Gender Identity Is Not A Disorder

By Kathleen LaTosch


On Dec. 3 the American Psychology Association announced that it is replacing "Gender Identity Disorder" with the more neutral and less-stigmatizing title, "gender dysphoria" in its Diagnostic and Statistical Manual of Mental Disorders, more commonly known as the DSM.

The DSM is the mental health professional's diagnostic book. Psychiatrists, psychologists, social workers and counselors all use this book to assign a diagnostic code to mental health disorders. These codes are then used to bill insurance for proper medical treatment and are often required to justify covering the cost of office visits, prescriptions, and needed medical procedures. It's critical in the healthcare of someone who is transgender. Perhaps at no other time in one's life is it more important to have quality healthcare than during a gender transition.

The change comes after decades of advocacy to remove the more stigmatizing diagnosis which equates one's own gender identity with a mental health disorder - "Gender Identity Disorder". Being transgender is not a mental health condition and it's not abnormal. There is no normal - normalcy is only what one perceives as common in his/her own existence. If I grow up a white woman in a middle-class Catholic neighborhood, that's my normal. If a lot of women grow up the same way around me, it's common. But we're not normal for everyone, just for us. If I grow up Arab American in Dearborn and all my friends are bilingual and go to the same church and celebrate the same holidays, that's my normal.

Being transgender is not abnormal. It's just not as common and it's doesn't appear en masse within families and communities. It can be a very isolated and isolating experience. And it's not a mental health disorder. It's like being born red-haired in a blonde, black and brown-haired world. Or at least it should be but it's not - red-haired people aren't kicked out of their homes, fired from their jobs, abused on the street, and denied basic human dignity.

Having to cope with the societal stigma of gender transition drives many mental health concerns for transgender individuals. Layer hormone therapy and other medical issues on top of that and it's a difficult and uncommon territory to navigate. Seeing a professional to sort through all that can help, but it comes with a cost - the cost of having that mental health diagnosis attached to your name, the cost of being "outed" to every other person who comes into contact with your medical record.

And how do you find a therapist who understands these same truths - that there's nothing abnormal about being transgender, that it's a personal characteristic. How do you find someone who understands that the anxiety you are dealing with is caused by societal stigma and not caused by your gender identity? It's not easy.

Last week Affirmations brought together leading Michigan experts on LGBT mental health in what's been called a queer mental health "think tank." After months of work, The LGBT Mental Health Task Force led the first ever two-day training on Clinical Issues & Sexual Orientation for therapists. It was sold out with a waiting list for the next training. This March, they are forging even newer territory - putting together the first two-day training on Clinical Issues & Gender Identity for therapists and counselors. It will be the first such training offered in Michigan. On the heels of the APA's new announcement, there is no better time to be preparing mental health professionals to competently and knowledgeably provide services to our transgender community members.

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