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Grey Matters - Mental Health in the Old Pueblo

Is Transgenderism a mental illness?

by on Jan. 07, 2010, under brain disorders, depression, General Mental Health, Health, LGBT, mental illness, Politics, stigma

transgenderismThe American Psychiatric Association thinks so, or is history repeating itself?  The new DSM-V, the medical profession’s bible for diagnosing, is set to come out in May after delays caused by several areas of controversy.  But, the APA has a legacy of uneasy relations with the lesbian, gay, bisexual and transgender community, having included homosexuality in the DSM‘s list of psychiatric disorders until 1973.  Some transgender activists want issues of gender identity kicked off the list of mental illnesses too.

Transgender is an umbrella term used to describe people whose gender identity (sense of themselves as male or female) or gender expression differs from that usually associated with their birth sex. Many transgender people live part-time or full-time as members of the other gender. Broadly speaking, anyone whose identity, appearance, or behavior falls outside of conventional gender norms can be described as transgender. However, not everyone whose appearance or behavior is gender-atypical will identify as a transgender person.

Wikipedia says:  Beginning therapy is recommended for all people who are frustrated by their gender, especially if they desire to transition. People who experience discord between their gender and the expectations of others or whose gender identity conflicts with their body benefit by talking through their feelings in depth with someone who will listen indefinitely. However, gender identity is new to psychology and research is still in its infancy.

Some believe a person with a diagnosed Gender Identity Disorder (GID) experiences distress and/or disability and it may manifest as depression or inability to work and form healthy relationships with others. This diagnosis is often over-simplified to mean that simply being transgender means a person suffers from GID which is not true. This has caused much confusion to transgender people and those who strongly seek to either criticize or affirm them. Transgender people who are comfortable with their gender, whose gender does not directly cause inner frustration, or impair their functioning, do not have GID and are not applicable for a related mental disorder. GID is not permanent and is usually resolved through therapy and transitioning, especially its social aspects. GID does not refer to people who feel oppressed by the negative attitudes and behaviors of others.

Transgender issues are new in the scientific field and affect relatively few people, so understandably many mental healthcare providers know little about transgender issues. People seeking help from these professionals often end up educating the professional rather than receiving help.

 The issues around psychological classifications and associated stigma have recently become more complex since it was announced that colleagues from The Centre for Addiction and Mental Health (CAMH), a consortium of mental health clinics at several sites in Toronto will serve on the DSM’s Sexual and Gender Identity Disorders Work Group. CAMH has aims to ‘cure’ transgendered people of their ‘disorder’, especially in children.

 The issue is that a person who is unclear about his gender identity, just like a person who is  lesbian or gay should not have to face cruelty and stigma based solely on their sexual preference or identity. Kudos to President Obama for making history on New Year’s Eve when he appointed the former Mitchell Simpson, who now identifies himself as a female named Amanda, to a position as a senior adviser in the Commerce Department. Simpson apparently is the first transgendered individual become a presidential appointee to the federal government.

amanda  Amanda Simpson now serves as a senior advisor in the Commerce Dept.

People in the LGBT community can experience double stigma when they also live with a mental illness. The National Alliance on Mental Illness supports the LGBT community in its Multi-cultural Action Center.  For more information visit www.nami.org


  • http://www.obamahealthcareplan.org nanacyle

    Against the Health care plan? express your opinion at http://www.obamahealthcareplan.org

    • koreyk

      Considering that this article has nothing to do with the Health care plan, your link is simply spam.

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  • leftfield

    This is really a well-written piece.

    • greymatters

      thanks!  I always consider  your replies to be toughtful! ( ;

  • xrk9854

    Wow!  This article is a bit behind the times.  The DSM is NOT going to be released soon.  They’ve pretty much decided to delay publication for a couple years to rethink things.  It’s even possible it will never be published again in the traditional (paper) sense.
     
    And those “colleagues” at the CAMH are known to be anti-trans junk scientists who are only out to protect their own turf.  I would go further and describe them as junk scientists our of step with the majority of gender experts.
     
    The history of psychology is replete with example of pathologizing people who were misunderstood and/or oppressed.  Trans people are only the latest example.  Just like homosexuality transsexualism will be removed from the DSM.  In fact the wheels are already turning in that direction as many national and international groups are calling for it to be reclassified a MEDICAL condition.  A medical condition that can be treated through transition.
     
