Academic journal article Canadian Journal of Counselling and Psychotherapy (Online)

Giving Voice to the Trans Community on GID Reform in the DSM-5: A Saskatchewan Perspective/Donner la Parole À la Communauté Trans Au Sujet De la Réforme Du Trouble D'identité Sexuelle Dans le DSM-5 : Un Point De Vue De la Saskatchewan

Academic journal article Canadian Journal of Counselling and Psychotherapy (Online)

Giving Voice to the Trans Community on GID Reform in the DSM-5: A Saskatchewan Perspective/Donner la Parole À la Communauté Trans Au Sujet De la Réforme Du Trouble D'identité Sexuelle Dans le DSM-5 : Un Point De Vue De la Saskatchewan

Article excerpt

Is it a boy or a girl? This is one of the first questions posed to parents of a newborn child. For most parents, the simple answer to this question is based on the information provided by the obstetrician and the outward appearance of the infant's genitalia. Imagine the resulting confusion when that child ages and begins to feel at odds with their biologically prescribed gender identity, or during key moments when an adult realizes that their biological gender and psychological gender are not in sync. Individuals that step outside of society's prescribed gender norms or roles have led to confusion for centuries, although it is a phenomenon that has been documented throughout history. There is a debate underway with regard to the inclusion of gender identity disorder (GID) in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is currently undergoing revision (Melby, 2009). This has provided the opportunity to gather information regarding the diagnosis and how it should be presented, if at all, within the nomenclature. There is little research on how those most affected by the decision (i.e., transgender-identified people) feel about the situation. The trans-identified population is already marginalized and their opinions should be considered in the process of making this decision. To be involved in the decisions that affect one's life gives an individual a sense of empowerment and control instead of alienation and suppression.

There are a number of positions on the issue of GID in the upcoming DSM-5. Lev (2006) questions whether GID is truly a mental disorder and thus believes it should be removed. There are also those who believe it should be retained (Fink, 2006; Spitzer, 2006). Most proponents for keeping GID in the DSM express concern that its removal would also remove access to treatment through insurance coverage. There are also those who believe the diagnosis should remain, but be reformed (Bockting & Ehrbar, 2006; Winters, 2006).

This study adds the voice of the affected population to the existent data. There is also little research conducted specifically within Canada. The purpose of this study is to provide useful information and potential strategies for those who are working with trans-identified clients. It also provides an opportunity for transgender people to voice their opinion regarding the diagnosis of GID and the current debate regarding its removal, retention, or reform in the DSM-5. The questions to be answered by this research are:

* What is it like to live as a trans-identified person in Saskatchewan?

* What effects does being diagnosed with a "disorder" have on you?

* How does the debate regarding GID inclusion in the DSM-5 affect you?

* What differences do you believe you would experience if GID were removed from the DSM-9.

The diagnosis of GID as it currently stands in DSM-JV-TR (4th ed., text rev.; American Psychiatric Association, 2000) draws both criticism and support regarding the diagnostic criteria and, in fact, its inclusion in the nomenclature. Following is a discussion of the evolution of the DSM diagnosis and a brief review of the current literature regarding the debate.

GENDER IDENTITY DISORDER

GID first appeared in DSM-III (APA, 1980) as a subclass of psychosexual disorders with two diagnostic categories: transsexualism and gender identity disorder of childhood (Winters, 2006). In the DSM-III-R (APA, 1987), GID was moved to "disorders usually first evident in infancy, childhood, or adolescence," which recognized that symptoms generally appear in childhood (Winters, 2006). The diagnostic criteria were expanded to include gender role nonconformity in girls, which indicated an increased emphasis on social nonconformity. The diagnostic criteria were also expanded to include a wider range of gender variant individuals, with gender identity disorder of adolescence or adulthood, nontransexual type (GIDAANT) in section 302. …

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