Archive for the 'DSM-V' Category

DSM-V draft

February 10, 2010

Today, February 10, the American Psychiatric Association (APA) has published a draft of the fifth version of its Diagnostic and Statistical Manual of Mental Disorders (DSM-V). It must be stressed that this is only a draft, posted for review and comment – the full publication remains slated for May 2013. Needless to say, it still seems as problematic as expected, even (especially?) with the introduction of so-called dimensional ratings.

From The Economist:

The APA’s DSM-V task force, however, has suggested it would like to introduce a “new paradigm” into the manual. It wants to recognise that many conditions, such as anxiety and depression, tend to overlap, so that a diagnosis of only one or the other does not always make sense. The new version of the DSM is also expected to include a “dimensional” component, one that considers the severity as well as the nature of symptoms.

It’s going to take a while to read through the review documents – there are a lot of them – but it seems clear there will be much heated debate. How could there not be with proposals to add, for example, Hypersexual Disorder and Paraphilic Coercive Disorder to the DSM-V?

Autogynephilia, as expected, looks set to be given the fancy new title of Transvestic Fetishism – and if the Sexual and Gender Identity Disorders Work Group thought they could bury it in the depths of the Paraphilias section (along with such things as pedophilia) where nobody would notice, well, guess what Dr Zucker? We’ve got news for you…

The main index page for the Sexual and Gender Identity Disorders consultation documents is at http://www.dsm5.org/ProposedRevisions/Pages/SexualandGenderIdentityDisorders.aspx

Read it and weep.

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ETA: Digging a little deeper, I see that in section 302.3 Transvestic Fetishism, under the Rationale tab, a distinction is made between “paraphilias” – which don’t cause distress or impairment, and thus don’t require psychiatric intervention – and “paraphilic disorders” – which do cause distress or impairment, and thus do require psychiatric intervention.

The Paraphilias Subworkgroup states: “This approach leaves intact the distinction between normative and non-normative sexual behavior, which could be important to researchers, but without automatically labeling non-normative sexual behavior as psychopathological.”

Another change worth noting appears in the end notes under sections 302.6 Gender Identity Disorder in Children and 302.85 Gender Identity Disorder in Adolescents or Adults – “Gender Identity Disorder” will be renamed “Gender Incongruence”:

In a recent survey that we conducted among consumer organizations for transgendered people (Vance et al., in press), many very clearly indicated their rejection of the GID term because, in their view, it contributes to the stigmatization of their condition.

So what was previously described as “a strong and persistent cross-gender identification” is now referred to as “a marked incongruence between one’s experienced/expressed gender and assigned gender”.

Additionally:

The term “sex” has been replaced by assigned “gender” in order to make the criteria applicable to individuals with a DSD (Meyer-Bahlburg, 2009a, 2009b). During the course of physical sex differentiation, some aspects of biological sex (e.g., 46,XY genes) may be incongruent with other aspects (e.g., the external genitalia); thus, using the term “sex” would be confusing. The change also makes it possible for individuals who have successfully transitioned to “lose” the diagnosis after satisfactory treatment. This resolves the problem that, in the DSM-IV-TR, there was a lack of an “exit clause,” meaning that individuals once diagnosed with GID will always be considered to have the diagnosis, regardless of whether they have transitioned and are psychosocially adjusted in the identified gender role (Winters, 2008).

Which seems to suggest two things:

  • First, it enables the diagnosis of intersex people with GI. The use of the highly contentious acronym DSD – “disorders of sex development” – doesn’t go unnoticed. The Organisation Intersex International (OII) has been protesting the use of the term since it was first coined in 2008 – more details here.
  • Second, it will enable people who have transitioned to be free of the diagnosis. I’m unclear what effect this may have on people who have transitioned and who live in countries where there is state-funded prescription of, for example, hormones. Presumably if it’s decided that you no longer experience GI, then there will be no requirement for the state to contribute to the cost of your meds. I don’t know if that’s what will happen, but it certainly seems like it could be a possibility.

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ETA, February 12: The concept of “Assigned Gender” is a new introduction in the DSM 5 – but it doesn’t seem to be clearly defined anywhere in the documentation. It appears in sections 302.6 Gender Identity Disorder in Children and 302.85 Gender Identity Disorder in Adolescents or Adults, under the description of Gender Incongruence – “A marked incongruence between one’s experienced/expressed gender and assigned gender […]”.

