Transvestic Disorder, the Overlooked Anti-Trans Diagnosis in the DSM-5

Kelley Winters, Ph.D.
GID Reform Advocates
http://www.gidreform.org
kelley@gidreform.org

On May 5th, the American Psychiatric Association (APA) released a second round of proposed diagnostic criteria for the 5th Edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These include two diagnostic categories that impact the trans communities, Gender Dysphoria (formerly Gender Identity Disorder, or GID) and Transvestic Disorder (Formerly Transvestic Fetishism). While GID has received a great deal of attention in the press and from GLBTQ advocates, the second Transvestic category is too often overlooked. This is unfortunate, because the Transvestic Disorder diagnosis is designed to punish social and sexual gender nonconformity and enforce binary stereotypes of assigned birth sex. It plays no role in enabling access to medical transition care, for those who need it, and is frequently cited when care is denied (Winters 2010). I urge all trans community members, friends, care providers and allies to call for the removal of this punitive and scientifically unfounded diagnosis from the DSM-5. The current period for public comment to the APA ends June 15.

Like its predecessor, Transvestic Fetishism, in the current DSM, Transvestic Disorder is authored by Dr. Ray Blanchard, of the Toronto Centre for Addiction and Mental Health (CAMH, formerly known as the Clarke Institute). Blanchard has drawn outrage from the transcommunity for his defamatory theory of autogynephilia, asserting that all transsexual women who are not exclusively attracted to males are motivated to transition by self-obsessed sexual fetishism (Winters 2008A). He is canonizing this harmful stereotype of transsexual women in the DSM-5 by adding an autogynephilia specifier to the Transvestic Fetishism diagnosis (APA 2011) . Worse yet, Blanchard has broadly expanded the diagnosis to implicate gender nonconforming people of all sexes and all sexual orientations, even inventing an autoandrophilia specifier to smear transsexual men. Most recently, he has added an “In Remission” specifier to preclude the possibility of exit from diagnosis. Like a roach motel, there may be no way out of the Transvestic Disorder diagnosis, once ensnared.

What You Can Do Now

  1. Go to the APA DSM-5 web site (APA 2011), click on “register now,” create a user account and enter your statement in the box. The deadline for this second period of public comment is June 15.
  2. Sign the Petition to Remove Transvestic Disorder from the DSM-5 (IFGE 2010), sponsored by the International Foundation for Gender Education.
  3. Demand that your local, national and international GLBTQ nonprofit organizations issue public statements calling for the removal of this defamatory Transvestic Disorder category from the DSM-5. Very few have so far.
  4. Spread the word to your network, friends and allies.

For more information, see GID Reform Advocates (Winters, 2010)

References

American Psychiatric Association (2011) “DSM-5 Development; Proposed Revisions, 302.3 Transvestic Fetishism,” http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=189#

Ehrbar, R., Winters, K., Gorton, N. (2009) “Revision Suggestions for Gender Related Diagnoses in the DSM and ICD,” The World Professional Association for Transgender Health (WPATH) 2009 XXI Biennial Symposium, Oslo, Norway, http://www.gidreform.org/wpath2009/

International Foundation for Gender Education (2010) “Petition to Remove Transvestic Disorder from the DSM-5,” http://dsm.ifge.org/petition/

Lev, A.I., Winters, K., Alie, L., Ansara, Y., Deutsch, M., Dickey, L., Ehrbar, R., Ehrensaft, D., Green, J., Meier, S., Richmond, K., Samons, S., Susset, F., (2010). “Response to Proposed DSM-5 Diagnostic Criteria. Professionals Concerned With Gender Diagnoses in the DSM.” Retrieved December 4, 2010 from: http://professionals.gidreform.org

TransYouth Family Allies (2010) “Comments on the Proposed Revision to 302.6 Gender Identity Disorder in Children, Submitted to the American Psychiatric Association,” April 20, http://www.imatyfa.org/whatsnew/2010/10apr-commentsondsm-v.html

