I've extracted the following from a piece by Jack Molay which I found interesting. He summarizes several key points about the current official thinking about gender dysphoria by the psychiatric profession as spelled out in the current release of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The full piece can be found here:

What the DSM-5 says about terms like transgender, transsexual and gender dysphoria


1. The DSM-5 defines "transgender" as a wider umbrella term that encompasses a wide variety of gender variance. Gender dysphoria is not needed to be classified as transgender. Transsexual is a sub-category of transgender. The terms are not synonymous.

2. The diagnosis "gender dysphoria" does not require a complete identification with one of the two genders as traditionally defined. Non-binary identities are accepted.

3. "A strong conviction that one has the typical feelings and reactions of the other gender" is only one of many possible criteria. It is not a required criteria. In fact, you need to fulfill only two of the six criteria for gender dysphoria listed to be diagnosed as having gender dysphoria.

4. The manual stresses that "In adults with gender dysphoria, the discrepancy between experienced gender and physical sex characteristics is often, but not always, accompanied by a desire to be rid of primary and/or secondary sex characteristics and/or a strong desire to acquire some primary and/or secondary sex characteristics of the other gender." (Jack's emphasis) This is important as it is often argued that an anatomic dysphoria is needed for someone to be classified as gender dysphoric.

5. Crossdressers and crossdreamers can be diagnosed with having gender dysphoria. The chapter underlines that "An individual with transvestic disorder who also has clinically significant gender dysphoria can be given both diagnoses. In many cases of late-onset gender dysphoria in gynephilic natal males, transvestic behavior with sexual excitement is a precursor."

In other words: The DSM-5 clearly states that there is no absolute distinction between the groups of crossdreamers and crossdressers on the one hand and other transgender people on the other. Some (but not all) crossdreamers are truly gender dysphoric. In fact, the manual argues that crossdreaming can be an early sign of gender dysphoria and therefore transsexualism.

6. One of the reasons the DSM-5 distinguishes between gender dysphoria and transsexualism, is that people with gender dysphoria do not always end up transitioning. In the DSM the word transsexual is limited to those who plan to transition to their target sex, or who have done so.

7. The DSM-5 does not require "bottom surgery" for someone to be considered transsexual.


I find this a huge step forward in understanding the diversity of cross gendered people among the professional ranks, and should help thousands of gender variant people find ways to cope with their condition.

Clara

Many thanks Clara for posting this. It came at just the right moment to answer queries my O&O had for me after our discussion yesterday.

Hugs!

You're welcome, Annie, I'm glad it was of value. Yes, the subject of gender-variance in the population is becoming better understood for what it is: a natural outcome of the development of a human being at conception (genetics), prenatal (brain development), and postnatal (environmental influences). It's so nice to see the term 'Gender Identity Disorder' (GID) removed from DSM-5. Our gender issues are not a mental disorder, nor are they a paraphilia. Now we just have to make the public at large understand these basic facts.

Clara

You're welcome, Annie, I'm glad it was of value. Yes, the subject of gender-variance in the population is becoming better understood for what it is: a natural outcome of the development of a human being at conception (genetics), prenatal (brain development), and postnatal (environmental influences). It's so nice to see the term 'Gender Identity Disorder' (GID) removed from DSM-5. Our gender issues are not a mental disorder, nor are they a paraphilia. Now we just have to make the public at large understand these basic facts.

Clara

yes, however sadly that will likely take far longer and be far more complex than it should be.

Our gender issues are not a mental disorder, nor are they a paraphilia. Now we just have to make the public at large understand these basic facts.

My thoughts exactly. No doubt conflict and confusion about one gender's identity can cause the person distress, but I don't think that equates as a mental disorder for everyone that has a cross-gender or non-binary gender identity. This reminds me of how homosexuality was included and then subsequently removed from the dsm in the 1970s.

Can including gender dysphoria in the dsm be helpful for those who seek professional help? Yes, I think so. However, I don't like the implication that being transgender is a disorder that needs to be fixed.

Our gender issues are not a mental disorder, nor are they a paraphilia. Now we just have to make the public at large understand these basic facts.

My thoughts exactly. No doubt conflict and confusion about one gender's identity can cause the person distress, but I don't think that equates as a mental disorder for everyone that has a cross-gender or non-binary gender identity. This reminds me of how homosexuality was included and then subsequently removed from the dsm in the 1970s.

Can including gender dysphoria in the dsm be helpful for those who seek professional help? Yes, I think so. However, I don't like the implication that being transgender is a disorder that needs to be fixed.

It was very helpful to me to show my wife that DSM-V no longer considers a transgender identity a 'disorder'. It is only the dysphoria associated with being transgender that needs treatment; treatment which is spelled out in the Standards of Care (SOC).

Clara

No doubt conflict and confusion about one gender's identity can cause the person distress, but I don't think that equates as a mental disorder for everyone that has a cross-gender or non-binary gender identity.

A relationship breakup or getting stuck in traffic can cause a person distress, too. So can being broke, getting fired, getting extra homework, or breaking a nail. None of those are psychiatric disorders. So yeah... I'm with you there.

It was very help to me to show my wife that DSM-V no longer considers a transgender identity a 'disorder'. It is only the dysphoria associated with being transgender that needs treatment; treatment which is spelled out in the Standards of Care (SOC).