“Experienced/expressed gender” seems fairly self-explanatory – but “assigned gender”? The cynic in me wonders if the omission of a definition might be deliberate, to give practitioners plenty of ‘wiggle room’ in their interpretations.

Does it mean “legally assigned gender” or “medically assigned gender”?

If “legally assigned gender” is intended then:

  1. In the end notes, where it says “[…] one’s assigned gender (usually at birth) […]”, does that mean “most people are not transsexual and for non-transsexual people the concept is simple” or does it mean “legally reassigned gender is usually to be ignored for diagnostic purposes”.
  2. Does it mean the legally assigned gender where the patient resides, or the legally assigned gender where the patient is being diagnosed, as these may be different if a transsexual person travels?
  3. Does it mean the legally assigned gender at birth, or at the time of diagnosis?
  4. For people who live in federated republics (such as the U.S.) does it mean legal gender in Federal law or legal gender in State law?
  5. What about places (for example, the state of Victoria, Australia) where babies may be assigned a gender of male, female or intersex?
  6. What about people who have multiple citizenships and passports (and other documents) in different sexes? (See my recent post about Jenny T. Ramsey for an example of the kinds of problems already existing)

But if the DSM 5 means “medically assigned gender” then:

  1. What about people who have multiple medical providers (and/or non-government insurers), some of whom treat the patient as being “medically male” and others regard the patient as “medically female”?
  2. Does it ignore, or not ignore, prior medical gender reassignment?
  3. What about the situation where a second medical opinion results in a different medical gender being assigned?
  4. Some countries (for example, Cuba) regard transsexualism as not being a mental disorder at all. Is the medically reassigned gender of people in those countries considered for mental health diagnostic purposes?

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Cross-posted at Questioning Transphobia

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Previous related posts:

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Psychiatry’s civil war

December 12, 2009

New Scientist magazine has published a lengthy article – Psychiatry’s civil war – about the proposed revision of the Diagnostic and Statistical Manual of Mental Disorders and the “open conflict [which] has broken out among the upper echelons of US psychiatry” regarding the attempt to “extend definitions of mental illnesses so broadly that tens of millions of people will be given unnecessary and risky drugs”.

(Note: Since the article was posted, the American Psychiatric Association has announced that the publication of DSM-V will be delayed until May 2013 to “allow more time for public review, field trials and revisions”.)

The whole article is worth reading, but in particular it has this to say about the redefinition of gender identity:

We are who we say we are

Is history repeating itself? That’s the question facing psychiatrists considering how gender identity should be defined in DSM-V. The APA has a legacy of uneasy relations with the lesbian, gay 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.

These activists are up in arms over the membership of DSM-V’s sexual and gender identity disorders work group, in particular the selection of Kenneth Zucker of the University of Toronto, Canada, as its chair. Zucker is reviled by some transgender activists for his work on therapy to reorient children who feel that they were born into the wrong sex. An online petition objecting to the work group’s composition has more than 9500 signatures.

The group is nevertheless likely to recommend changes that could actually ease tensions. One of these is a change in the name of a diagnosis that as currently phrased is inherently offensive to transgender people. “‘Gender identity disorder’ falsely implies that the gender identities of gender variant people are in themselves disordered,” says Kelley Winters, founder of GID Reform Advocates.

The work group has not yet revealed its proposed name, but “disorder” will be dropped. “We’re sensitive to issues of language,” says Zucker. One possibility is “gender dysphoria”, which focuses on the inherent distress of people living in a body that doesn’t match their identity.

That would not satisfy those transgender activists who want issues of gender identity removed from the DSM altogether. But others argue for the retention of a renamed condition to make it easier for those distressed by the mismatch between their identity and their bodies to seek assistance, and also to help those who need sex-change surgery to get it paid for. Even now, many transgender people face problems when insurers refuse to recognise the treatment as a legitimate medical expense.

My opinion on the binary options mentioned in the last paragraph is somewhere between the two viewpoints: I would be more than happy for any mention of gender identity to be dropped provided that trans people are not, as a consequence, denied access to timely, appropriate and free medical treatment. Transitioning needs to be refocused away from a gatekeeping approach to one of facilitation and support.

