The History of Gender Variance

On June 28, 1969, at Stonewall Inn, marked history for its three-day riot between lesbians, gays, bisexuals and transsexual (LGBT) and the New York Police Department. This riot began with the police intruding into the LGBT “safe house” and the LGBT community fought back (PBS, 2011), making this the turning point for the LGBT’s first movement for freedom. Sylvia Rivera “was one of those outcast femmy boys and butchy girls… who was a veteran of Stonewall,  joined the new Gay Activists Alliance (GAA) and began working furiously to pass a gay rights bill in New York City” (Wilchins, 2002). Wilchins (2002) addresses in her writings that although Rivera’s commitment to the GAA was to help and protect the LGBT community, the transgender community was eliminated, leaving Sylvia to start the Street Transvestite Action Revolutionaries, or STAR. Throughout all of Rivera’s efforts, the transgender community continued to live in the shadows and was neither unseen nor spoken of, until Gender Identity Disorder surfaced in the DSM-III in the 1980’s. The point is, the transgender community has gone through a lot of trials and tribulations throughout the history of their gender variance; which is now less stigmatized due to the many revisions, leading to the DSM V.

The history of Gender Identity Disorder began in 1957 when John William Money studied the sexual consciousness about disorders of sex development and advocated the concept of gender.

“Thereafter the disparity between anatomical sex and gender identity was referred to as the psychopathological condition of gender identity disorder, and this was used for its diagnostic name when it was introduced into DSM-III in 1980. However, gender identity disorder encompasses a spectrum of conditions, and DSM-III -R categorized it into three types: transsexualism, nontranssexualism, and not otherwise specified. The first two types were subsequently combined and standardized into the official diagnostic name of ‘gender identity disorder’ in DSM-IV” (Zasshi, 2012).

“The exact cause of gender identity disorder is not known, but several theories exist. These theories suggest that the disorder may be caused by genetic (chromosomal) abnormalities, hormone imbalances during fetal and childhood development, defects in normal human bonding and child rearing, or a combination of these factors” (WebMD, 2010). Although the causes are unknown, according to L. Fleming Fallon, Jr. in the Encyclopedia of Mental Disorder, (2012), DSM-IV-TR diagnoses are as follows:

-A strong and persistent cross-gender identification

– Repeatedly stating a desire to be, or insistence that he or she is, a member of the other sex.
– Strong preference for wearing clothes of the opposite gender. In boys, displaying a preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing.
– Displaying strong and persistent preferences for cross-sex roles in make-believe play or experiencing persistent fantasies of being a member of the other sex.
– Having an intense desire to participate in the games and pastimes that are stereotypical of the other sex.

– Persistent discomfort with his or her sex or having a sense of inappropriateness in the gender role of one’s birth sex.

– The disturbance is not concurrent with a physical intersex condition, such as hermaphroditism in which a person is born with the genitalia of both male and female.

– The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The transition from Gender Identity Disorder in DSM-IV to Gender Dysphoria in DSM-V in terms of diagnosis is not different, just more clarification. The DSM not only determines how mental disorders are defined and diagnosed, it also affects how people see themselves and how we see each other. “DSM-V aims to avoid stigma and ensure clinical care and access to

insurance coverage that supports mental health for individuals who see and feel themselves to be a different gender than their assigned gender” (APA, 2013). This change is due to respecting the patient and ensuring access for individuals who continue to undergo hormone therapy, related surgery, or psychotherapy or counseling to support their gender transition. “Ultimately, the changes regarding gender dysphoria in DSM-V respect the individuals identified by offering a diagnostic name that is more appropriate to the symptoms and behaviors they experience without jeopardizing their access to effective treatment options (APA, 2013).

Although there is no real cause of the conflict of a person to have a mismatch in their gender and sex, researchers continue to explore this area. The exploration is for hope to find a cause or better treatments to those whom are diagnosed. Had Sylvia Rivera been alive today, she would have seen all her efforts worthwhile, because her main concern is to de-stigmatize the transgender community. Her wishes is for the community to accept and have resources to help those whom are born with the mismatch, which can be found in DSM-V.

