TGEU Policy Statement on DSM Reform

November 3, 2008

I need to read this a little more closely, to be certain of exactly what’s being said. I agree that gender dysphoria urgently needs to be destigmatized; and no longer categorizing it as a mental illness would, in theory, be a great step forward.

However, I’m concerned that, should gender dysphoria be completely removed from the DSM-V, this may – in the UK, at least – have the effect of allowing the state to declassify genital reaffirmation surgery from a medical necessity to a cosmetic procedure. My fear is that such a change could mean that the onus is thereby removed from the state (via local PCTs) to provide treatment under the NHS, as it does (albeit somewhat half-heartedly) at the moment.

TGEU Policy Statement on DSM Reform

The Steering Committee of Transgender Europe lends its support to the joint statement of May 28, 2008 issued by the American organizations National Center for Transgender Equality (NCTE), the Transgender Law and Policy Institute (TLPI), the Transgender Law Center (TLC) and the Transgender Youth Family Allies (TYFA). After meeting with the APA, these four groups reported that “[they] are confident that a fair, unbiased review of current knowledge can result in a DSM-V that can move society toward a more rational and humane understanding of transgender people.” The review process will go on for several years, and the APA welcomes suggestions from lay persons as well as mental health professionals in this process.

Transgender Europe expressed in its press release after the Berlin Council:

Despite much scientific controversy, forms of transgender continue to be listed in the DSM IV of the American Psychological Association (APA), just as homosexuality once was, and in the ICD-10 of the World Health Organization (WHO) as psychological disorders. DSM and ICD are guideline manuals used in healthcare to standardise the definitions of what constitutes mental illness. Transgender Europe (TGEU) emphatically refuses this pathologisation and will assist the next reformulation of the DSM in a critical manner.”

We, the Steering Committee, are firmly of the conviction that the stigmatization, which in part is grounded in the mistaken assumption that gender variance is prima facie a medical disorder, is discriminatory. Furthermore, we cite the Yogyakarta Principles, Article 18:

No person may be forced to undergo any form of medical or psychological treatment, procedure, testing or be confined to a medical facility, based on sexual orientation or gender identity. Notwithstanding any classifications to the contrary, a person’s sexual orientation and gender identity are not, in and of themselves, medical conditions and are not to be treated, cured or suppressed.

A number of national governments and international bodies have passed resolutions in support of these principles: the European Parliament, the Council of Europe, Organization of American States.

Any revision of the DSM and the ICD must be carried out with full compliance to the Yogyakarta Principles.

Vienna, Nov 1st 2008

The Steering Committee of Transgender Europe

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Here are the links to my previous posts (newest first) on DSM related topics: