Archive for the 'DSM-V' Category

Lynn Conway targeted by Kenneth Zucker for speaking out against his appointment to the APA Task Force

March 5, 2009

Transcript:

Staying Sane
365Gay News
Logo
Originally aired 26 February 2009

Ross Palombo: A transgender university professor targeted, she says, for speaking out, and her fight against a prominent psychiatrist may help others keep their sanity. Chagmion Antoine has that story from New York. Chagmion.

Chagmion Antoine: Ross, even though homosexuality was removed from the American Psychiatric Association’s list of mental illnesses back in 1973, people who are transgender are still diagnosed with gender identity disorder today. And one professor at the University of Michigan says that’s crazy talk.

Chagmion Antoine (voiceover): Lynn Conway has been fighting for the rights of transgender people ever since her own experience cost her her job in the 1960s. Now she’s a professor emeritus at the University of Michigan, and her website is a respected resource for trans people all around the world. So why is she being sued for libel by one of the world’s leading researchers on gender identity?

Professor Lynn Conway: This isn’t between Dr. Zucker and Professor Lynn Conway, this is between Dr. Zucker and the entire transgender community.

Chagmion Antoine (voiceover): Dr. Kenneth Zucker, a Toronto-based sexologist, spent his career diagnosing children with gender identity issues as mentally ill. When he was appointed to the APA as an authority on gender identity disorders last year, Conway sounded the alarm.

Professor Lynn Conway: Dr. Zucker and his clinic are the sources of decades of pseudoscience claiming that transgender people, especially transgender children, are mentally disordered and in need of reparative therapy. I seek to expose that.

Chagmion Antoine (voiceover): And she did. Zucker’s appointment to the APA’s committee was protested by trans people around the world.

Mishyana: To say the least, Dr. Zucker is not appropriate for this position.

Chagmion Antoine (voiceover): Zucker fired back with this letter to Conway, threatening to sue. He never followed through. Zucker declined to comment to 365, but Conway says his scare tactics are meant to draw attention from the bigger picture.

Professor Lynn Conway: There are a lot of us out there. A lot of us are actually rather cool people. I think he’d enjoy meeting us all.

Chagmion Antoine: Here’s an interesting fact. Lynn Conway is also a pioneering researcher in computer chip technology. She literally helped write the book. Ross.

Ross Palombo: Thanks, Chagmion.

Lynn Conway’s side of the story can be found by clicking here.

I’ve been unable to find any response from Kenneth Zucker; if anyone knows of such a thing, please post the link in the comments and I’ll update this post accordingly.

The TS Roadmap website’s page about Kenneth Zucker can be found by clicking here.

(Cross-posted at Questioning Transphobia)

————

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

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

————

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

Developing DSM-V in Secret

October 17, 2008

Here’s a brief statement by Robert L. Spitzer, MD, Professor of Psychiatry at Columbia University in New York City.

It’s an editorial called Issues for DSM-V: Developing DSM-V in Secret, which was apparently rejected by the American Journal of Psychiatry.

The gist of it is that the DSM-V will be developed behind closed doors; apparently this is a significant break with the process of peer review which was in place during previous revisions of the DSM. The members of the Task Force and Sexual and Gender Identity Disorders Workgroup have all signed confidentiality agreements – a policy which is the direct opposite of that adopted by the World Health Organization for its development of ICD-11 (the next revision of the International Classification of Diseases).

According to Robert Spitzer, no meaningful reasons for this secretive approach have been offered by the DSM-V and APA leadership.

Issues for DSM-V: Developing DSM-V in Secret

Perhaps the best-kept-secret about DSM-V is that rather than being “an open and transparent process” as has been claimed (1), it will essentially be developed in secret. Task Force and Workgroup members have been required to sign “confidentiality agreements” prohibiting them from discussing with anybody anything having to do with DSM-V. The language in the agreement is quite clear: “I will not, during the term of this appointment or after, divulge, furnish or make accessible to anyone or use in any way …any Confidential Information. I understand that “Confidential Information” includes all Work Product, unpublished manuscripts and drafts and other pre-publication materials, group discussions, internal correspondence, information about the development process and any other written or unwritten information, in any form, that emanates from or relates to my work with the APA task force or work group.”

