Archive for the ‘DSM-V’ tag
In the movie Ghostbusters professor Peter Venkman, played by Bill Murray, deflected questions with a quip,
Back off, man. I’m a scientist.
In the reality of human gender diversity, the current diagnostic categories of Gender Identity Disorder (GID) and Transvestic Fetishism in the Diagnostic and Statistical Manual of Mental Disorders (DSM) convey a presumption that internal gender identity or social gender expression that vary from assigned birth sex roles are intrinsically pathological and sexually deviant. Their authors and supporters have defended this axiom by disparaging skeptical criticism and indignation as “attack” on science and academic expression. Thus, the premise of “disordered” gender identity has ascended to the level of dogma in American psychiatry and psychology, imposing a near-impossible burden of proof upon contrary evidence, dissenting opinion and especially upon transitioned individuals to demonstrate our legitimacy in our affirmed roles.
In an interview with MSNBC this year, Dr. Kenneth Zucker, chairman of the current DSM-V Sexual and Gender Identity Disorders work group and a chief author of the current GID diagnosis, stated that there “has to be an empirical basis to modify anything in the DSM.” But has the appropriate burden of proof been reversed here? Should his work group be equally committed to review the validity of the current diagnostic categories? What is the basis, where is the science to substantiate the premise of “disordered” gender identity that underlies them?
Lilienfeld, Lynn and Lorh, editors of Science and Pseudoscience in Clinical Psychology, noted that
the burden of proof in science rests invariably on the individuals making a claim, not on the critic.
At the core of the GID diagnosis is the presumption that social or medical transition contrary to birth sex is always a negative outcome and acquiescence to birth sex role is a positive one. This is reflected in the diagnostic criteria, which tar even the happiest, most well adjusted post-operative transsexual men and women as disordered, and absolve closeted or concealed gender dysphoria (distress with current physical sex characteristics or ascribed gender role) from diagnosis of mental illness. This doctrine of “disordered” gender identity is underscored throughout the supporting text, where persistent gender identity differing from birth sex is termed a “chronic course” of disorder and the need for gender congruence is disparaged as “preoccupation.”
I strongly recommend reading the whole post at Bilerico or at the GID Reform Weblog.
Of Zombie Commuters, Nice Young Policemen, Creepy Old Men, and Protests
In the days when the Sun was setting on it, British Rail extended the overhead electrification on the Kings Cross to Cambridge line north, beyond Cambridge, to the line’s end at Kings Lynn, on the north Norfolk coast. In true British fashion, they did it on the cheap, and the power supply north of Cambridge would supposedly break if you try to take an 8 coach train to Kings Lynn.
This turned out to be fortuitous for me this morning, because of the 6 trains an hour between Cambridge and London, 2 of them are expresses – the xx:15 and xx:45 trains. The xx:45s don’t start at Cambridge, but come form the north first, giving the intrepid fenland commuters an hourly fast service to London.
In peak periods though, 4 coaches won’t cut it – they struggle to fit the rush hour load in 8, and these are some of the most overcrowded trains in the country. This means that they have 4 waiting at Cambridge and the 4 coming from Norfolk creep up behind them, before coupling onto them. This takes time.
That’s why, despite running out onto the platform, breathless at 06:46 this morning, I was still able to catch the infeasibly early 06:45 departure to Kings Cross. It was full of people who sat there for the whole journey in total silence, most of us apparently resenting being there. To add insult to injury, the morning was overcast and we weren’t even rewarded with a sunrise for our efforts.
The hurtle at London was otherwise uneventful, and I only had to endure a few stops of nose-to-armpit, oven-like conditions on the Victoria Line before emerging amongst the shop workers, arriving for their morning shifts, at Oxford Circus Underground station.
I made my way to the Royal Society of Medicine on Wimpole Street and found nobody there. For a few minutes I was having visions of being a one-woman protest, and looking very foolish, but others soon arrived, starting with the very pleasant bird_of_paradox, who I’d not met before. Also on the scene were two very young male policemen, there to make sure that the demonstration we had planned went off peacefully, or whatever it is policemen at these things are supposed to do (stand there and look bored for 2 hours, it turns out, but at least they did it decoratively)
After a little while, we were all assembled, and Natacha, who had worked hard to herd everyone on Facebook and cleared everything with the police got to work setting up some placards for some of us to hold. There were three in the event, and we decided there and then what to put on them. “Don’t block blockers”, “Trans Children are human beings – treat them like it”, and “No reparative therapy here”.