    Lastly, if you like to know more about why transsexual (a birth condition) or GID (merely a symptom of that birth condition) should be removed from the DSM I suggest you peruse this website:
     
    http://www.GIDReform.org

    • xrk9854

      Forgot to mention the AMA already considers transsexualism a medical condition.  It also call for the insurance industry to eliminate exclusions to the care of transsexual people.  Read the resolution for yourself:
       
      http://www.tgender.net/taw/ama_resolutions.pdf

    • greymatters

      My bad….I went back and checked my resources and you are right.  The new DSM-V is scheduled to be realease in May, but not until 2013. 

  • Ferraribubba

    I’ve only known one transgengered person in my life. Mike Penner/ Christine McDaniel, late of the L.A. Times.
    It’s been a rough past few months for Anaheim Western Junior High School grads, where both my kids also went to school.
    First Tiger Woods’ world comes crashing down around him, then Mike Penner commits suicide a few weeks later.
    Mike, a gifted sportswriter for the L.A. Times suddenly ‘came out of the closet’ without warning to the readers in 2005 when his byline suddenly changed to Christine McDaniel and his old ‘thumbnail’ photo was of the new ‘woman.’
    Oh, there was an explanatory box that ran with his/her stories for a few days, but that was it.
    The rest of the sports department and newsroom excepted the shocking change well I heard, (at least to Christine’s face), but I can’t imagine the hell my friend must have gone through trying to interview those juiced-up steroid taking jocks after the games.
    I guess that the harassment got too much for her to handle, and so bad that, about a year before she comitted suicide, she switched back and became Mike again.
    A tragic story and the loss of a very gifted fellow human being.
    I’ll miss Mike and his wonderful/witty stories.
    Yer pal, Ferrari Bubba

    • koreyk

      The general public attitude toward transgender-ism has vastly improved since the time of Christine Jorgensen, but, as Ferrari Bubba’s story illustrates, it still has a long way to go.

      My condolences on the loss of your friend.

  • Carolyn Classen

    Isn’t that a photo of Amanda Simpson on the featured section of this blog?
    She was the first transgendered person to be a Democratic candidate for LD 26 house in 2005 here in Tucson, and is now an Obama appointee to the Dept. of Commerce.  She’s a Senior Technical Advisor  in the Bureau of Industry and Security.

    • greymatters

      thanks for the additional info Carolyn.  I didn’t realize she was one of Tucson’s own! 

      • Carolyn Classen

        yes, she worked at Raytheon in Tucson for years I believe, and is a graduate of the U of A.

      • http://aebrain.blogspot.com Zoe Brain

        “She” is one of Tucson’s own?
        In the article you stated “the former Mitchell Simpson, who now identifies himself as a female named Amanda”.
        Now you’re saying that this person is female after all, not merely “identifying” as female? Please be consistent.
        I note that you make a lot about CAMH – otherwise known as “Jurassic Clarke”, infamous for its past treatment of the “inferior races” as the former head of that institution put it.
        Perhaps you should look at the symposium on the subject given at the recent American Psychiatric Association annual meeting:
        Seminar S10:
        S10. The Neurobiological Evidence for Transgenderism

        1. Brain Gender Identity Prof. Sidney W. Ecker, M.D.
        2. Transsexuality as an Intersex Condition Prof Milton Diamond, Ph.D.
        3. Novel Approaches to Endocrine Treatment of Transgender Adolescents and Adults Norman Spack, M.D.
        Prof Ecker’s slides are available on the web.
        Or you could read any of the following – there’s hundreds of papers on the subject now.
        Specific Cerebral Activation due to Visual Erotic Stimuli in Male-to-Female Transsexuals Compared with Male and Female Controls: An fMRI Study by Gizewski et al J Sex Med 2009;6:440–448.

        Neuroimaging Differences in Spatial Cognition between Men and Male-to-Female Transsexuals Before and During Hormone Therapy by Scoening et al J Sex Med. 2009 Sep 14.

        Male-to-female transsexuals show sex-atypical hypothalamus activation when smelling odorous steroids by Berglund et al Cerebral Cortex 2008 18(8):1900-1908;

        Male–to–female transsexuals have female neuron numbers in a limbic nucleus. Kruiver et al J Clin Endocrinol Metab (2000) 85:2034–2041

        Sexual differentiation of the human brain: relevance for gender identity, transsexualism and sexual orientation. Swaab Gynecol Endocrinol (2004) 19:301–312.

