There’s a petition doing the rounds at the moment on pathologisation of Trans people in medical classification.
Please don’t sign it.
The petition misses some important caveats that are critical to ensuring Trans folk continue to get healthcare and it is not clear if the authors of the petition realised this.
Many people believe that if being homosexual could be removed as a disorder, so can gender dysphoria. But you don’t need a doctor to be gay. I don’t need a doctor to be Trans either, but access to surgery and HRT makes life liveable. If Gender Dysphoria is no longer recognised by the WHO, Health Services will see less need to provide services. In many countries, including the UK, health care for Trans folk is already poor to non-existant in places.
For an example of the details have a look at the European Parliament motion they reference on the same topic: they asked the WHO “to withdraw gender identity disorders from the list of mental and behavioural disorders while ensuring a non-pathologizing re-coding in the 11th version of the International Classification of Diseases (ICD-11).”
The latest petition misses the nuance and just calls for “ICD 11…to stop considering transexuality as an illness.“
I don’t agree. I think the point the petition is making is that the WHO (and some other bodies) are hanging onto the historical diagnosis of Gender Identity Disorder (GID), and was considered to be a psychiatric disorder.
Gender Dysphoria (GD – which is replacing GID as a diagnosis) is still considered a treatable medical condition, and as such is eligible for funding and so on – it’s just not a *psychiatric* condition.
The American DSM update due within the next few months will deprecate GID in favour of GD, and all being well, the WHO will follow suit.
If that’s the point the petition is trying to make, it needs to be explicit in it’s aims because at the moment, it’s written as if to say it should be dropped from ICD-11 completely and that’s the way most people have interpreted it. The confusion is compounded by confusion between DSM and ICD.
I’ve not spoken to Max but I chatted with Sarah Savage (Another MTSer) and she didn’t understand the nuance, so it looks likely the obvious interpretation of the petition (dropping GID/GD from ICD totally) is the one intended by the authors. The petition may get updated as a result of the fuss on Twitter today. however.
Hmm, that’s no good. If that’s how people are reading it, then the petition definitely needs to be more explicit.
It’s a subtle complexity: gender nonconformity is not an illness – but gender dysphoria (when one’s gender nonconformity causes suffering that needs addressing in some way) is a treatable condition.
GID as a diagnosis belongs on the scrapheap with homosexuality-as-mental-disorder, but GD is a live and real issue that needs the understanding of the healthcare profession.
Max, the petition’s author, has now made it explicit on Huffington Post (http://www.huffingtonpost.co.uk/2012/10/18/transgender_n_1982321.html) that he regards being Trans as a choice – “I chose to be like this because I like it” – and that he wants complete declassification of Trans as an illness. It now doesn’t look like it’s just badly written, but more as if the petition itself is simply wrong and harmful to the community.
In the new DSM V, Gender Indentity Disorder, is no longer referred to as a disorder.
I’ve just taken another look at the petition and its wording, and I still don’t think it’s problematic in itself.
Whatever Max may have to say about trans outside of the petition itself (and he’s not the first person I’ve heard say that being trans isn’t a choice, but transitioning is one – which I can only say isn’t my own experience), the petition is calling to cease classing transgender as a mental disorder.
I’m unclear why people assume this could lead to gender dysphoria not being considered a treatable medical condition. It’s just addressing the “mental disorder” stigma that’s attached to it.
This petition could have been worded better. The error is literacy, not principle. There are a number of points.
1. It applies to ICD-11 not DSM-5. In DSM-5 Gender Dysphoria is still classed as mental illness despite flimflam wording in the description of it.
2. Absence of a GID or equivalent mental diagnosis will not make proven successful treatment for conditions go way. There are other examples in medicine of successful treatment that survive the debunking of the theories used to support the diagnosis.
3. Medical sex must be distinguished from scientific sex must be distinguished from legal sex. They are respectively about (a) health (b) biology (c) law and only loosely connected each with the other.
4. After GID is abolished treatment will be on a same-sex rather than a trans-sex basis. That is to say, for example, an MTF will receive estrogen because she has no ovaries rather than because he has a disordered identity.
5. Change of medical sex (quite possibly legal sex also) will come before therapy, psychiatry, hormones, surgery – to the extent any or all of those are DESIRED by the patient.
6. Argentina has shown the way. There legal sex is changed before medical treatment begins.
Please sign the petition, as long as we conspire in bogus mental health conditions we are partners in crime and will never throw off of psychiatrist abusers (as the homosexual people did generations ago).
I disagree. Max has made it very clear he supports complete declassification of Trans issues, which is wrong on principle as far as I’m concerned.
On point 2, yes it will – not just in the UK but in other countries too. Insurance companies and national healthcare providers already look for excuses not to provide care and the “this is a choice” line being pushed by Max gives them exactly the ammunition they need, “we don’t fund lifestyle choices”. An example given where healthcare is provided but it’s not an illness is misleading IS included in ICD-10.
Point 4 only works post-SRS.
Points 3 and 5 are meaningless, there is no clear binary concept of “medical sex”.
I will not sign this petition, because I will not throw people who cannot afford private treatment under the bus just because I’m OK now I’ve already had surgery.
Medical sex is not meaningless. It is the assignment of sex which, (in the considered professional judgment of a person authorized to practice medicine), is the assignment which best promotes the health of the patient. Best promotes.
Medicine needs to remember its credo which is to promote health and it is NOT merely to validate science. Scientific sex is non binary; just as nature provides near infinite variety through the mechanisms of mutation and evolution. Legal sex is binary (in most jurisdictions) because it is purely a concept invented by men. Medical sex can be binary (M,F) or non binary (M,F,I), that is a matter of medical judgment and best left to the doctors.
To suggest that treatment will end is scaremongering; but even if it were true then treatment on a basis of a fictional identity disorder is dishonest, it is fraud. We will never be free so long as we conspire in fraud. Please put an end to the dishonesty, please support the petition.
“To suggest that treatment will end is scaremongering” – Please go and talk to your local NHS managers about funding priorities if you believe this is true. It’s not.
Medical sex? What’s medical sex? Oh hang on, I’ve got a nurse’s uniform and a speculum. That could work…
Medical sex is the assignment of sex which, (in the considered professional judgment of a person authorized to practice medicine), is the assignment which best promotes the health of the patient.
It is a matter of medicine, as contrasted with science and also as contrasted with law.
They’re bluffing.
Eh, what?! You’re not in the UK are you? (Or if you are, you’re lucky enough to have avoided any exposure to the NHS whatsoever!) Disbelief that Gender Dysphoria is a serious medical issue is already used as an excuse not to provide treatment – as something that already happens, and that we have to fight against by pointing out it’s in documents like ICD, it is most definitely NOT a bluff.
Whilst declassification and complete removal from ICD might work in whatever country you are in, it does NOT work for the UK. Please consider the very serious harm you are doing to Trans people worldwide with your views.