DSM-V – First Reactions

The draft of DSM-V, the latest revision of the American Psychiatric Association’s diagnostic manual, has been released and reactions are beginning to be posted. The excellent Zoe Brain has a long analysis of the implications for trans and intersex people for those who are interested.

On the plus side, it isn’t nearly as bad as I had feared. All of the suggested language about classifying all trans people as sexual perverts appears to have been dropped. Only the poor transvestites are still left at the mercy of Ray Blanchard’s mad fantasies.

The best part is most definitely the addition of an “exit clause” whereby people diagnosed with the new Gender Incongruity condition (which replaces Gender Identity Disorder) can be said to be cured once they have transitioned to a gender they are comfortable with, rather than having to live with the stigma of mental illness all of their lives as was the case before.

The worst bits are a result of the general desire to expand the scope of the DSM to catch ever more people in the psychiatrists’ net. For example, intersex people who have been brought up in a gender that is uncomfortable for them are now to be regarded as mentally ill even though all that is wrong is the way other people treat them. Equally it used to be the case that a transvestite who was happy with his life could not be diagnosed as mentally ill. Now he has no escape. In a similar vein, here’s The Guardian talking about how things like temper tantrums and binge eating are being added to the ever-growing list of mental illnesses. Thank goodness Blanchard is not in charge of the whole thing, or they’d all be classified as sexual perversions.

3 thoughts on “DSM-V – First Reactions

  1. Sometimes I wonder how much of this the shrinks justify by using health insurance companies or federal funding as a justification, when at the bottom of it is this raw naked hatred for people who don’t jam nicely into tickboxes.

    I wonder how many actual psychiatrists and clinical psychologists (not the LICSWs and whatever most of us actually see) really give thought to the fact that naming a thing doesn’t magically make it “curable”.

    I also love how all developmental disorders they can’t name they’ll lump under autism . . . . interesting how something that is trendy and getting attention right now gets used as the description for everything. *sigh*

    1. A lot of it has to do with how social services and legal systems want actions to depend on diagnoses. The rise of autism, for instance, has come with a nearly identical decline in diagnosis of other psychological problems in kids. Some of that shift has to be kids getting the right diagnosis where they’d have gotten the wrong one before, but there is widely suspsected to be a certain element of “your kid needs access to services that will help them, so here is the label that give them that access.” (I’m not aware of any studies that have managed to quantify that element, though.)

      Similarly, the woman who recently won the right to deduct her gender reassignment surgery from her taxes did so on the basis that it was appropriate and necessary treatment for a medically recognized health issue.

  2. There’s a related news story in Finland that might interest you. A recent bank robber was caught – apparently she’s a pre-operative trans woman (I hope I’m using the right terminology here!), still officially a man. There’s talk in papers if she should go to men’s prison or not (hope not!). I think that Finns are being more understanding after the very public case of the trans vicar. At least there is no talk of mental illness that I’m aware of…

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