Additionally, New Scientist has also published an op-ed companion piece – Time’s up for psychiatry’s bible – which suggests that:

With the advent of the internet, there is no longer any compelling need to rewrite the diagnostic criteria for the whole of psychiatry in one go. Yes, diagnoses should be revised as new scientific findings come in. But for this, specialists can be assembled when necessary to address specific areas that have become outmoded. Their suggestions can be posted on the web for comment. More research can be commissioned, if necessary. And when consensus is reached, new diagnostic criteria can be posted online.

Similarly, standing panels could periodically review issues that cut across the whole of psychiatry – such as the inevitable shift away from checklists of symptoms towards a system based on measurements of the underlying biological and psychological determinants of mental health.

Apparently there is resistance to this move towards such a “living document” because such a transition (no pun intended):

[…] would have hurt the APA’s coffers, as a book that becomes a required reference is a big earner; DSM sales since 2000 exceed $40 million.

Which rather leaves me wondering exactly where the APA’s real priorities lie: in providing a framework that would actually help the people who need it, or generating arguably obscene profits at the expense of our health and wellbeing.

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(Curtsey to Martha T.G.O. on the TGEU listserv for the heads-up)

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Cross-posted at Questioning Transphobia

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Previous posts about the DSM on this blog:

GID Reform Now protest at annual APA meeting – speaker Madeline Deutch, MD

May 20, 2009

Here’s a video (edited by Mila Pavlin of Trans-Ponder) from the recent GID Reform Now protest at the American Psychiatric Association 2009 Annual Meeting. This is the approximately 7-minute speech of Madeline Deutch, MD, that she made to the 150 protesters. A transcription of a large portion of the speech begins below the video.

This video has been removed by the author

(Curtsey to Autumn Sandeen at Pam’s House Blend)

ETA, May 21: Sorry everybody; I have no idea why the link has been removed. I found an alternative link (click here) which seems to play just fine on You Tube – although it too comes up with a ‘video removed’ error when I embed it in this blog page.

ETA, May 23: There’s also a You Tube vid of Kelley Winters’ speech here

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Cross-posted at Questioning Transphobia

IFGE calls for action from APA

May 18, 2009

IFGE logoThe Board of Directors of the International Foundation for Gender Education (IFGE) has issued the following resolution:

Resolution

Whereas people are naturally endowed with a wide diversity of gender expression, identities, and sexual orientations;

Whereas, the distress felt by gender non-conforming people is fundamentally due to social prejudice and heterosexism, and is not a characteristic of their identities;

Whereas diagnosis of psychological disorders has been used as a form of social control;

Whereas, the inclusion of normal variations of behavior as diagnostic criteria has been widely used to justify discrimination against gender non-conforming people by individuals, governments, and corporations; and has resulted in material harm to people;

Whereas, the principle responsibility of medicine is to “Do No Harm;”

Therefore, be it resolved that we find the American Psychiatric Association to have a responsibility to ameliorate this harm, and hereby call for the following remedies:

(1) We hereby call on the Board of Trustees of the American Psychiatric Association to issue a declaration stating that: Gender variance, and gender non-conforming behavior do not constitute a psychological disorder;

(2) We hereby call on the American Psychiatric Association to remove the diagnosis of so- called “Transvestic Fetishism,” which explicitly pathologizes gender non-conforming behavior, from their Diagnostic and Statistical Manual;

(3) We hereby call for the reform of any diagnosis that can be made solely based on gender non-conforming behavior, specifically including “Gender Identity Disorder in Children.”

Resolved this day May 15, 2009 by the Board of Directors of
The International Foundation for Gender Education

(Via IFGE, link here)

Whether the APA listens and takes note of this resolution remains to be seen. Somehow, I have my doubts.

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Previous posts about the DSM on this blog:

Transsexuality will no longer be classified in France as a mental illness

May 17, 2009

Flag of FranceVia Le Provence, mangled into English by Google Translate:

Transsexuality will no longer be classified in France as a mental illness, a government decision Saturday qualified as “historic” by the associations, on the eve of World Day against homophobia and transphobia.

Health Minister, Roselyne Bachelot, has taken these days “High health authority for a decree transsexuality leaving the category of psychiatric disorders”, said a spokesperson of the ministry.

So far, transsexuals enjoyed an exemption from user fees for medical care under a long-term ALD23 classified for “persistent or recurrent disorders”.

For the Department of Health, it is a “strong signal to the whole community”, transsexuals feeling “this admission ALD23 as stigmatizing”.

