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From the American Psychiatric Association’s (APA’s) media release:
The American Psychiatric Association today released the proposed draft diagnostic criteria for the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM). The draft criteria represent content changes under consideration for DSM, which is the standard classification of mental disorders used by mental health and other health professionals, and is used for diagnostic and research purposes.
“These draft criteria represent a decade of work by the APA in reviewing and revising DSM,” said APA President Alan Schatzberg, M.D. “But it is important to note that DSM-5 is still very much a work in progress – and these proposed revisions are by no means final.” The proposed diagnostic criteria will be available for public comment until April 20, and will be reviewed and refined over the next two years. During this time, the APA will conduct three phases of field trials to test some of the proposed diagnostic criteria in real-world clinical settings.
Proposed revisions
Members of 13 work groups, representing different categories of psychiatric diagnoses, have reviewed a wide body of scientific research in the field and consulted with a number of expert advisors to arrive at their proposed revisions to DSM. Among the draft revisions are the following…
Changes to the DSM have been submitted, and release of the final, approved DSM-5 is expected in May of 2013.
One of the things I see that is going to cause a lot of problems on a lot of levels is the failure to remove the diagnosis for Transvestic Fetishism, and beyond the failure to remove the diagnosis, the proposed new inclusion in the diagnosis of autogynephilia:
[12] There is a need to distinguish different types of transvestism according to the foci of the patient’s erotic interest. Transvestites vary greatly in their overt behavior and in their mental content during sessions of cross-dressing. Some seem quite similar to simple fetishists in their preference for very specific garments and report no conscious thoughts of themselves as female even while dressed in multiple pieces of female attire. Other transvestites, whom Blanchard (1989) has called autogynephiles, are most aroused by the thought or image of themselves as women. As a practical matter, the autogynephilic type seems to have a higher risk of developing gender dysphoria. This was confirmed in a secondary data analysis reported by Blanchard (2009c). The results of that analysis clearly suggested that the addition of the proposed specifiers to the diagnosis of Transvestic Disorder could provide clinically meaningful information as well as data useful for research.
To say the least, autogynephilia is a controversial and disputed diagnosis among trans community. Andrea James, in her article “Autogynephilia”: a disputed diagnosis, she states:
“Autogynephilia” is a sex-fueled mental illness made up by Ray Blanchard. Blanchard defines it as “a man’s paraphilic tendency to be sexually aroused by the thought or image of himself as a woman.”
Support for this disease model of gender variance is almost nonexistent, limited to a tiny online “autogynephilia” support group with fewer than 40 contributors out of a worldwide population of transwomen numbering in the millions. This support group was taken down in early 2005. The disease was also prominently featured in The Man Who Would Be Queen by J. Michael Bailey and has been heavily promoted by Anne Lawrence, a former anesthesiologist who has taken up “autogynephile” as a personal identity.
One of the key concepts in this model is the premise that everyone who is gender variant can be categorized based on one of two “male” sexual interests: homosexuality or paraphilia.
Among the few people who identify with this term, a significant number do not think this is what “autogynephilia” means. These people often interpret the word’s Greek etymology quite literally and think it means an innocent and happy “love of oneself as a woman,” or in apposition to a phobia. This is clearly not how the word is being used in the context of psychology or sexology, so we can dismiss comments from these people as irrelevant to the scientific debate.
Many mental health professionals and theorists question if this is a legitimate or scientifically useful descriptor. See parallels with other discredited illnesses…
It should be noted that Ray Blanchard, Ph.D., is a member of DSM-5′s Sexual and Gender Identity Disorders workgroup. It should also be noted that the attorneys for the Internal Revenue Service (IRS) in O’Donnabhain v. Commissioner of Internal Revenue argued that Rhiannon O’Dannabhain may just have autogynephilia, and as such didn’t deserve to deduct medical expenses related to genital reconstruction surgery.
Stay tuned. I’m sure we’re going to hear lots more about the whole of how the changes proposed to be incorporated into DSM-5 impact trans people, as well as broader LGBT community.
9 Comments
What is the matter with these people? FFS. Why aren’t we past this yet?I’m really at a loss for words. This makes me so angry.
Transvestic FetishismI suggest that all the community’s attention now be directed towards the TF diagnosis and Blanchard’s influence. Autogynephilia should be easy to use to attack the entire category, which is just a tool for shaming.
Most of our attention had been directed to de-stigmatizing GID, which was accomplished. As a result, TF was largely ignored. It should no longer be.
I’m not transgender but…why can’t we “LGBT” all just be QUEER?
Why all this need to box us ontologically into little boxes instead of the idea gender is a continuum?
I’m a very happy, well adjusted gay man and the only grief I’ve ever experienced is because society doesn’t like it when I sometimes display overt effeminate behavior. I’m usually perceived as masculine, but like most gay men, I sometimes catch my hands fluttering about or scream, “Oh Mary!” LOL!
Isn’t that the issue, really? Society and it’s inability to accept diversity?
I’m just really glad I have trans brothers and sisters who have fought the good fight for us and refused to compromise in being WHO they ARE as wonderfully diverse QUEER people.
From reading the historyof the DSM it seems all the revisions, from when they took homosexuality out in 1973, have endeavored to simply change the terms rather than actually remove things from their “bible.” The inclusion of autogynephilia and the retention of transvestic fetishism will most certainly be used against transsexual and other gender variant people in the right wing’s propaganda as well as against those who are trying to convince their families that they are not demonic perverts when they come out as trans. I can also easily imagine how the homophobes can use the terms to demonize LGB people too. Just as the “disorder” label pathologized us, so will the “autogynephile” label.
I wondered what kind of damage to our identities and lives we would see when I heard that Zucker, Blanchard and their cronies were on the committees in charge of revising these sections. Well, now we know and now we can direct our energies towards fixing them. Blanchard’s research is almost exclusive to the justification for autogynephilia in the draft DSM. We need to insist that this kind of single source science be held insufficient to justify inclusion into such an important document as the DSM.
TFWell said, Emelye.
Maybe not all … the attention, but a significant amount of it, agreed.
I wouldn’t consider GID / GI completely destigmatized while it is still classified as a “sex and gender disorder.”
I’m in complete agreement.
hee heeOddly enough, I’ve been saying the same thing for a long time now.
You said it better though.
Should not the DSM committee look into Blanchards pastI just do not get how they can overlook the obsessive way Blanchard went about for years measuring men’s penises for to find a link between sexuality and penis size.
Now we find Blanchard treating trans people in the same way as he does paedophiles in Canada and its excepted as a real treatment. How the American Psychiatric Association allowed him anywhere near the DSM-V let alone chair a committee is beyond belief.
The way how Zucker and Blanchard are allowed to screen out patients who would potentially disprove their so called research is criminal. In what other field of science would research be considered reliable when it excepted only 5 people out of over 400 who sought treatment as Zucker did last year. Its just bad science to discount the other 400 odd kids that you feel you could not manipulate with aversion therapy, so you discount them and present that your treatment works. I could prove just about anything using the Zucker and Blanchard method of selective research and sudo-science.