Transgender rights talks from the fifth annual Trans Pride March rally in Dolores Park

A significant amount of time in the four hour TransMarch rally was spent in discussions of medical problems related to the continued classification of transgender people in the DSM IV (Diagnostic and Statistical Manual of mental illness) as a mental health condition. The DSMIII had considered gay and lesbian people as having mental illness, those diagnoses have since been eliminated. Activists burned a copy of the manual on stage as a protest.

Transgender activists are organizing to eliminate this diagnosis. The World Health Organization is in the process of revising the manual, so activists intend to seize the opportunity to eliminate this “disorder” from the manual. This diagnosis means that transgender individuals are automatically labeled as having a mental health condition. Since cultural competence obviously does not exist in the mainstream medical system, the archaic stereotypes in this manual probably are the main reference point for the diagnosing and treating physicians. While some transgender people do suffer from mental illness, this type of diagnostic process places the cause purely on the internal workings of the individual, as opposed to hostile and discriminatory forces in society.

Speakers also spoke of the need for adding a physiological diagnosis that can work to insure that transgender people have right and access to the physical health care they need, including surgical procedures. One speaker highlighted an example of suicide from an individual who was arbitrarily denied surgery at a clinic because they chose not to accept liability for his treatment.

The mental health diagnosis is “Gender Identity Disorder”. It is consistently referred to as a “disturbance“. Excerpts of diagnostic criteria include:

“In adolescents and adults, the disturbance is manifested by symptoms such as stated desire to be the other sex, frequently passing as the other sex, desire to live and be treated as the other sex, or the conviction that he or she has the typical feelings and reactions of the other sex.”

“...the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g. request for hormones, surgery, or other procedures to physically alter sex characteristics to simulate the other sex) or belief that he or she was born the wrong sex.”

“Adults with Gender Identity Disorder are preoccupied with their wish to live as a member of the other sex. This preoccupation may be manifested by as an intense desire to adopt the social role of the other sex or to acquire the physical appearance of the other sex through hormonal or surgical manipulation”

The descriptions for children seem to me much worse and not even worthy to print here.

To me, some of these words see really problematic. Disorder, disturbance, intense desire, preoccupation, symptoms, simulate??? The appropriate physiological diagnosis could legitimize instead of pathologize these health and societal needs. As with the mental health system overall in this country, I wonder how many transgender people are severely mistreated or harmed by the mental health system?

Speakers encouraged the crowd that the time is right to work for these changes, both because the manual is changing and because transgender people are better organized than in the past. Hopefully the changes will be implemented.