Stop Sexualizing Us!

A Guest Essay by Julia Serano, Ph.D.
Presented at a Protest Rally at the
Annual Meeting of the
American Psychiatric Association
San Francisco, May 18, 2009

For decades, the general public, and especially the media, have had a lurid fascination with trans people’s bodies and sexualities. From talk shows like Jerry Springer, to reality shows like There’s Something About Miriam, novels like Myra Breckinridge, and the countless movies that portray trans women almost exclusively as either sex workers, sexual predators and sexual deviants. This hypersexualization of transgenderism predominantly targets trans women and others on the trans feminine spectrum—because in a world where women are routinely objectified, and where a woman’s worth is often judged based on her sexual appeal, it is no surprise that many people presume that those of us who were assigned a male sex at birth, but who identify as women and/or dress in a feminine manner, must do so for primarily sexual reasons.

We are here today to say, stop sexualizing us!

This sexualization of trans feminine gender expression also runs rampant in psychiatry. In the current version of the DSM, there is a diagnosis called Transvestic Fetishism, which specifically targets “male” expressions of femininity. When nontransgender women wear traditionally feminine clothing, they are viewed as healthy. But when the same behavior occurs in people assigned a male sex at birth, the APA deems it psychopathology. This is hypocrisy!

We say to the APA, stop sexualizing us!

And while crossdressing by men is often an expression of femininity, or of an inner gender identity, Transvestic Fetishism presumes that the act of wearing feminine clothing must (in and of itself) be an expression of aberrant sexuality.

We say to the APA, stop sexualizing us!

Studies have shown that, “Cross-dressers…are virtually indistinguishable from non-cross-dressers.” Despite the empirical lack of evidence that crossdressing is associated with psychopathology, the APA continues to mischaracterize crossdressing as a mental disorder.

We say to the APA, stop sexualizing us!

And if that wasn’t bad enough, Transvestic Fetishism has been categorized in the Paraphilias section of the DSM—the category that used to be called Sexual Deviations. This section used to be home to diagnoses like Homosexuality and Nymphomania—societal double standards that for decades were reified in the DSM as mental disorders. Like its predecessors, crossdressing is a harmless, consensual activity that is unnecessarily stigmatized in both the culture at large and within psychiatry. We are here to call for the removal of all forms of crossdressing and transvesticism from the DSM.

We say to the APA, stop sexualizing us!

And while there are many psychologists who understand the distinction between gender and sexuality, who understand that trans people’s identities, personalities and sexual histories are infinitely varied, the APA passed over such people, and instead tapped Ray Blanchard to chair of the sub-working group for the next DSM’s Paraphilia section.

We say, to the APA, stop sexualizing us!

Blanchard is the inventor of the controversial theory of autogynephilia, which claims that all transgender women are sexually motivated in our transitions. Despite the overwhelming scientific and experiential evidence that contradicts his theory, it has gained traction in the psychological literature—including a mention in the current DSM—precisely because it reifies hypersexualized stereotypes of trans women.

We say, to the APA, stop sexualizing us!

Blanchard views trans feminine spectrum individuals the way most movie producers do. To him, we are all either gay men who become women in order to attract straight men, or we are male perverts who become women in order to fulfill some kind of bizarre sex fantasy.

We say, to the APA, stop sexualizing us!

Blanchard not only believes that we are sexually deviant, but in the psychological literature, he has forwarded his belief that those people who are attracted to us—our lovers, partners and spouses—must also suffer from a paraphilic disorder.

We say, to the APA, stop sexualizing us!

Blanchard’s theories have been challenged by a majority of trans activists, allies, advocates and countless trans-knowledgeable psychologists and therapists. Yet, the APA selected him to play a lead role in rewriting trans feminine gender expression back into the DSM.

We say, to the APA, stop sexualizing us!

When you sexualize someone, you invalidate them. That’s why feminists have worked so hard to put an end to sexual harassment in the workplace, and it’s why we as trans activists seek an end to the psychiatric sexualization of trans feminine gender expression.

We say, to the APA, stop sexualizing us!

