spotlight as they did twenty years ago.

The facts.

The December first 2012  press release from the APA announcing the next bureaucratic step needed to publish the DSM-5 had been taken by the board voting it's approval.

And the world fell over themselves to announce trans people were no longer listed as "disordered" by in the DSM.

Did I miss something in that press release?

The  Message From APA President Dilip Jeste, M.D., on DSM-5 offers no specifics, only justifications and denials regarding the process.

So whats up?

The often quoted Med Page published in May following the last public meeting reports what may not up:

"Gender identity disorder. Individuals who believe their biological gender doesn't match their gender identification will no longer be labeled with a disorder. Instead, if they seek psychiatric treatment, they can be labeled with "gender dysphoria."

The workgroup responsible for dealing with the hot-button issue considered a variety of other approaches, addressed later in this article. Ultimately they settled on a formal diagnosis -- potentially qualifying a patient for insurance-paid treatment if they want it -- but with a less pejorative name than "disorder."


So the name might change but what is the difference between the two words and what does it mean to trans people? The free medical dictionary defines....

Gender Identity Disorder:

"The psychological diagnosis gender identity disorder (GID) is used to describe a male or female that feels a strong identification with the opposite sex and experiences considerable distress because of their actual sex."

Gender Dysphoria:

"unhappiness with one's biological sex or its usual gender role, with the desire for the body and role of the opposite sex.

Not much difference between the two words is there?

Please understand this is just conjuncture since no further official information available untill the DSM-5 is published in May 2013.
But given that one D word is being substituted for another what's the end result?

We remain pathologized by the APA

pa·thol·o·gize

/pəˈTHäləˌjīz/Verb

Regard or treat (someone or something) as psychologically abnormal or unhealthy

Which in my opinion denies  us our rightful place among the worlds well adapted productive citizens.

So try as hard as I may I failed, kind of. Who knows. I did give space to those who wanted conversation. But most importantly, those who wanted our total removal from the DSM as well.

 But now its just a waiting game. The APA has what it wants, our undivided attention, our money, the guidelines to normality, acceptability and our chances at success in life.
















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