FOR IMMEDIATE RELEASE
May 26, 2010
The World Professional Association for Transgender Health has prepared and released a statement urging the de-psychopathologisation of gender variance worldwide. The statemen is as follows:
The WPATH Board of Directors strongly urges the de-psychopathologisation of gender variance worldwide. The expression of gender characteristics, including identities, that are not stereotypically associated with one’s assigned sex at birth is a common and culturally-diverse human phenomenon which should not be judged as inherently pathological or negative.
Excerpt: Improvements over DSM IV- TR
We would like to begin with expressing our respect for the work of the WGSGID and the Gender Identity Disorders subworkgroup, in particular, concerning the proposed changes for the diagnosis and the revised criteria. The proposal is definitely a step in the right direction, addressing several of the primary concerns raised about the diagnosis as currently stated in DSM IV-TR.
More specifically:
(1) The change in name from Gender Identity Disorder to Gender Incongruence is an improvement. It is less pathologizing as it no longer implies that one’s identity is disordered.
(2) The proposed criteria are better able to account for the diversity in gender and transgender identities encountered in clinical practice, reflecting the paradigm shift
away from a binary understanding and treatment approach toward affirmation of a spectrum of transgender identities (Bockting, 2008).
(3) Criterion 1, “a strong desire to be of the other gender or an insistence that he or she is of the other gender,” is proposed as required in order to qualify for a diagnosis of Gender Incongruence in Children. This will appropriately prevent children with a gender variant expression without an incongruence between gender identity and sex assigned at birth to receive the diagnosis, which was a common point of critique for DSM IV (e.g., Bockting & Ehrbar, 2005). Gender role nonconformity is not uncommon among children who go on to develop a gay or lesbian identity, and hence the diagnosis was viewed by many critics as a diagnosis of homosexuality in disguise, potentially justifying “reparative” therapy (see also Zucker, 2005). Requiring criterion 1 should alleviate at least part of this concern.
(4) Adding a specifier of “with or without a Disorder of Sex Development” is an improvement over the need to use the “Not Otherwise Specified” diagnosis because individuals with intersex conditions may have a similar experience regarding their gender identity and desire corresponding treatment interventions. In DSM IV-TR, individuals with intersex conditions are specifically excluded from the unqualified diagnosis (American Psychiatric Association, 2000).
(5) The removal of the specifier of sexual orientation is a welcome change, acknowledging that gender identity and sexual orientation are two separate components of identity that are often conflated (e.g., Bockting, Benner, & Coleman, 2009); transgender individuals may be attracted to men, women, or other transgender persons, and their sexual orientation is of little or no consequence for making treatment decisions.
(6) The proposed diagnosis includes an “exit clause” so that individuals who have successfully resolved their incongruence no longer are considered to have a mental disorder.
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