Winters, K. (2008). Gender Madness in American Psychiatry: Essays from the struggle for Dignity, GID Reform Advocates, www.gendermadness.com

Winters, K (2008A) Autogynephilia: The Infallible Derogatory Hypothesis, Part 1, GID Reform Advocates, November 10, http://www.gidreform.org/blog2008Nov10.html

Winters, K. (2010) “Ten Reasons Why the Transvestic Disorder Diagnosis in the DSM-5 Has Got to Go,” GID Reform Advocates, Oct. 15, http://www.gidreform.org/blog2010Oct15.html

Winters, K. and Ehrbar, R. (2010) “Beyond Conundrum: Strategies for Diagnostic Harm Reduction,” Journal of Gay & Lesbian Mental Health, 14:2, 130-139, April World Professional Association for Transgender Health (2010). “Statement Urging the De-psychopathologisation of Gender Variance,” May 26, http://wpath.org/publications_public_policy.cfm

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.

14 Responses to Transvestic Disorder, the Overlooked Anti-Trans Diagnosis in the DSM-5

  1. HenryHall says:

    On May 12, 2011, Finland became he latest nation to remove Transvestic Fetishism and similar diagnoses from the localised version of the ICD-10. The formal announcement is at http://www.thl.fi/fi_FI/web/fi/uutinen?id=25489

    It is a trend, other countries will follow until only pariah nations are left.

    • Jack Molay says:

      Norway, Denmark, Sweden and Finland have all removed crossdressing as a diagnosis.

      By many Scandinavian experts the inclusion of crossdressing is considered a violation of their human rights.

      • HenryHall says:

        France too for sure.
        Not sure about Spain, can’t get a straight answer.

  2. It’s so sad that I can be punished at any time just for being me, if only for the selfishness of society. No wonder we have such a high suicide rate and unemployment rates, being treated sub-human by the so-called “authorities” who are the biggest part of the problem.

  3. Jeff B. says:

    In addition to signing the petition and commenting at the APA site, it would be helpful to 1) Contact any local/county providers of LGBT health service to ask what action they/their staff is taking. 2) Reach out to any mental health professional you can get a hold of,. Although psychiatrists rule the roost @ APA, the PhDs, MSWs, LCPCs do have a voice in the matter as well.

  4. Pingback: DSM-V: Transvestic Disorder: The Overlooked Anti-Trans Diagnosis | My Evanesce

  5. gidreform says:

    Several people have reported problems posting comments to the dsm5.org web service. If you are unable to post, please let me know the operating system (mac osx, windows7, ubuntu 11.04, etc) and the browser (exploder, firefox, safari, etc.) that your are using at kelley@gidreform.org. Please be specific with the version numbers. Thanks.

  6. Cynthia Lim says:

    As a psychiatric nurse … I am appalled that we want to go backwards in our diagnosing of “mental disorders”.
    Cynthia Lim, RPN

  7. Pingback: DSM-5 and Transvestic Disorder at Questioning Transphobia

  8. Pingback: Proposed DSM-5 Changes: Derogatory Labeling & Pathologizing The Identity Of Trans Persons | From Eternity To Here

  9. Pingback: Trans Segment #39: Crossdressers are weird and freaky. « goodbyelazarus

  10. Pingback: Dysphoria > Disorder > Dysphoria – en|Gender

  11. So when are we just becoming normal? Despite the insurance and what?

  12. Charles Moyer says:

    I support your effort. Perhaps the following more theoretical approach will be more successful:
    1. Determine the statistical mental health of transvestites whose mental development occurred in an openly transvestism-tolerant community. Thailand is the only partially transvestism tolerant community that I have heard of.
    2. The medical status of each interface from the local community to the transvestite is one of the following:
    a. Neutral, if the community has traditions that openly tolerate transvestism.
    b. Chronic traumatic stress, if the community has prominent traditions of prejudice and discrimination and conflict against transvestism.
    The transvestite experience has both of the previous components.\

    Charles Moyer

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