• Choose a category
• All
• Classic-Fiction

By Root 1965 0

“clinically significant distress or impairment in social, occupational, or other important areas of functioning.” Clearly, a far greater number of people meet these criteria than meet the more limited criteria for trans-sexualism. In shifting the focus from an expressed desire to change sex to cross-gender identification, distress, and impairment in functioning, the new diagnosis encompasses not only the relatively few individuals who desire sex reassignment, but also the far greater number who are perceived by themselves or by others to express some form of gender variance. However, in the absence of a strong desire for body modification, are the “distress and impairment” experienced by such individuals due to the disorder itself, or are they a consequence of the harassment and social ostracism gender-variant people endure?

Activists argue that the decision to delete homosexuality as a mental disorder from the seventh printing of the second edition of DSM-III and the subsequent creation of the diagnosis of gender identity disorder was a kind of psychiatric sleight of hand. Although the focus of the diagnosis has changed from deviant desire to subversive identity, the core of the diagnosis remains the same: the individual is not a “normal” male or female, and his or her deviance from the norm is conceived as illness or pathology. The diagnosis of gender identity disorder becomes a particularly troubling matter, activists say, when applied to children and adolescents. Four of the following behaviors must be present to justify a clinical diagnosis of gender identity disorder in children: (a) a repeatedly stated desire to be, or insistence that he or she is, the other sex; (b) in boys, a preference for cross-dressing or simulating female attire, and in girls, an insistence on wearing only stereotypical masculine clothing; (c) a strong and persistent preference for cross-sex roles in make-believe play or persistent fantasies of being the other sex; (d) an intense desire to participate in the stereotypical games and pastimes of the other sex; (e) a strong preference for playmates of the other sex.

A little boy who enjoys playing with dolls, avoids sports and other rough activities, prefers the company of girls, and says that he wants to take care of babies when he grows up is likely to be diagnosed with gender identity disorder—even though such behavior is perfectly acceptable in girls. “Behaviors that would be ordinary or even exemplary for gender conforming boys and girls are presented as symptomatic of mental disorder for gender nonconforming children,” says Katharine Wilson, Ph.D., an advocate for GID reform. “For boys, these include playing with Barbie dolls, homemaking and nurturing role play, and aversion to cars, trucks, competitive sports and ‘rough and tumble’ play. For girls, pathology is implied by playing Batman or Superman, competitive contact sports, ‘rough and tumble’ play, and aversion to dolls or [to] wearing dresses. It is unclear whether the intent of the DSM is to reflect such dated, narrow and sexist gender stereotypes or to enforce them.”

The diagnostic criteria for GID have been steadily broadened in successive revisions of the DSM, critics of the diagnosis point out, and the broadening of the criteria points to its essentially subjective (and disciplinary) character. “Recent revisions of the DSM have made these diagnostic categories increasingly ambiguous, conflicted and overin-clusive,” says Katherine Wilson. “The result is that a widening segment of gender non-conforming youth and adults are potentially subject to diagnosis of psychosexual disorder, stigma and loss of civil liberty.” Wilson and other activists fighting to have GID redefined or removed from the DSM point out that even children who do not express discomfort with their gender identity are now subject to the diagnosis, if significant adults in their life (parents, teachers) feel that their behavior is inappropriate for their gender. “GID of Children is clearly not limited to ego-dystonic subjects. High functioning children may be presumed