This classification, derived from that of the World Health Organization (WHO), was also linked to the fact that transsexuality was on the list of diseases identified in the medical manual DSM (Diagnostic and Statistical Manual of Mental Disorders) which refers the medical profession, just as homosexuality was there a few years.

In an article published in Le Monde dated Monday-Sunday, many people [including] first secretary of the Socialist [party] Martine Aubry, the Communist Marie-George Buffet, Green Daniel Cohn-Bendit and the Nobel Prize [winners] Françoise Barré-Sinoussi (medicine) and Elfriede Jelinek (literature), have requested WHO “to no longer consider transsexuals as mentally disordered.”

This is because the WHO had decided on 17 May 1990 [to remove] homosexuality from its list of mental illnesses, that date was chosen for the World Day against homophobia celebrated from Saturday and Sunday in many places .

It is symbolic that France chose that moment to be “the first country in the world” to “delete [transsexuality from] the list of mental illnesses,” commented the IDAHO Committee (International Day Against Homophobia and transphobia).

This “historic decision” is also “an explosion of hope for all trans people in the world,” said Joel Bedos, Secretary General of the IDAHO Committee.

The association Homosexualités et Socialisme (HES) has “welcomed” the announcement that also answers “to a claim of long-range” of the lesbian, gay, bi and trans de France (LGBT). For UAS, it is time now to move from symbol to action, fighting against violence and discrimination […].

image from Le Provence

(The full text of the announcement in French can be found in this PDF of a Microsoft Word document originally posted on the IDAHO website)

I absolutely agree that classifying transsexuality as a ‘psychiatric disorder’, a ‘mental illness’, a ‘disease’, is wrong – it stigmatises us in ways that only compound the negative, discriminatory and profoundly damaging views of trans people that mainstream cis society already holds.

What does concern me is if, in the forthcoming DSM-V revision, the condition is either completely decategorised (I believe that would allow healthcare authorities such as Britain’s National Health Service (NHS) and specialist healthcare insurers worldwide to stop offering support and essential services to us) or recategorised into such an extreme paraphilia that we are even more stigmatised by its pathologisation.

Worryingly, this second proposal has already been outlined by Ray Blanchard (chair of the Paraphilias Subcommittee and inventor of the mental illness he terms autogynephilia) in a paper presented at the Annual Meeting of the Society for Sex Therapy and Research (SSTAR) in April 2009 (link here; see also Julia Serano’s piece for Feministing, “Why feminists should be concerned with the impending revision of the DSM”, link here).

My fear is that this unilateral move by France, although initially seeming to be a positive thing, may actually provide ammunition for the members of the APA Task Force and Sexual and Gender Identity Disorders Workgroup in their quests to medically mandate us out of existence. Janice Raymond must be proud of them.

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Previous posts about the DSM on this blog:

APA protest – San Francisco, May 18

May 16, 2009

Via Reform GID Now:

Protesters call for Reform of Gender Disorders at American Psychiatric Association Convention

What: San Francisco, California. A coalition of transgender community advocates and mental health providers will gather in San Francisco May 18 to protest how the American Psychiatric Association (APA) is handling revisions to “gender identity disorder” and related diagnoses in their fifth edition of the ‘Diagnostic and Statistical Manual of Mental Disorders’ (DSM-V).

Where: At the corner of 4th Street and Howard Street –Outside the Moscone Center

When: Protest starts at 6:00pm, Monday May 18th

Who: Community leaders scheduled to speak include Julia Serano, PhD; Madeline Deutsch, MD; Masen Davis, MSW; Kelley Winters, PhD; Danielle Askini, MSW; Mara Keisling; Andrea James, MA; Lore Dickey, PhD; Michele Angello, PhD; and Rebecca Allison, MD.

gidreformnow_poster1

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Cross-posted at Questioning Transphobia

Looking back, pushing forward

April 30, 2009

In The Life screengrabVia In The Life comes this useful overview of “the controversy raging over the inclusion of Gender Identity Disorder in the American Psychiatric Associations Diagnostic and Statistical Manual“, examining whether GID should be removed from the forthcoming DSM-V, or reclassified.

At the risk of oversimplifying and making sweeping generalisations, TS/TG adults are as reliant on a diagnosis of GID as we are pathologised by it, because healthcare systems around the world require the diagnosis before we can access hormones, surgery, etc. The challenge seems to be how to balance those needs with the destigmatisation of TS/TG people by both the medical profession and mainstream cis society.

