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:


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


8 Responses to “APA Task Force Report underreports the prevalence of gender identity disorder”

  1. queenemily Says:


    As if you just *naturally* move from dysphoria to expensive surgery. As if the ability to have surgery isn’t related to economic privilege, class, race etc.

    They *could* have measured by hormone treatments, plus a little (a lot?) more to account for people who get hormones themselves, but no. Wankers.

  2. Helen G Says:

    I’m just reading the last of the three links that Lynn sent, the profile of Anne Lawrence on the TS Roadmap site – I’m just completely gobsmacked!

    And she has influence on the APA’s Task Force how, exactly?

    *shakes head in utter disbelief*

  3. drakyn Says:

    Uggg. I hate Zucker/Lawrence (and Blanchard and Bailey too). And I totally don’t trust the APA so long as they use those quacks’ research and/or give them official recognition.
    Do you think emails to the APA would help? Or would it be wasted like the emails against Zucker and Blanchard on the DSM-V were.

  4. LawSchoolAlumnus Says:

    The thing that struck me about the APA press release entitled “APA Resolves To Play Leading Role In Improving Treatment For Gender-Variant People” was the part ” … The task force recommended that APA take no position with respect to the diagnosis of gender identity disorder …”.

    So just how exactly does one “play a leading role” by taking no position on the far and away most important part?

  5. Lisa Harney Says:

    Anne Lawrence is so extremely unprofessional, from sexually assaulting a woman under general anaesthesia to generalizing her own motives for transitioning into a wide area diagnosis for trans women everywhere that I’m amazed she’s allowed near medical textbooks, let alone allowed a say in how to define treatment for anyone.

    Also her diagnosis of all trans women who disagree with autogynephilia as experiencing “narcissistic rage.” Anne’s spent years trying to bully the trans community into accepting that autogynephilia has a thing to do with being transsexual.

    Zucker’s a monster. He’s destroying childhoods.

    It’s reprehensible that they’re using those numbers to assert prevalence.

  6. […] APA Task Force Report underreports the prevalence of gender identity disorder BirdofParadox has all the details. […]

  7. justme Says:

    I’d feel sad for Anne Lawrence, having convinced herself that she transitioned because she’s a pervert (I suspect her genital modification fetish might instead be a result of decades of repression of feelings she couldn’t make fit into her inflexible worldview, or even just a pure and simple post-rationalization), if she weren’t trying to convince the world we’re all perverts just so she wouldn’t have to feel like such a weirdo about it.

    I have no such shred of sympathy for Zucker. His every action, and this Task Force Report is no exception, demonstrates unambiguously what he’s all about–having power over others. The failure of the report to cite Olyslager and Conway’s deconstruction of his bogus prevalence numbers, even while mentioning it in a footnote, is a case in point; mentioning it without citing it can only be seen as a calculated move to dismiss the findings of the report to those familiar with it, without lending it the credibility of an actual citation. It’s academic political maneuvering at its most naked and ugly, on a moral and ethical par with hurtful high school rumormongering. His “I’m so misunderstood” protestations about his methods are either a cynical and calculated smokescreen, or an indication of self-delusion on a clinically significant scale, but either way, he’s the moral equivalent of Nurse Ratched. Why there’s not a personality disorder in the DSM to cover people like him, I can only speculate.

  8. […] of Michigan recently released a report that strongly criticizes the APA task force report (Via Paradox) (Via Queers United.) You can find Conway’s study here. Summary and […]

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