        A sex difference in the human brain and its relation to transsexuality. by Zhou et al Nature (1995) 378:68–70.

        A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity by Garcia-Falgueras et al Brain. 2008 Dec;131(Pt 12):3132-46.
        We can reliably induce transsexuality in experimental animals by appropriate hormonal intervention during gestation, just as we can induce other anomalies, such as cleft palates and spina bifida.
        It’s a gross over-simplification to say “Female Brain, mostly Male otherwise”, but close enough. If you credit the theory that personality is a function of neurology, then and only then is this person female. If you see the personality as something distinct, supernatural, then perhaps not.
        I’m Intersexed by the way, in a rare way. In 1985 I was diagnosed as a mildly Intersexed male. In 2005, after having a most unexpected female puberty, I was re-diagnosed as a severely intersexed female. Psychologically though, I am indistinguishable from a normal, common-or-garden, transsexual like Amanda.
        I’m the perfect experiment: what happens if you take a biological woman who looks male at birth, and bring her up as male: will she have a male or female gender identity? The sample size is n=1, but the evidence so far says “female, and indistinguishable from a transsexual woman”. Right down to having Gender Dysphoria, until puberty.
        I’m even a Rocket Scientist, with 30 years in Aerospace and Defence, as she is. Into Submarines rather than Aircraft though. Qualifications in Pure Mathematics, Information Technology and Computer Science.
        The non-standard neurology tends to increase the chance of talents in certain areas.

  • http://arizonaabby.wordpress.com/ Abby

    You did a reasonably good job with this article until you got to the second to the last paragraph.  It is offensive to trans people, like myself, to refer to them by their former names and identities and to not use the pronouns that conform to their gender identities.  It is completely irrelevant to this or any other article about this issue what Amanda’s old name was.  Plus, Amanda is not “the former Mitchell Simpson, who now identifies himself [sic] as a female named Amanda.” Saying that she merely “identifies [her]self as a female named Amanda” implies that she isn’t “really” a woman and her name isn’t “really” Amanda and that, instead, she is just pretending to be a woman named Amanda and deceiving the public in the process.  Amanda IS a woman, regardless of what her past might have been, and her name IS Amanda, regardless of what her former name might have been.  Why does this matter? It matters because the beliefs that we aren’t really who we say we are and are just deceiving people are responsible for the discrimination, harassment, assaults and, yes, even murders of trans people that happen all too often in this country.  (Recent surveys indicate that anywhere from 50% to 97% of trans people have been the victim of employment discrimination because of their gender identity.  The risk of murder for a trans person, especially a trans woman of color is approximately 12 times that of the general population.)
    Tucson has a large and active transgender community and the Southern Arizona Gender Alliance (SAGA), now a part of WingSpan, is one of the oldest organizations in the country dedicated to supporting and advocating for the rights of trans people.   Before you write another article on trans issues, I suggest you contact Alison Davison, the coordinator of SAGA.  I’m sure she would be happy to talk with you, to suggest others you might want to talk to and provide you with other resources.  You can learn about SAGA and find how to contact Alison here:  http://www.sagatucson.org/.
    In addition, I suggest you read the media guide prepared by the Gay and Lesbian Alliance Against Defamantion (GLAAD) on transgender terminology and reporting. You can find the media guide here:  http://www.glaad.org/Page.aspx?pid=376.  It contains much useful information for anyone who wants to write about trans people and the issues we face.
    If you would like, I’d be happy to talk to you, as well.  You can contact me through my email address, which you now have.

  • alisonaz

    I am the coordinator of the Southern Arizona Gender Alliance (SAGA) http://www.sagatucson.org
    You did a pretty good job introducing some of the issues transgender people face. It is too bad you mucked things up in your last paragraph. If you would really like to know more about Trans identities, experiences, issues, or the local community, please contact me at Wingspan.
    Alison

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  • Andy Morales

    It will be a great day when when these things won’t matter anymore – when we can move on and know that some things are none of our business.
     
    We have to move beyond tolerance and start teaching acceptance.
     