This unprecedented attempt to develop DSM-V in secret indicates a failure to understand that revising a diagnostic manual is a scientific process that benefits from the very exchange of information that is prohibited by the confidentiality agreement. Such scientific exchanges were recognized in DSM-III, DSM-III-R, and DSM-IV as being crucial in order to insure that outside perspectives were considered throughout the development process, not merely when the revision is in close-to-final form. In contrast to this new APA confidentiality policy, the World Health Organization has adopted the opposite policy with regard to developing ICD-11. Minutes of ICD-11 meetings are posted on the WHO website (2) and they have explicitly noted that “it is to the benefit of the revision process for ICD-11 advisory group members to make presentations at professional and scientific meetings in order to provide information about the revision and facilitate opportunities for participation and input.”(3).

Repeated attempts to get the DSM-V and APA leadership to explain this policy change have been met with either no response or explanations which make little sense. For example, one justification was that the confidentiality agreements are needed so that “those working on the project have the opportunity to freely discuss and candidly exchange their views with others in their Work Group or the DSM-V Task Force without concern that those initial and perhaps tentative views will be made public.” (4). It is hard to imagine a distinguished DSM-V researcher or clinician being reluctant to speak candidly because of such concerns. Nothing like this has ever been observed or reported in previous DSM revisions..

Given the fact that articles in the press critical of psychiatry are in no short supply and often distort issues for sensational effect, concern about media access is, of course, justified. However, no one is suggesting that the media be allowed to sit in during DSM-V meetings, which could certainly stifle discussion. What is suggested is simply a return to the previous policy, namely that DSM-V participants be encouraged to interact freely with their colleagues and that summaries of DSM-V meetings be made available to interested parties. This will insure that the DSM-V process will truly be open and transparent.

References

1. Moran M. Citing Importance of Advocacy, Robinowitz Urges, ‘Just Do It’. Psychiatric News 2008 June 6, 2008:1.

2. World Health Organization. (http://www.who.int/mental_health/evidence/en/. In; 2008.

3. International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders. Summary Report of the 2nd Meeting of the International Advisory Group for the Revision of ICD-10 Mental and Behavioural Disorders, 24 – 25 September 2007, Geneva, SWITZERLAND. In: World Health Organization; 2007.

4. (personal communication: May 22 2008 letter from Nada Stotland and James Scully to Robert L. Spitzer). In; 2008.

————

Wikipedia on Spitzer

According to Wikipedia:

[Spitzer] was chair of the task force of the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III) which was released in 1980. He has been referred to as a major architect of the modern classification of mental disorders which involves classifying mental disorders in discrete categories, with specified diagnostic criteria.

[...]

Spitzer attracted controversy in 1973 for arguing that homosexuality is not a clinical disorder. The mainstream psychiatric community agreed, and declassified homosexuality from its list of mental disorders.

In 2001, Spitzer delivered a controversial paper at the 2001 annual APA meeting arguing that highly motivated individuals could successfully change their sexual orientation from homosexual to heterosexual. The APA immediately issued an official disavowal of the paper, noting that it had not been peer reviewed and stating that “There is no published scientific evidence supporting the efficacy of reparative therapy as a treatment to change one’s sexual orientation.”

Two years later, Spitzer published the paper in the Archives of Sexual Behavior. The publication decision sparked controversy and one sponsoring member resigned in protest. The paper has been criticized on various grounds, including using non-random sampling and poor criteria for success.

See also this transcript of an APA roundtable on gender variance and DSM-V, held in 2003.

————

Here are the links to my previous posts (newest first) on the subject of DSM-V/Zucker/Blanchard:

Reminder: Demo against Zucker at RSM tomorrow

September 30, 2008

Just a brief reminder about tomorrow’s demonstration against Kenneth Zucker at 8.30am outside the Royal Society of Medicine, 1 Wimpole Street, London, W1G 0AE.

The demo is organised in cooperation with the Metropolitan Police and will take place outside the Royal Society of Medicine (just behind Debenhams/House of Fraser; nearest tubes are Bond Street and Oxford Circus)

Full details in my earlier post.

Hoping to see a good turnout – and if I haven’t got rid of this stupid laryngitis-bug-thing that totally poleaxed me yesterday, then I’ll be the one that’s miming not chanting ;)

————

Edited to add: Sarah and Natacha have each posted full reviews of the morning’s events; links here:

————

Here are the links to my previous posts (newest first) on the subject of DSM-V/Zucker/Blanchard:

Demonstration against Kenneth Zucker at RSM, 1st October 2008

September 22, 2008

A couple of weeks ago, I noted that Kenneth Zucker will still be speaking at the conference on Medical Care for Gender Variant Teenagers, to be held at the RSM in London.

