The Controversy of Gender Variance

For decades, there have been many controversies about what is normal and what is abnormal when it comes to human sexual behavior (Halgin, 2013, p. 47). In the past, homosexuality was regarded as a mental disorder but later disregarded in the Diagnostic and Statistical Manual of Mental Disorder (DSM) (Herek, 2004, p. 6). With the deletion of homosexuality in the DSM, the concept of Gender Identity Disorder (GID) arose in the DSM-IV. Now with the name change from GID in DSM-IV to Gender Dysphoria in DSM-V, the debate continues (Halgin, 2013, p. 47). Traditional Values Coalition argues that gender variance should be viewed as a mental disorder and implies that transgender people have psychological problems who need help rather than societal approval (Halgin, 2013, p. 48). On the contrary, Kelly Winters argues that “diagnosing gender variance as a mental disorder has imposed the stigma of mental illness and sexual deviance upon people who meet no scientific definition of mental disorder” (Halgin, 2013, p. 48). In agreement to Winters’ argument of gender variance, many people are falsely diagnosed “due to the DSM failing to distinguish the intrinsic distress of gender dysphoria from that caused by external societal intolerance” (Winters, p. 48).

According to the American Psychiatric Association (APA, 2013, web), The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States. “It is intended to be applicable by clinicians and researchers of many different orientations (e.g., biological, psychodynamic, cognitive, behavioral, interpersonal, family/systems). ‘Making a DSM diagnosis’ consists of selecting those disorders from the classification that best reflect the signs and symptoms that are exhibited by the individual being evaluated (APA, 2013, web). This implies that anything “diagnosable” within the DSM is a mental disorder regardless of the name or title given, resulting in the stigma being imposed upon gender variant people.

According to the DSM, Gender Dysphoria is diagnosable in the DSM by the following base components:

A marked incongruence between one’s experienced/ expressed gender and assigned gender, of at least 6 months’ duration, as manifested by certain criterion (APA, 2013, p. 453).

The condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning (APA, 2013, p. 452).

Although the change of Gender Identity Disorder changed to Gender Dysphoria in DSM-V is to avoid stigma and ensure 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, web), they fail conceptually. The failure is due to the section of “supporting mental health” because gender variant people are not mentally ill. The DSM “does not acknowledge the existence of many healthy, well-adjusted transsexual, and gender variant people or justify why we are labeled as mentally ill” (Winters, 2013, p. 55). According to Winters (2013, p.48) the DSM fails to distinguish the intrinsic distress of gender dysphoria from that caused by external societal intolerance. For example, a survey of nearly 6,450 transgender and gender nonconforming people was conducted by the National Center for Transgender Equality and the National Gay and Lesbian Task Force.  This survey found that as many as 63 percent of respondents experienced some form of discrimination due to bias about their gender identity. The discrimination included the loss of a job, bullying and even physical and sexual assault. As many as 41 percent of respondents reported they had attempted suicide — a rate 25 times higher than that of the general population (Glicksman, 2013, p.36). In Glicksman’s finding, it is easy to conclude that the stress imposed to these transsexuals is caused by the external societal intolerance; inadequately diagnosable to criterion B of Gender Dysphoria.

Although there is no real cause of gender variance, there lacks to be research in the difference of the” intrinsic distress of gender dysphoria from that caused by external societal intolerance” (Winters, 2013, p. 48). The exploration is for hope to find a cause or better treatments to those whom are gender variant without being diagnosed. Gender Dysphoria being diagnosed due to the DSM criterions can be falsely diagnosed due the evidence that Criterion B is leveraged toward significant distress or impairment in important areas of functioning, which is not by the individual but due to societal norms.

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