The Riddle of Gender - Deborah Rudacille [121]
Scholinski points out that though his primary diagnosis in the various institutions where he spent his adolescence was gender identity disorder, the psychiatrists and therapists who met with his parents told them “they were working on my depression. Well, I was depressed because the world was treating me poorly, but their plan was to get me to act more feminine so that the world wouldn’t treat me so badly— instead of realizing that if you try to make me be something I’m not, I’m going to be even more depressed. I never felt worse than on the days when I forced myself to wear makeup and had people telling me, ‘Wow, you look really pretty today’ “ he says with feeling.
In its Standards of Care for the Treatment of Gender Identity Disorder (SOC) in both adults and children, the Harry Benjamin International Gender Dysphoria Association notes that “the designation of Gender Identity Disorders as mental disorders is not a license for stigmatization or for the deprivation of gender patients’ civil rights. The use of a formal diagnosis is an important step in offering relief, providing health insurance coverage, and generating research to provide more effective future treatments.” However, it must be asked whether the present classification of gender identity disorder as a psychopathology meets these goals.
First, the designation of GID as a mental health problem does provide, and has provided, a license for stigmatization, and has undoubtedly contributed to the difficulty that gender-variant people have encountered in passing legislation protecting their civil rights. It is disingenuous to pretend that the deletion of the entry on homosexuality from the DSM has not greatly improved the status of gays and lesbians, or that the continued inclusion of gender-variant people in the DSM has not retarded their efforts to be recognized as healthy, functional members of society. Indeed, Dylan Scholinski says that since writing The Last Time I Wore a Dress and becoming an activist, he finds that “some of the toughest people to convince” that kids are still being institutionalized for gender identity disorder are gays and lesbians. “It’s like it brings up people’s worst fears,” he says. “People don’t want to believe that these kinds of things can happen now, they think that we’re beyond that. I tell them, ‘Well, maybe it didn’t happen to you, but it did happen to me.’”
Second, the diagnosis of gender identity disorder does not facilitate insurance coverage of medical or surgical procedures for people desiring hormonal or surgical treatment; it does not guarantee coverage of anything other than mental health treatment by a psychiatrist or a psychologist. “DSM is a red herring. It barely covers anybody,” says Dr. Dana Beyer, a retired surgeon who underwent sex-reassignment surgery in 2003. “Why we feel the need for this crutch is beyond me. This DSM crutch. But it’s the only recognition that it’s medical—it just happens to be in the psychiatric field, which causes more problems than it’s worth. So why can’t we just shift it from the psychiatric problem to congenital or genetic or developmental or whatever? That should be easy. But again it becomes a turf war. The psychiatrists don’t want to give it up. You’d think they’d want to get rid of us. But no, they don’t want to do that. As far as insurance goes, that’s a crock; it doesn’t cover anybody.”
Finally, rather than “generating research” or research funding, the classification of GID as a mental disorder seems instead to have limited the research done on physiological mechanisms for gender variance, or on the intriguing connections between GID and prenatal exposure to DES and other exogenous estrogens and androgens. Christine Johnson, an engineer who is using systems theory