I’m a bit slow to pick up on this – Natacha blogged it a week ago – but a demonstration against Zucker is planned for 1st October at 8.30 am outside the Royal Society of Medicine, 1 Wimpole Street, London, W1G 0AE.

The demo is organised in cooperation with the Metropolitan Police and will take place outside the Royal Society of Medicine (just behind Debenhams/House of Fraser; nearest tubes are Bond Street and Oxford Circus)

As Natacha says in this PFC News Alert:

It is important to come for two reasons:

  1. to show opposition to Ken Zucker’s ‘treatments’ being used on children and
  2. to oppose the nature of the Royal Society of Medicine’s highly political conference on trans identified adolescents

Natacha adds:

[...] The conference seems to have been set up to push a UK-based treatment protocol for GV children and trans identified adolescents. This protocol will not involve the use of hormone blockers to delay the onset of puberty. Puberty can not only be extremely distressing for some GV YP’s particularly those that grow up to be trans adults. Furthermore, as legal research has shown the refusal to consider this treatment means that trans adolescents develop secondary sexual characteristics, such as beard or breast growth that ultimately lead to major health interventions, in the future, which could have been avoided. In this sense it seems that it is also particularly politically motivated and as such as large presence outside is vital to make our feelings known and to distribute leaflets to delegates to make sure they understand the other side of the story.

Demonstration against Ken Zucker (the man who proposes reparative therapy for gender variant young people):
October 1st, 8.30am, The Royal Society of Medicine, 1 Wimpole Street, London, W1G 0AE

————

Here are the links to my previous posts (newest first) on the subject of DSM-V/Zucker/Blanchard:

Zucker *still* to speak at RSM conference

September 9, 2008

Further to my earlier post here, it seems that the reparatist Kenneth Zucker will still be speaking at the conference on Medical Care for Gender Variant Teenagers, to be held in London on 28 September.

The conference is organised and moderated by Richard Green (formerly Research Director/Head of the Gender Identity Clinic, Charing Cross Hospital).

Clinicians presenting will be Professor Norman Spack, Harvard Medical School, Professor Marvin Belzer, University of Southern California Medical School, Professor Kenneth Zucker, University of Toronto, and Dr. Annelou de Vries, Free University, Amsterdam. All are engaged in extensive programmes treating transsexual teenagers with pubertal blockers and cross-sex steroids. Dr Simona Giordano, School of Law, University of Manchester, will discuss ethical issues. Teens and parents from the Netherlands and the UK, the latter having travelled to the US for treatment, will discuss their experiences.

Mermaids and the Gender Identity Research and Education Society (GIRES) are helping to fund the conference.

I’m a bit… lost for words, actually. Concerned? Dismayed? I just don’t see why or how Zucker (amongst other presenters at the event) has any credibility left whatsoever…

…*sigh*…

(Via)

Open letter to the President of the APA

September 6, 2008

In my earlier post about the APA Task Force’s Report, which seemingly underreported the prevalence of gender identity disorder, (link here), I was grateful to receive additional clarification from Lynn Conway regarding the likely reasoning behind the apparent inaccuracies in the Report.

I see that Lynn has now published the text of an open letter she has written to the President of the APA on the subject.

What to do?

It matters not whether the APA Task Force’s falsification of prevalence values was intentional or whether it was due to carelessness, ignorance and/or group-think about old, oft-cited numbers. What matters is that the APA must terminate its propagation of erroneous trans-prevalence values and correct the Task Force report accordingly.

I recommend reading Lynn’s letter in its entirety; it’s published on her website here: Open letter to the President of the APA re Falsification of GID prevalence results by the APA Task Force on Gender Identity and Gender Variance

————

Previous, related posts on this blog (most recent first):

APA Task Force Report underreports the prevalence of gender identity disorder

August 29, 2008

Lynn Conway has just published a report on the APA Task Force’s underreporting of the prevalence of gender identity disorderlink here.

I don’t pretend to fully understand the finer points of Lynn’s investigations, but her summary alone speaks volumes in a way even I can understand:

Summary and Findings:

The APA Task Force Report on Gender Identity and Gender Variance [APA08 - PDF here] greatly underreports the prevalence of “gender identity disorder” by a factor on the order of 10 to 20.

