Being Transgender No Longer a Medical Disorder, DSM Revised

On December 1, the American Psychiatric Association's board of trustees approved the latest revisions to the Diagnostic and Statistical Manual of Mental Disorders, aka the DSM-V. In the revisions to the DSM, people who are transgender and gender non-conforming are no longer classified as having a mental disorder. As you might recall, gay people were also thought of as crazy until 1973, when the DSM-IV declassified homosexuality as an illness.

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The new DSM will diagnose trans people as having "Gender Dysphoria" (from the Greek word meaning "distress"), defined by "a marked incongruence between one's experienced/expressed gender and assigned gender." Previously, trans people were diagnosed under the term "Gender Identity Disorder," which pathologzied gender non-normative people, and was considered by some to be a barrier to social and legal progress. Unsurprisingly, being classified with a mental "disorder" is a term many in the trans community found limiting and harmful, and the stigma of "mental illness" has been used to discriminate against trans people in the arenas of parenting and employment, among other things.

But the new DSM language is not without its concerns as well.

As GLAAD noted on its website yesterday, some trans advocates worry about how the new DSM will affect insurance coverage for those who seek to medically transition. Under the current rubric, insurance companies can justify gender reassignment surgery and hormones on the basis that a "disorder" requires medical treatment. The new language might be another barrier that makes medically transitioning financially difficult.

While some might say that dysphoria vs. disorder is largely a semantics debate, it's clear that the APA is making considerable strides in regard to the health and rights of trans people. Over the summer, the APA Task Force on Treatment of GID released a report that called for better trans health guidelines, as well as position statements that support the "rights of persons of any age who are gender variant, transgender, or transsexual."

It remains to be seen whether the new language will have broader cultural and legal ramifications, but, as we can attest from the declassification of homosexuality as an illness, removing the "pathology" factor from non-conforming gender identities and expressions seems like a step in the right direction.