In other words, 'you lot are still fucked in the head, but we're going to be a bit more politically correct about it, because we're medical professionals and still need to make money.'

Someone tell me why it is that we're told that transgenderism is incurable (presumably in the direction of gendering the same as birth sex), and at the same time, told it's "treated" with hormone pills and surgeries(as long as you're going in the other direction)?

Does anyone stop to think about what they hear? Because there are some awfully confusing and contradictory messages out there... all being sold by the same dealers who seem to have a financial interest.

I find this a huge step forward in understanding the diversity of cross gendered people among the professional ranks, and should help thousands of gender variant people find ways to cope with their condition.

The bit in bold there bothered me the first time I read it, and it's still sticking in my craw. It just sounds like feeling sorry for oneself. Oh woe is me, I cannot be blamed for anything awful I do... I have a... condition. I'm coping with it.

Nope... I gotta say, I really don't like that attitude at all. It's not my attitude, and I'm not going to adopt it for myself.

I have... a talent... an ability... something rare and special. I'm not "coping"; I'm celebrating, learning, growing, evolving... harnessing that ability.

If I were to use the words "coping with my condition" out loud, it'd be with a sarcasm-indicating wink and smirk over a glass of wine.

Buuuut.... everybody's a victim nowadays.

It was very help to me to show my wife that DSM-V no longer considers a transgender identity a 'disorder'. It is only the dysphoria associated with being transgender that needs treatment; treatment which is spelled out in the Standards of Care (SOC).

In other words, 'you lot are still fucked in the head, but we're going to be a bit more politically correct about it, because we're medical professionals and still need to make money.'

I think one reason why some 'disorders' are listed in the dsm is so insurance will cover treatment for it.

I think a more sensible, but perhaps not practical approach for determining what is or is not a disorder on the individual level is deciding whether a particular behavior or condition impairs a person's ability to function on a daily basis.

Someone tell me why it is that we're told that transgenderism is incurable (presumably in the direction of gendering the same as birth sex), and at the same time, told it's "treated" with hormone pills and surgeries(as long as you're going in the other direction)?

I would wager this is because the brain is still a very mysterious organ and treatment options like hormones and surgery has proven to be effective with mitigating dysphoria. In other words, maybe it would be better to say that in the sense you describe, transgenderism is incurable but treatable?

Does anyone stop to think about what they hear? Because there are some awfully confusing and contradictory messages out there... all being sold by the same dealers who seem to have a financial interest.

Yes, I do stop to think about what I hear.

I find this a huge step forward in understanding the diversity of cross gendered people among the professional ranks, and should help thousands of gender variant people find ways to cope with their condition.

The bit in bold there bothered me the first time I read it, and it's still sticking in my craw. It just sounds like feeling sorry for oneself. Oh woe is me, I cannot be blamed for anything awful I do... I have a... condition. I'm coping with it.

Nope... I gotta say, I really don't like that attitude at all. It's not my attitude, and I'm not going to adopt it for myself.

I have... a talent... an ability... something rare and special. I'm not "coping"; I'm celebrating, learning, growing, evolving... harnessing that ability.

If I were to use the words "coping with my condition" out loud, it'd be with a sarcasm-indicating wink and smirk over a glass of wine.

Buuuut.... everybody's a victim nowadays.

I get where you're coming from Miss C, but I don't get that kind of vibe from Clara or any of the other regular contributors on this forum that I've gotten to know.

I think one reason why some 'disorders' are listed in the dsm is so insurance will cover treatment for it.

I think a more sensible, but perhaps not practical approach for determining what is or is not a disorder on the individual level is deciding whether a particular behavior or condition impairs a person's ability to function on a daily basis.

That makes good sense. Like occasional social drinking vs. full blown alcoholism.

I get where you're coming from Miss C, but I don't get that kind of vibe from Clara or any of the other regular contributors on this forum that I've gotten to know.

I didn't mean to point fingers there.

Many times we adopt language, and even entire processes of thought -- even whole religions! -- through osmosis, but without filtering it through our thinkers first. It is perfectly natural that the same phraseology gets repeated across the social sub-group. (This concept is akin to how every baseball fan knows what a triple play is, but a non-fan may not. It's language dialect, and it's not necessarily purely regional in nature.)

I've watched this language form over the time I've watched trans* forums. It wasn't always this way. In the early days of the internet, it was a blossoming time. Trannies everywhere were leaving closets, stretching their legs, enjoying some sunshine.

Now it seems all we read about is victimization. There was always the opinion of the shrinks that there's something wrong with the other-gendered -- that hasn't changed. What has changed is that a large majority of trans* people have fallen for it, jumped in with the herd, and are busy running around being victimized and offended at every opportunity.

For those few of us who cherish our otherness as a gift, the victim culture is one hell of a river to swim upstream in. It's all around us.

It's not been all for naught, however. The past decade has enormously leapfrogged the previous century for widespread awareness that there *are* others out there. The pendulum has swung far. Random people ask me questions that seem to indicate they know much of transexualism... but not any other form of gender otherness. Sometimes it feels as though I've been thrust into ambassadorship.

What it boils down to is... will we write our own stories? Or will we follow the narrative laid down by the professionals who profit from our struggles?