The underreporting of GID prevalence derives from a deliberate misuse of clinical definitions and a failure to mention known calculation errors in sources.

The unreasonably low prevalence numbers are given to three significant figures in the Report, as if they were precisely accurate – while failing to mention well-known sources of estimation error.

The Task Force then dismisses recent work by Olyslager and Conway that had exposed large errors in earlier studies by calling that work a “minority position” – as if a scientific analysis must be certified by a majority vote, rather than judged on its merits.

The Task Force further dismisses the work of Olyslager and Conway by insinuating that citation by “transgender activists” somehow reduces its validity – while failing to cite it themselves.

Finally, the Task Force fails to mention recent scientific studies that report far higher-levels of GID prevalence than does their Report.

The point Lynn makes is that the Task Force has apparently deliberately misrepresented GID prevalence by equating “the prevalence of ’sex reassignment’ as being ‘the prevalence of transsexualism’”.

The shift in meaning in [Bakker93 - PDF here] led to confusion for many decades. After all, most people want an answer to the question “How likely is it that someone might experience gender dysphoria?” The far smaller counts of “sex reassignments” answer a different question.

Key members of the APA Task Force were well aware of the true meaning of the [Bakker93] results, because Olyslager and Conway had exposed it in a presentation at the WPATH 2007 Symposium [Olyslager&Conway07 - PDF here]. In particular, members Zucker and Lawrence (WPATH’s experts in GID prevalence and responsible for revising that section in the 7th Ed. of the SOC) were quite familiar with [Bakker93] and with its deconstruction by [Olyslager&Conway07].

It thus appears that the Task Force knowingly misrepresented the results of [Bakker93] by referring to “sex reassignment” numbers as numbers for “gender identity disorder” – thereby making intense gender dysphoria appear to be far less prevalent than it actually is.

It really is quite disturbing that an organisation with such power would misrepresent the facts around such a debilitating condition, with all the consequences that such a course of action had, and has, on the lives of so many people. And why? For what purpose? I just don’t understand.

ETA: The whys and wherefores of this bugged me enough to email Lynn directly. She sent an interesting reply, which included the comment, “Hope this information is helpful to you. Please do pass it on to your friends and contacts too” – so here’s Lynn’s take on it:

Who might be responsible for this falsification?

It appears that the APA Task Force relied on Ken Zucker and Anne Lawrence for the section on prevalence. Zucker and Lawrence are considered WPATH’s ‘experts’ on prevalence, having been assigned responsibility for the revision of that section in the 7th Edition of the SOC. Furthermore, Zucker presented the exact same numbers for GID prevalence at the WPATH 2007 Symposium as presented in the APA report.

Why do the prevalence numbers matter?

Factors of 20 are important. By maintaining the old misimpression that fewer than 1 in 10,000 people experience gender dysphoria, the APA creates an illusion that it is an extremely rare “disorder”. If people were aware that gender dysphoria is experienced by at least 1 in 500 people, transgenderism would increasingly be seen for what it is – a natural variation in gendering. Furthermore, by maintaining the illusion that gender dysphoria is incredibly rare, gender-repartists such as Zucker can assure parents that it’s extremely unlikely their gender-variant child will become “transsexual” and suggest that all the child needs is some minor gender-repairs.

I think you can see why and how this happened. It all points to Zucker and Lawrence, who are principal figures in the “old-guard” psych community that has long demonized transwomen. Zucker in particular runs a gender-reparatist clinic in Canada, and is well-known for forcing young GID children to accept their birth gender.

For more on Zucker and Lawrence, see the following pages:
http://www.tsroadmap.com/info/kenneth-zucker.html
http://ai.eecs.umich.edu/people/conway/TS/News/Drop%20the%20Barbie.htm
http://www.tsroadmap.com/info/anne-lawrence.html

———-

Previous, related posts on this blog (most recent first):

Trans task force report for American Psychological Association is out

August 18, 2008

Posted by Andrea James at TS Roadmap:

Before Kenneth Zucker (the reparative therapist of trans children at Toronto’s notorious CAMH Clarke Institute) was appointed to chair the committee revising the DSM for the American Psychiatric Association, the American Psychological Association had appointed Zucker to a task force preparing a report on trans people.

