What's Up, Doc? Would Removing Transgender from the List of Mental Disorders Do More Harm Than Good?

Article excerpt

THE LAST WORD KELLEY WINTERS WOULD EVER USE to describe herself is disordered. But that's exactly how the medical profession describes her. Forget for a moment that Winters is a well-spoken Ph.D. in electrical engineering from the University of Idaho who went on to have an impressive 29-year career at Hewlett-Packard before retiring this June. Winters, who was born male, is transgender. And to receive the medical care she needed to transition, she had to be officially diagnosed with gender identity disorder-the psychiatric term used to describe people who feel their gender identity doesn't match their birth gender.

Winters agreed to the GID diagnosis so that she could live her life as a woman, but she refused to accept it. Instead, she founded GID Reform Advocates, an organization committed to changing how psychiatrists view and classify transgender men and women. Her ultimate goal? To remove GID from the Diagnostic and Statistical Manual of Mental Disorders, the physician's bible for diagnosing mental health problems.

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"The current diagnosis of GID," says Winters, "carries the same burden of social stigma that homosexuality did for gays and lesbians before 1973." When the American Psychiatric Association voted to remove the diagnosis of homosexuality from the DSM on December 15,1973, it was a watershed for the gay rights movement. "With homosexuality no longer classified as a mental illness," says psychiatrist Jack Drescher, past chair of the APA's Committee on GLB Issues, "it removed the rationalization for discrimination, and it made the question about whether gays should be accepted as full citizens a moral one."

ON THE LIST

WHETHER REMOVING gender identity disorder from the DSM would be a similar turning point for transgender rights has been cause for heated debate among trans people themselves. At its core, the dispute hinges on whether GID is truly an accurate classification for a person who is uncomfortable in his or her body. Some transgender advocates believe that the term GID incorrectly pathologizes being transgender, arguing that gender variance is as normal as homosexuality and therefore shouldn't be deemed a mental disorder. However, others point out that having GID in the DSM actually helps with specific legal and medical wrangling, so it's foolish to remove it. Still others propose a middle ground--a place on the list but with a less stigmatizing diagnosis, such as gender dysphoria.

While the removal of gender identity disorder doesn't seem as clear-cut as homosexuality (at least in retrospect), parallels do exist. Says Winters: "Intolerant people don't make a distinction between gay, lesbian, bisexual, and transgender. In that respect the equation of difference with disorder, disease, and psychosexual perversion is very much the same for gender-variant people as it was for the gay and lesbian community."

But there is one important distinction: A gay or lesbian person doesn't require medical treatment because he or she is gay. In contrast, many transgender men and women seek out medical care, such as surgery and hormone therapy, which most will need for the rest of their lives. And depending on what type of surgeries they have, some transsexuals will always continue to require medical services related to their biological sex.

Shannon Price Minter, who has litigated a number of high-profile transgender cases as legal director for the National Center for Lesbian Rights, believes that removing GID from the DSM would be devastating because the diagnosis, whether it is fair or not, allows access to costly medical care. "The medical framework is enormously significant in legal advocacy," he says. "When we go to court to advocate for transsexual people to get medical treatment in a whole variety of circumstances, from kids in foster care to prisoners on Medicaid," the GID diagnosis is used to show that treatment is medically necessary. …