Anatomical Sex Vs. Gender Identity

            Transgender is an umbrella term for people whose gender identity is different from the sex and gender role they are assigned with at birth (Sonnie, 2000, p. 247). Transgender people do not necessarily want to have sex-reassignment surgery (SRS) but lives in their preferred gender. Transgender includes heterosexuals, homosexuals, and bisexuals. Transgender occurs as a disorder known as Gender Dysphoria, previously known as Gender Identity Disorder (DID). Gender Dysphoria is disapproved of society due to the misconception and education of a disorder that the transgender community experiences. Gender Dysphoria affects the transgender community and societies nationwide causing a lot of distress to and within the transgender communities. The transgender community can be viewed as a disgrace in society, human interest, and family values particularly due to the norm of religion, society, and personal reasons; a view that can be changed with the acknowledgement that transgender is not a decision, it is something an individual is born with. The more ways that transgender people are talked about in popular culture, academia, individuals’ awareness, knowledge, and openness about transgender people allows them and their experiences to grow because they are now part of the norm in our societies.

In order to understand Gender Dysphoria, one must know the difference between anatomical sex, gender identity, or self-identification. According to Definition-of.com (2013), anatomical sex is the apparent gender, male or female, of an individual based on physical sex characteristics. The American Psychological Association (2011) defines “anatomical sex is assigned at birth and is associated with the physical attributes such as chromosomes, hormone prevalence, and internal/ external anatomy. Self- identification is the psychological sense of being male or female ( p. 2)”. This refers to the socially constructed roles, behaviors, activities and attributes that a society considers as appropriate for males and/ or females. The differences between biological sex and self identity are the fundamentals of Gender Dysphoria and how Gender Dysphoria arises; furthermore, the understanding of the transgender community.

According to Sue, Sue, Sue,

GID is characterized by conflict between a person’s anatomical sex and his or her gender identity, or self-identification as male or female. GID involves the person experiencing strong and persistent cross-gender identification and persistent discomfort with his or her anatomical sex, creating significant impairment in social, occupational, and other important areas of functioning. People with this disorder do not choose to be born this way; they do not mentally decide their gender identity, rather emotionally bound to it. They hold a lifelong conviction that nature has placed them in the body of the wrong gender. This feeling produces a preoccupation with eliminating the “natural” physical and behavioral sexual characteristics and acquiring those of the opposite sex (2010, p.286).

Gender Identity Disorder is now changed to Gender Dysphoria with retrospect that a conflict between one self continues to be the issue. Gender Identity Disorder is changed because it was thought to be only for homosexuals; which was seen as a disorder, but this is not the case. Gender Identity Disorder includes homosexuals and heterosexuals. In addition to the change, the concept of homosexuality being a disorder, is no longer seen as a disorder, thus making this change. Also, as reported by the National Alliance on Mental Illness (2013), mental illness is a medical condition or conditions that disrupt a person’s thinking, feeling, mood, ability to relate to others and daily functioning which make it confounding. Many transgender people do not experience their gender as distressing or disabling in any form or way, which also implies that Gender Dysphoria is not a mental illness. According to the DSM-5 (2013), “Gender dysphoria refers to the distress that many accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender. Although not all individuals will experience distress as a result of the incongruence, many are distressed if the desired physical interventions by means of hormones and/ or surgery are not available (p. 451)”. Another distressing or disabling issue for them is to minimize discrimination. Although there are Anti-discrimination laws in most U.S. cities and states, it does not protect them from gender identity or gender expression (APA, 2013, p. 3).

            In conclusion, the transgender community can be viewed as a disgrace in society because of the misconception of how transgender occurs. Transgender occurs to a disorder known as Gender Dysphoria. Gender Dysphoria is disapproved to society due to a misconception due to lack of knowledge and awareness of such a thing. Gender Dysphoria is the conflict between a person’s anatomical sex and his or her gender identity, or self-identification as male or female, which is not a mental illness. Identity conflict is not an issue a person chooses for themselves, they are born with it. The more ways that Gender Dysphoria is talked about in popular culture, academia, individuals’ awareness, knowledge, the openness and acceptance of the transgender community can grow and develop as every individual has the right to.