Clothing choice does not constitute a psychopathology. We call for the complete removal of crossdressing and Transvesticism (in any form) from the DSM.

We say to the APA, stop sexualizing us!


About the Author:

Julia Serano is an Oakland, California-based writer, spoken word performer, trans activist, and biologist. Julia is the author of Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity (Seal Press, 2007), a collection of personal essays that reveal how misogyny frames popular assumptions about femininity and shapes many of the myths and misconceptions people have about transsexual women. Julia has gained noteriety in transgender, queer, and feminist circles for her unique insights into gender. She has a Ph.D in Biochemistry and Molecular Biophysics from Columbia University and is currently a researcher at UC Berkeley in the field of Evolutionary and Developmental Biology.

Published here with permission of the author
Copyright © 2009 Julia Serano

About gidreform
Kelley Winters, Ph.D.is a writer on issues of transgender medical policy, founder of GID Reform Advocates and an Advisory Board Member for TransYouth Family Advocates. She has presented papers on the psychiatric classification of gender diversity at the annual conventions of the American Psychiatric Association, the American Counseling Association and the Association of Women in Psychology.

5 Responses to Stop Sexualizing Us!

  1. Erica Keppler says:

    I have been involved in the transgender community of my city for several years. I first started out in the crossdressing community, in hopes that some measure of private crosddressing would satisfy my lifelong desire for femininity. It clearly failed in that ambition, and instead only made matters worse when I had to go back to a male life. I then moved on to become very involved in the transsexual community as well. I have met probably several hundred transgender people in my journey. I’ve been looking back as of late thinking about this subject of transvestism, and trying to correlate it to my personal experience. In all those people I met, I can think of only one person who at the time left me with the impression that they were crossdressing purely out of a pursuit of sexual gratification, and that person went on to fully change sex. Clearly, my initial impression was wrong. So, in the end, out of several hundred people, I can’t put a finger on a single person that I could confidently describe as a transvestite.

    Based on my experience, I really feel that the concept of a transvestite is a myth. There is no such creature, or is so incredibly rare as to lack justification for having a devoted word in the English language. I think it’s time for the psychologic professional community to put up or shut up and provide proof of this so-called “Transvestic Fetishism” condition.

  2. While I am a transsexual male, I also don’t have a problem with these diagnoses being in the DSM. There is a clear distinction in the diagnostic criteria that says (paraphrasing) – Must cause clinically significant social and occupational distress or impairment. The majority of diagnoses in the DSM have this requirement, including such diagnoses as Generalized Anxiety Disorder, Hypomania, Major Depressive Episode, etc.

    A responsible therapist does not hear a client mention their fetishistic behavior and immediately jump to a diagnosis. There must be impairment or distress as indicated by the client. Furthermore, diagnoses are usually given for insurance purposes and sometimes in order to get a client hormones.

    As I understand the diagnostic criteria for Transvestic Fetishism, the individual must be a straight (assumption: biological) male who enjoys wearing women’s clothing for sexual gratification. It’s called a fetish for a reason. This diagnosis is not pathologizing those individuals who wear women’s clothing as a matter of self-expression (whatever that means for that individual). It is purely for sexual gratification, and beyond that, the person must have expressed SIGNIFICANT SOCIAL OR OCCUPATIONAL IMPAIRMENT OR DISTRESS AS A RESULT OF THIS FETISH.

    It seems pretty clear to me the scope of this diagnosis. I am a transsexual, but I also attempt to look at this objectively with my emotions put aside.

    • gidreform says:

      Thanks for writing and for illustrating some common misunderstandings about the Transvestic Fetishism (TF) diagnosis.

      First, the clinical significance criterion was indeed added to most all DSM-IV diagnoses in 1994. However, this TF criterion fails to provide clarifying language to exclude distress or impairment resulting from intolerance or bigotry by others. Criterion B may implicate victims of discrimination as pathologically impaired, regardless of how happy and well adjusted they are. In fact, the APA DSM-IV Casebook (1994) recommends a TF diagnosis for an otherwise ego-syntonic (happy/satisfied) cross-dresser, whose only impairment is an intolerant spouse.