I had suggested dozens of revisions to the draft after one trans member of the Task Force resigned in protest. My involvement was unofficial and last-minute, though, and only some of my suggestions were incorporated in the report which is now out.

Task force members: 
Chair: Margaret Schneider, PhD, University of Toronto, Canada 
Walter O. Bockting, PhD, University of Minnesota Medical School 
Randall D. Ehrbar, PsyD; New Leaf Services Our Community, San Francisco 
Anne A. Lawrence, MD, PhD, Seattle 
Katherine Rachlin, PhD, New York 
Kenneth J. Zucker, PhD, Centre for Addiction and Mental Health, Toronto, Canada

Please note this is separate from the DSM-V issue, though it does discuss the DSM. One refreshing bit of news from the press release:

The task force recommended that APA take no position with respect to the diagnosis of gender identity disorder, which is sometimes required for transgender clients to obtain needed care. “Psychologists who work with clients with gender identity issues are not of one mind on this issue,” task force members wrote. They noted that the psychiatric profession publishes the Diagnostic and Statistical Manual, which contains GID, “and thus revision is their responsibility.”

This means they are putting the onus on the American Psychiatric Association in terms of perpetuating the mental illness diagnosis of “gender identity disorder” in the DSM. This DSM-V revision is the issue that all politically-minded trans people need to make their top priority, as it will affect all trans people for many years after its publication.

DSM-I published in 1952 
DSM-II published in 1968 
DSM-III published in 1980 
DSM-III-R published in 1987 
DSM-IV published in 1994 
DSM-IV-TR published in 2000 
DSM-V to be published in 2012

In other words, a mental illness listing of trans people will probably remain on the books until at least 2020, with a projected DSM-VI probably not until at least 2030. We will be faced with one to two decades of mental illness diagnoses before the issue will be reconsidered, unless we take a stand now.

More on this soon. In the meantime, I urge everyone to review this American Psychological Association task force report and start thinking about how to deal with the upcoming separate but related American Psychiatric Association DSM revision.

APA press release 
http://www.eurekalert.org/pub_releases/2008-08/apa-art080808.php

APA brochure 
http://www.apa.org/topics/transgender.html

Full text of the task force report (PDF) 
http://www.apa.org/pi/lgbc/transgender/2008TaskForceReport.pdf

APA resolution 
http://www.apa.org/pi/lgbc/policy/transgender.pdf

See also: 
My cover letter of protest

My comments on the draft

Once I have had time to review the full document, I will publish my full commentary on the draft and note where changes were incorporated.

Zucker to Speak At Royal Society of Medicine Conference

August 15, 2008

In my earlier posts I think I’ve made my position quite clear that I have (understatement alert) certain reservations about the appointment of Kenneth J. Zucker to the panel responsible for overseeing revisions to the GID diagnosis in the proposed DSM-V.

Now I learn from Lisa at Questioning Transphobia, that this man has been invited to address attendees at a conference to be held next month on gender-variant youth in the UK. I’m just going to blockquote Lisa’s post and then go add my name to the linked petition.


PLEASE POST WIDELY.

Protest Zucker’s Invite to Speak at Royal Society of Medicine Conference

Please sign the petition below to protest the horrific decision to invite trans-reparatist quack Kenneth Zucker to address attendees at a conference on gender-variant youth in the UK. First he was invited to sit on the committee to oversee revisions to the GID diagnosis in the DSM, now this? When will this universally reviled doctor in the trans community stop being rewarded by the mainstream for his dangerous and egregious actions? Enough is enough!

Here is the text of the petition and a link to it:

We the undersigned wish to protest in the strongest possible terms against the inclusion of Dr Kenneth Zucker in the Royal Society of Medicine’s conference on “Gender Identity Disorder in Adolescents”. We believe that his methods are harmful to young people and that his theories on transgenderism are both outdated and rejected by most of the psychological community as they are based on personal bias and flawed methodology.

We respectfully ask that you replace him with a contributor to the conference who does not give such offence to the transgendered community.

http://www.ipetitions.com/petition/zucker/index.html

And there’s an article in The Guardian of 14 August which is pertinent to the issue of gender-variant youth: ‘My body is wrong’.

———-

Here are the links to my previous posts (newest first) on the subject of DSM-V/Zucker/Blanchard:

Follow

Get every new post delivered to your Inbox.

Join 57 other followers