That same pathologisation results in gender variant children being subjected to so-called reparative therapies by parents and mental health professionals that regard adult transsexuality or homosexuality as a “bad outcome”.

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(Cross-posted at Questioning Transphobia)

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Previous related posts on this blog:

APA Task Force reviews possible Gender Identity Disorder treatment guidelines

April 29, 2009

DSM-IV TRA possibly interesting development (or is it a stitch-up?) with regard to the DSM revision process seems to be suggested by this press release from the APA yesterday (link here to PDF):

ARLINGTON, Va. (April 28, 2009) – The American Psychiatric Association (APA) Board of Trustees has established a task force on the treatment of Gender Identity Disorders (GID) to address concerns about the relative lack of evidence-based treatment guidelines and to determine if guidelines should be developed. The task force was created on a recommendation by the APA Committee on Gay, Lesbian, and Bisexual Issues.

The board asked the task force to review the literature on the treatment of Gender Identity Disorder at different ages and to report back with “an opinion as to whether or not there is sufficient credible literature to take the next step and develop treatment recommendations.”

The board asked the task force to communicate with the Diagnostic and Statistical Manual of Mental Disorders (DSM) work group on Gender Identity Disorder, which can serve as a resource on diagnostic issues during the term of the task force.

After the May 2008 announcement of DSM-V work group membership, the APA received many inquiries regarding the Gender Identity Disorders work group on treatment. These inquiries most often dealt with treatment controversies for GID in children, rather than issues related specifically to the DSM text and diagnostic criteria. While the diagnosis and treatment of mental disorders are inextricably linked, separation of the diagnostic mission of the DSM work groups from the evaluation of treatment issues is especially important.

At first reading it suggests that the APA is actually taking seriously the criticism received regarding (a) “the relative lack of evidence-based treatment guidelines” and (b) “treatment controversies for GID in children“.

Both these points seem to refer to reparative treatments for the condition – treatments which don’t appear to have had any meaningful success and indeed may have caused more harm than good.

But, of course, when the Task Force has been asked “to communicate with the Diagnostic and Statistical Manual of Mental Disorders (DSM) work group on Gender Identity Disorder” – chaired by Ken Zucker – whose reparative techniques are under criticism here – and with Ray Blanchard (chair of the Paraphilias Subcommittee and inventor of the mental illness he terms autogynephilia) – well, it doesn’t really inspire confidence that this will be an unbiased, objective and independent review.

Plus ça change, plus c’est la même chose…

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(Cross-posted at Questioning Transphobia)

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Previous related posts on this blog:

Close the CAMH Gender Identity Clinic – Facebook group

April 28, 2009

Close the CAMH Gender Identity ClinicThere’s a new Facebook group (link here) aimed at highlighting the controversial policies and practises which are carried out at the Centre for Addiction and Mental Health (CAMH) in Toronto.

Lynn Conway has also posted a wealth of information on the TSRoadmap site (link here) about CAMH and its staff, including Ken Zucker and Ray Blanchard. In addition to their favoured ‘reparative therapy’ approach at CAMH, they have also been the subjects of some controversy following their appointments to the American Psychiatric Association’s Sexual & Gender Identity Disorders Work Group, which is charged with reviewing the Diagnostic and Statistical Manual of Mental Disorders (DSM) – a hugely influential document which includes five different diagnoses for ‘Gender Identity Disorder’ (GID).

The Clarke Institute is a Toronto mental institution charged with serving gender-variant clients in the area. Under the direction of Ray Blanchard, it has become widely known as one of the most notorious facilities in the world in terms of controlling access to medical services.

According to their website they offer services, including for “those who wish to manage their cross-gender feelings and the expression of those feelings while remaining in their original gender role.” This is another way to describe reparative therapy similar to groups who claim to “cure” gays and lesbians.

Much of the anti-trans thinking in the world today emanates from The Clarke, long nicknamed “Jurassic Clarke” in the trans community for its regressive policies.