For those unfamiliar with what’s got transpeople so excised over a conference at the Royal Society of Medicine, I’ll provide a bit of background. The conference was about the use of GnRH agonist drugs in pubescent trans people to delay their puberty and buy them time. This is a practice that is widespread in some parts of the world, but not in the UK. There’s an American-Canadian psychologist called Kenneth Zucker, who was presenting the opening address to the conference, and he has achieved notoriety in the trans community for what many see as the use of aversion/reparative therapy in young children to make them conform to gender roles. Essentially, this involoves punishing the children for playing “inappropriately”, until they get “programmed” to react badly to the “inappropriate” gender cues, rather like Alex in A Clockwork Orange, who finds himself feeling violently ill when exposed to Beethoven’s 9th Symphony.
Some of us feel this is emotional and psychological abuse. It’s bad enough when it’s done to adults. Zucker says he’s done it with children as young as three. This is where the “ex-gay” movement has run to after being discredited over so-called conversion programmes with homosexual adults and teenagers – it now plys its trade under the guise of “therapy” aimed at preventing children growing up with “gender-inappropriate” behaviour. The subtext is that, “if forcibly stop little Jimmy playing with Barbie, we might stop him from wanting to hug a boy in 15 years time, which he probably won’t want to do anyway”.
Anyway, we set up what turned out to be a terribly “nice” middle class affair, with us saying, Good morning” to people as they walked past, while offering them a copy of this leaflet. The takeup rate was pretty good, with most people meeting our cheery smiles. A small proportion of people, maybe about 10-20%, walked past us either waving dismissively, or muttering under their breath and looking at us in disgust. There was a surprising correlation between the people who did that, and the people who then went and stood right in front of the arrow in the picture, tugging at a locked door.
Perhaps, in their “not had morning coffee” state, they were thrown by the sight of a bunch of transpeople and allies, distastefully sullying the entrance to the RSM and having the nerve to try and hand out leaflets. They might be contaminated! They might catch TEH TRANZ from them! That’s a rather nicer interpretation than the alternative – that a large number of the UK medical establishment’s great and good can’t work out how to walk through an open door, when there are signs.
But we handed out lots and lots of leaflets. So many, in fact, that by 9am our initial pile of over a hundred leaflets was looking seriously depleted. Thankfully there was a copy shop that was opening for the morning just literally across the road. I nipped in there and had another hundred made, and apparently while I was in there I missed the opportunity to hand a leaflet to Dr Curtis, my erstwhile gender specialist. Oh well.
There was person I didn’t miss though, and this has to go down as the creepiest thing that’s happened to me today (and something happened earlier this morning that was quite creepy to start with – someone, who I have good reason to believe may work for the Metropolitan Police, has been leaving fun little anonymous comments on my LJ over the Toiletgate incident, so it already faced stiff competition).
There were various people from, mostly non-mainstream media organisations there; I spoke on camera to a lady who was involved in making a film, about why we were protesting. I hope I didn’t look like a dork, or sound too male. Anyway, while handing leaflets out, I was dimly aware of someone else hovering around the other side of the street taking photographs of us, the demonstrators, with an SLR camera.
As the time for registration approached, this chap came over and made to go in. One of my fellow demonstrators stopped him and said, “Are you with the press?”
He gave a rather abrupt, “No”, and as he was doing so, I said, in the cheery manner we’d been greeting people for the last hour, “Good monring!” and held out a leaflet.
As he took it, I looked up and realised who our would be paparazzo was; I recognised him as none other than Professor Richard Green, formerly head of the Charing Cross Gender Identity Clinic.
And he was hanging around, taking photos of protesters outside an RSM conference on trans issues.
Right. Well that didn’t at all feel like the creepy old man hanging round by the school gate, oh no.
Perhaps he has a Little Book of Uppity Trannies. A rogues’ gallery of those of us who need putting in our place? I wonder if he realised that I was the same person who playfully taunted him as he left the General Medical Council with his tail between his legs after the GMC had failed to grant him and Charing Cross a virtual monopoly on treatment of transpeople in southern England last year?
If that’s the case, you’re out of luck, Dick. They already cut it off, dear.
