Friday, July 6, 2012

the DSM - defining TS as a mental illness?


A heated discussion recently highlighted how distressing some women born TS find the inclusion of true transsexualism in the Diagnostic Service Manual. The DSM-iv, and the upcoming DSM-v include GID as a psychiatric condition.

Some people find that this is offensive to TS women. Their arguments run along the lines of "it says we are mad, or requiring psychological intervention. We are not. We have a medical condition, not a psychiatric one"

I couldn't agree more. surgery / hormones, and in the future, gene therapy are admirably successful treatments for being born TS. Physical form correction works, with a 97% success rate. It is clear, that once correctly diagnosed, being born TS is a medical, not a psychiatric issue. We simply need to amend our bodies to match us, due to some misconfiguration of the chromosomes during our conception.

However, it is a big thing to come to an unambiguous and correct self-diagnosis. 

How do we really know? getting philosophical, there is no outside measure, no matter how well we may be able to read each other's thoughts. 

Simply following the journey is not that easy, at least it was not for me. It is good to have support available, support trained in understanding mind, psychology. Support that can help us work through our stuff, and its initially very specific stuff that no other group on earth has to deal with.

and then there are those people who should NOT be getting surgery. The ones who are willing to go off prematurely, and risk, or convince themselves that they need surgery. How many other psychological states could lead to an erroneous self-diagnosis?

Even if this was treated as a medical issue, the medics would still need to send the prospective patients to psych evaluation, if only to cover their legal liability.  Looking at it from a purely business perspective, i, as a surgeon, would be demanding as much signed and stamped documentation as i needed to ensure that the person i was operating on wouldn't sue me. Looking at if as a person, i'd want to make sure that what i was about to do would help, as opposed to make things worse. Its not an easy thing. I'd need to have people i trusted to do the work with the patients before hand, and be sure that this was ok.

Which, effectively boils down to needed a diagnosis, from a psychiatrist,

its not about US, it is about THEM. the medical staff and the non-TS folk who need to be kept safe.

in my day to day life, i've not met anyone who tries to imply i'm in any way psychotic or mad. I might get labeled as a man, but never as mad. I do not see the inferred 'slur' against women born TS. I also don't really see why it matters - having a psychiatric diagnosis should carry no negative consequence. It is simply information. Information that says "yes, i was checked out by specialists and we all agree, i need surgery" or "i was checked out by specialists and they are sorting me out with some CBT so i can deal with my cross-living fetish without having to ". Any extra meaning in those statements is, in my opinion, projection.

I think, far more than campaigning for the removal of an useful safety net for many people, we should instead spend our energies getting an exit-clause added to the GID diagnosis, so that we can be 'officially' <word that means discharged or 'cured'>. 

having said that, i no longer have much interest in wanting to change anything. its too much work trying to deal with life. that's a fair bit of the requirement for a GID diagnosis gone.

oh. anonymous commenters who want to simply bitch? i'm not interested. get a name and a life and i won't delete your comments, but totally fail to comprehend what i'm saying? bye.