April 15, 2013

Gender Dysphoria Diagnosis Is Not Progress Enough

Michael Salas

With the latest version of the Diagnostic and Statistical Manuel of Mental Disorders (DSM) about to be released, there is criticism and discussion about the changes that have been made. In the latest version, one of the most discussed changes is that the language for the diagnosis of Gender Dysphoria has been softened. The current version of the DSM, the DSM-IVTR used the diagnosis of Gender Identity Disorder, but has changed this to Gender Dysphoria to show greater acceptance of the transgender community, and to show that this is not a disorder. The American Psychological Association (APA) is changing its terminology to become more politically correct, yet changing the language misses the point. Why does it need to be included in the DSM at all?

“Homosexuality” used to be a mental health diagnosis in the DSM. The APA would later remove this and its secondary version with softer language, “Sexual Orientation Disturbance”. The circumstances for these changes were similar to those changes that are made in the upcoming version of the DSM to reflect a better understanding of the transgender community. Therefore, if we look at this issue from a historical standpoint, there really is no reason to include Gender Dysphoria at all. If homosexuality was re-established as something that was diagnosable, there would be a huge controversy, and rightfully so. Fear is fear and depression is depression, no matter what community you are part of.

Therefore, to best de-stigmatize the transgender community, it is my opinion that any diagnosis regarding issues of coping with one’s identified gender be completely taken out of a book that is intended to diagnose. Clinicians should be experienced in helping clients who are dealing with transgender-related issues, if they are going to work with this population. This is no different than any other culturally competentency requirement. Thus, although I agree that it is progress to use softer language, the undertones of stigmatization remain. And they will likely remain until transgender “diagnoses” are completely removed from the DSM altogether.

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