It was nice to see a number of people I knew going in, some of whom stopped for a nice chat and to exchange information (got some fab stuff from the GIRES people). One attendee in particular had a special handout prepared for them – an A4 brown envelope containing 20 copies of the leaflet which they were going to strategically leave around inside.
We never saw Zucker himself, so perhaps he was ferried in a side entrance, lest the bunch of, polite middle class people with the cheery greeting decided to offer him a leaflet and wish him good morning with intent.
But all-in-all, I think the protest went very well. I’m sure plenty of the people we gave the leaflets to were there for other reasons (such as working there), but that’s probably good. As with the Bitch protest in May, the effect we were hoping for was to perhaps make the RSM think twice about inviting people like Zucker next time. Perhaps they’ll realise that if they rub transpeople’s collective noses in it, we’ll come along and perhaps cause them a bit of embarrassment in front of their target audience.
In closing, I did feel a bit sorry for the policemen, who got to stand there looking bored (and very, very young – am I really going to be 35 tomorrow?)
I did offer them a copy of the leaflet to read, in order to pass the time, after they realised that nobody had brought pitchforks and flaming torches, but they declined. They seemed like nice chaps anyway.
An update to this post from earlier today. I’ve spoken to someone who was in the conference, and they asked Richard Green why he was taking photos of us.
Apparently he was doing it at the request of Zucker himself, who wanted a souvenir, because he “found the attention amusing”.
So there are going to be pictures of me, a few other transpeople, and a bunch of allies in Zucker’s holiday snaps album. Knowing what they say about those who protest too much, I do hope he’s not planning to view them with a box of Kleenex at the ready.
Urgh! I think I need a shower.
From the transfeminist livejournal community:
The London Transfeminist Group is meeting this Thursday, 25th of September, in order for those planning to protest the invitation of controversial American-Canadian doctor, Kenneth Zucker, to keynote the Royal Society of Medicine’s discussion on treatment of transgendered adolescents on October 1st.
Kenneth Zucker is infamous within the trans community for using what many feel to be aversion therapy on children as young as three, who show “gender variant” behaviour. Some of us feel that subjecting any child, yet alone those so young, to “treatment” which involves confiscating their favourite toys and forbidding them contact with their best friends amounts to psychologically abusing these children. We further feel that in engaging with this treatment, Dr Zucker is pandering to the homophobic and transphobic fears of the parents of these children that they might “grow up gay”, or “grow up to be trans”.
We further feel that the Royal Society of Medicine brings itself into disrepute by inviting someone who subjects children to treatment which harkens back to a dark age of abuse of queer and gender-variant people by the mental health community. Regardless of whether Dr Zucker is sometimes in favour of trans-positive treatment for adolescents, such as the use of puberty blocking drugs, inviting this man to present the keynote shows a woeful lack of respect for trans and queer people in the UK, and sends the message that “doctors” who are prepared to engage in reparative and aversion therapy against queer and gender-variant people are still tolerated and respected amongst their peers.
Please join us for a pre-protest discussion of this issue, as well as collaborating in producing leaflets, placards, etc. for the protest at Gays The Word Bookshop, Marchmont Street, this Thursday at 7:30 pm.
An excerpt from Lynn Conway’s report:
Summary and Findings:
The APA Task Force Report on Gender Identity and Gender Variance [APA08 - PDF here] greatly underreports the prevalence of “gender identity disorder” by a factor on the order of 10 to 20.
The underreporting of GID prevalence derives from a deliberate misuse of clinical definitions and a failure to mention known calculation errors in sources.
The unreasonably low prevalence numbers are given to three significant figures in the Report, as if they were precisely accurate – while failing to mention well-known sources of estimation error.
The Task Force then dismisses recent work by Olyslager and Conway that had exposed large errors in earlier studies by calling that work a “minority position” – as if a scientific analysis must be certified by a majority vote, rather than judged on its merits.
The Task Force further dismisses the work of Olyslager and Conway by insinuating that citation by “transgender activists” somehow reduces its validity – while failing to cite it themselves.
Finally, the Task Force fails to mention recent scientific studies that report far higher-levels of GID prevalence than does their Report.
Please read Helen G’s post for more details – she covers it in pretty much the same detail I would.
The short form is that the APA task force is claiming that GID occurs approximately 1/20th the rate it actually does in the real world, allowing them to claim it’s a rare condition and probably supporting Zucker’s reparative therapy for trans children, since he’d be able to assure parents that it’s unlikely their child really has GID.