      Second, access to hormones is an issue for reform or replacement of the current GID diagnosis. The Transvestic Fetishism diagnosis plays no role in access to hormonal transition care.

      Third, Criterion A for TF is grammatically ambiguous, ending with the clause, “or behaviors involving cross-dressing.” It was cleverly crafted to support implication of all MTF cross-dressing behaviors as pathological, regardless of sexual motivation. This intent is again illustrated by the DSM-IV Casebook, which recommended a TF diagnosis for cross-dressing that is not necessarily erotically motivated. This diagnosis labels expression of femininity that would be ordinary or even exemplary for born women as sexually deviant for others.

      I agree that responsible and supportive clinicians would not misapply psychiatric diagnosis or exploit ambiguous flawed language. If all mental health practitioners were conscientious, we would have less to worry about. But this is not the case. Cross-dressers and many other gender variant people lose their jobs, homes, children and civil justice because of horrible false stereotypes of mental illness and sexual deviance perpetuated by this TF diagnosis. Cross-dressers have been subjected to the cruelest imaginable gender-reparative/gender-conversion ‘treatment’ by mental health professionals, including psychotropic drugs, forced vomiting and electric shock.

      Please consider joining us in calling for the removal of the Transvestic Fetishism category.

  3. queerunity says:

    great post, I think it says more about the APA than does it about trans people
    http://queersunited.blogspot.com

  4. naomi pinson says:

    As someone who “gave up” my f to m trans identity via being psychiatrized 45 years ago in locked seclusion for months on end, I can only say…
    read this and think…

    From: Audrey Ervin
    Subject: Bias in Psychiatric Diagnosis Website
    Date: Saturday, February 6, 2010, 6:40 PM

    FOR IMMEDIATE RELEASE – BIAS IN PSYCHIATRIC DIAGNOSIS
    Website Highlights Concern About Upcoming DSM-V

    February 6, 2010 – Who makes the powerful decisions
    about what defines emotional normalcy or dysfunction?
    In 2013, the American Psychiatric Association is set
    to publish the Diagnostic and Statistical Manual of
    Mental Disorders, Fifth Edition (DSM-V). The DSM,
    often called the therapist’s Bible, is used to
    diagnose mental disorders, but for a quarter of
    a century, the Association for Women in Psychology has
    raised questions about the science, ethics
    and implications of psychiatric diagnoses, and its
    Committee on Bias in Psychiatric Diagnosis has just
    created a website to present its concerns about the
    upcoming DSM edition.

    Concerns about the new edition of the DSM-V
    include the secrecy surrounding its development,
    proposals to add questionable new diagnostic
    categories of mental disorder – such as “obesity”
    and
    “Parental Alienation Syndrome,” the failure to remove
    existing categories that cause harm and do not benefit
    patients, the failure to take into account the many
    kinds of harm that result from the use of psychiatric
    diagnoses, and the notion that emotional suffering
    comes primarily from within the individual rather than
    being heavily influenced by social or systemic
    factors.

    Paula J. Caplan, a psychologist and researcher at Harvard
    University, chairs the committee of academics, researchers

    and clinicians that has created
    the materials for the website, which is intended to
    provide
    information to mental health professionals, journalists
    and other interested individuals about biases and other
    problems in psychiatric diagnosis. The site includes
    critiques of specific diagnostic categories and ways
    that more general forms of bias, such as classism and
    racism, pervade the creation and use of psychiatric
    diagnostic categories. As new information about plans
    for DSM-V emerges, new material will be added. The site
    also includes related references, links, and announcements

    about conferences and publications and is at
    http://awpsych.org/index.php?option=com_content&view=article&id=102&Itemid=126

    The Association for Women in Psychology (AWP) is a
    scientific and educational professional organization of
    psychologists and other social scientists committed to
    encouraging feminist psychological research,
    theory and activism. ###

    Contact:
    Audrey Ervin, Ph.D.
    Spokesperson,
    Association for Women in Psychology
    http://awpsych.org/

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