(Via TSRoadmap)

However, even a recent internal report has voiced concerns about “dismissive, condescending and authoritarian attitudes” at CAMH and cites the following key concerns:

1. Homophobia has been cited as one of 3 major internal issues
2. LGBTTTQQI issues are not part of the cultural competency of all staff
3. Although there are Queer & Trans-specific services in the Addictions program, these are not offered in Mental Health
4. The Gender Identity Clinic (GIC) and the Gender Identity Disorder Service (GIDS) have not been well regarded by some members of LGBTTTQQI communities due to negative experiences, underlying operational theories, approach, and treatment philosophy.

(Direct link here to PDF of the full report – and – direct link here to PDF of the executive summary)

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(Cross-posted at Questioning Transphobia)

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Here are the links to previous posts on this blog on DSM related topics (as mentioned above, Ken Zucker and Ray Blanchard of CAMH have also been appointed to the APA’s Sexual & Gender Identity Disorders Work Group, which is charged with reviewing the DSM):

OII receives a letter from Dr Zucker’s legal representatives

March 21, 2009

OII logoLooks like it’s not only Lynn Conway who’s out of favour with Kenneth Zucker. Less than a month since Lynn talked about being sued for libel for speaking out against Dr Zucker’s appointment to the APA Task Force, the OII’s Curtis Hinkle, over at Intersex News, says he’s received a request from Dr Zucker’s representatives to remove information about certain allegations against Zucker from the OII website.

It’s curious that Dr Zucker would make such a request when, according to Curtis, “OII never published any false statements or misleading information on the page in question”. That page, apparently, published information about serious allegations made against Dr Zucker by one of his former clients. Curtis felt that the details should be reported to WPATH and other authorities. (Dr Zucker is a professional member of WPATH)

Additionally:

Curtis Hinkle, the founder of OII, has lodged complaints against Ken Zucker concerning many different ethical issues with the APA and pending the ongoing Federal and professional investigations

(Via Intersex News)

It’s difficult to avoid the conclusion that Dr Zucker is seeking to silence any commentary that might show him in a bad light, although his legal representatives are keen to point out that:

Our clients are not trying to intimidate you or your organization and strongly deny any allegation that they are trying to stifle free speech.

(Via copy of the letter to Curtis Hinkle, direct link to PDF here)

But:

The OII Open Letter to WPATH has been online since the early summer of 2008. Zucker and his WPATH colleagues knew about it all that time, but Zucker has not complained to OII about it until now. So why now? Recently, in what appears to have been an attempt to suppress Lynn Conway’s website, Zucker and Petersen falsely accused Dr. Lynn Conway of “libel” for simply linking to the OII Open Letter to WPATH from her Trans News Updates. The OII Open Letter to WPATH was clearly “news” in the Transgender community, and it was common for readers to link to it from their blogs and web pages. Thus it quickly became clear that Zucker had falsely accused Dr. Conway of libel for simply linking to that page – especially since Zucker had never complained to OII about the page in the first place. It appears that Zucker’s and Petersen’s recent letter to OII is an effort in damage control, i.e., an attempt to retroactively cover up the fact that they had not complained about it before.

(Via Intersex News)

I find it disturbing that Dr Zucker apparently has such a zeal for litigation against the more high profile members of the trans and intersex communities. In his professional life he already wields considerable power, and his position as Chair of the Sexual and Gender Identity Disorders Work Group for DSM Revision confers still more. I wonder who will be next to receive a letter from his legal representatives.

And, like Curtis, I also wonder at the timing of these threats. The APA’s website sets out the schedule of an imminent round of presentations by members of the DSM Work Group at various professional meetings:

  • Society for Sex Therapy and Research (April, 2009)
  • American Psychiatric Association Annual Meeting (May, 2009)
  • World Professional Association for Transgendered Health (June, 2009)
  • International Academy of Sex Research (August, 2009)

(Via Report of the DSM-V Sexual and Gender Identity Disorders Work Group, November 2008)

A more cynical person than I might be tempted to conclude that – despite the protestations of his legal representatives – Dr Zucker is attempting to ensure that there will be no potentially disparaging remarks made by any of the more influential members of the TS and IS communities to coincide with any of these presentations. Also, according to Wikipedia, an early draft of the DSM-V will be released for comment in 2009.

On the other hand, it may simply be a rather heavy-handed attempt to extend the apparent tendency towards secrecy around the development of the DSM-V, as suggested by Robert Spitzer in his editorial of October last year, called Issues for DSM-V: Developing DSM-V in Secret (direct link to MS Word document).

Perhaps we shall never know the true story.

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