    I’ve met Amanda and she is a woman just like I have curly hair and my wife is blonde.
     
    Live and let live.
     
    Andy

  • Ferraribubba

    So Zoe: How does your drivers license identify you. If I ever had to arrest you (God forbid, but it does happen) would you be in the womens’ or men’s lock-up? Or as I think, in isolation?
    I never had this come up in the seven years that I was with Anaheim. Even in the 7 months that I was working Vice. 
    And while we’re on the subject . . . .
    Back in the day, there was this strip-mall transvestite bar in Garden Grove called The Queen Mary. They had an annual chili cookoff the same weekend that the Long Beach Grand Prix was held each year. It was a lot of fun to say the least. <g>
    Well, I was dating this very high-maintenance redhead at the time who was working in the kitchen of the famous Chasens’ Restaurant in Beverley Hills.
    Dave Chasen’s chili is stuff of legend! All the Hollywood stars ate it, and Elizabeth Taylor loved it so much that she had it air-freighted to wherever in the world that she was making movies.
    It didn’t take me long to get Dave secret recipe from the redhead and enter it in the Queen Mary Chili Cookoff as ‘Officer Billy’s Code 3 Chili.’
    So I show up at the cook-off in my uniform, in my Anaheim patrol car, with the redhead in handcuffs, set up my stand, make the chili, and win 1st Prize!
    (I had cleared it with the Chief beforehand, saying it would be good PR and present a human face to that community.)
    I still have the trophy, and the recipe, but alas, the redhead is long gone. <g>
    Book ‘em Dano! Yer pal, Officer Bubba

    Pop Quiz: Which has more fingerprints, the FBI or ETA?

    Answer: Elizabeth Taylor’s ass by a mile.

  • http://aebrain.blogspot.com Zoe Brain

    Ferraribubba – I live in a state (actually, territory) where they stopped putting sex on the driver’s license long ago.
    Go by my (non-US) birth certificate, and it says “boy”.  Go by my passport, or immigration record,  and it says “female”.
    If I enter the mainland USA, I could easily be refused entry, and put in an immigration holding area, due to the inconsistency. With other women, if I’m lucky. If not… I’d try to kill myself as soon as possible, of course.  Few survive the experience, even if they don’t suicide.
    Having been in Vice, no doubt you’d know plenty of teenage TS girls. So many are ejected from home by their parents, and survival sex work is one of the few avenues open to them. When you’re 13, and need $50 a week for hormones just to look normal, and $30,000 for the surgery – and are living on the street – it’s not quite universal, but close.
    Maybe 1 in 8 survive to age 20. If they’re lucky, a pimp will pay for the boob job and hormones, but not usually for the surgery. Get that, and their value goes way down, he’d lose his investment. So they’re kept on till they’re used up, then expended on someone with a taste for snuff scenarios.
    Not just teens though. I know a few former CEOs, engineers, bankers, who after they transitioned, lost all their assets, became unemployable, and oddly enough, trans women often find bureaucratic difficulties getting any relief. Even homeless shelters refuse them.
    A friend of mine, ex-Marine, froze to death last year on the steps of a church in Texas for this reason. She’d just sung “Silent Night” to the council a few hours before.
    You know that the clear-up rate of homicides of trans women is less than 30%? Compared to 70%+ of the general population? I’m sure you’ve seen your share. “NHI” right? No Humans Involved? Trouble is, it’s true. After years of treatment like that, they’re often sociopathic.
    There but for the grace of God, go I.
    I try to help them. I’m really glad I’m not a Vice cop, that would really be the pits. Almost as bad as a cop investigating child abuse. That would really corrode the soul.
    Oh, of I’m ever arrested, then while being held before trial, I’d be put in the special block. No windows, allowed out for a shower once in 3 days, no books, playing cards, writing implements, no privileges… a gal in Virginia had 4 months of that before pleading guilty to whatever they charged her with.  She would have confessed to assassinating JFK if they wanted. Just to get out into a normal prison. But they ignored the Judge’s orders, and kept her in solitary afterwards for a few more months. Now she’s in the hospital wing, quite, quite insane and unresponsive.

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  • http://femaleshemale.net/?author=1 Heshe

    @ SgButterfly.
    It’s all genetic. Is being gay a mental illness? No!

  • greymatters

    please do!

  • greymatters

    Sure……


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