Transgender Diagnosis

[Anonymous]

It is an unfortunate fact that if you want to be safely treated and supported with the endeavors to change the birth sex you are , you will have to go to the medical fraternity for help. It maybe a natural but to attain a personal psychological settlement it often requires medical intervention with chemicals if not surgery so a diagnosis is a tool for the application of appropriate care. It is not a lable , it becomes a lable where society uses the diagnosis to describe the person. People who are responsible for doing so are usually challenged by the diversity of others , to suggest that a diagnosis is other than a scientific tool is to degrade the medical community I fear.

No one should be afraid to have a problem diagnosed for it is a tool that may allow you to seek a solution to what ails or concerns you. I have a diagnosis and it confirmed that which I had already believed to be the case. It has allowed me to legally and with support access hormone treatment I feel I require . It allows me the confidence that I am transgender and I feel as I do because I am . The interview showed to me how times have changed. I am sure that the lack of support was due to the lack of understanding in the eighties as apposed to now. With Drs the understanding comes with the details of the diagnosis of course I would not say not all Drs will support treatment as some have spiritual objections. But there is no way that we can object to the diagnosis if we require medical or psychological help!

[Adrian]

Quote:

Cate’s “transgender diagnosis” reinforces the misperception that being transgender is a medical/psychological problem

The diagnosis of “being transgender” and its associated passport to “transition“ are increasingly looking like relicts from the last century, relics with a rapidly approaching use-by date. They reflect a time when the preferred way of helping those who exhibited discomfort with the sex society had assigned them was to assist them “to the other side”.

The way it has too often been presented, the “diagnosis” and the “cure” are binary – you are or you are not. Small wonder that those who seek medical or surgical intervention treasure a “positive result” in the same way one would passing a professional qualification. The treasure is so compelling that many will privately admit to “guillding the lilly” when it comes to convincing a doctor to give them access to the treatments they want. There is plenty of advice available on the things you need to say to get past the DCM hurdle. This isn’t something new. As far back as 1987 Sandy Stone wrote referring to the then only textbook on transexualism by Harry Benjamin:

Quote:

It took a surprisingly long time–several years–for the researchers to realize that the reason the candidates’ behavioral profiles matched Benjamin’s so well was that the candidates, too, had read Benjamin’s book, which was passed from hand to hand within the transsexual community, and they were only too happy to provide the behavior that led to acceptance for surgery.

I think we can say the same thing now about the current diagnosis guidelines – I can’t think of any other instance where people knowingly lie to medical professionals to engineer a desired outcome. No wonder Lisa (who is superbly qualified to comment in this area) wrote recently in these forums:

Quote:

Remember that GID is not an easy diagnosis to make. There is no simple blood test to give the correct answer.

Now, to avoid being misconstrued, I am not claiming that all the participants in this treatment pathway are dishonest, nor would I suggest that the narrow treatment endpoints are inappropriate for everyone. But I do think that the number of people who genuinely 100% fit the diagnosis and will derive maximum benefit from the treatment offered is statistically low.

The rich diversity of gender identities reported in the 2011 TgR Survey makes it unlikely that a “Transgender Diagnosis” is an appropriate qualification for the majority.
So when someone repeatedly asserts that their “diagnosis” created the imperative for selecting the most extreme form of transitioning “The lady doth protest too much, methinks”. We are becoming increasingly aware of the wide range of “ transitions” we can embrace to celebrate the “normality” of our inner gender. So falling back on a poorly defined diagnosis as indicating or justifying one particular journey makes little sense – it seems to be driven by the need for self-justification of our choices.
The more I think about the straight-jacket imposed by pathologising our natural condition the more I take the opposite view from Kristyana when she wrote

Quote:

diagnosis is a tool for the application of appropriate care

I suggest that in fact the diagnosis in so many cases leads to inappropriate, or at the very least, suboptimal care.
I agree that “No one should be afraid to have a problem diagnosed” – but gender diversity isn’t a problem – it is a life enriching experience based on normal natural variation.

We should all reject diagnosis as an essential first step towards normalisation and acceptance in society. And in this context I agree that Cate McGregor’s interview may have sent some dated messages to the general public.

But all publicity is good! And on balance I think we can live with some mixed messages going out.

[Anonymous]

The introduction to DSM V, which was released in May this year, states that “It is important to note that gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition.” In DSM IV, a desire to transition was a disorder, i.e. Gender Identity Disorder. Those who “cross-dressed”, to whatever degree, were likely to be diagnosed as either 302.81 Fetishism or 302.83 Transvestic Fetishism. There has never been a “Transgender Diagnosis” as such in DSM. DSM V still leaves cross-dressers in a fetishist limbo land.

The introduction to DSM V also states “To get insurance coverage for the medical treatments, individuals need a diagnosis. The Sexual and Gender Identity Disorders Work Group was concerned that removing the condition as a psychiatric diagnosis—as some had suggested—would jeopardize access to care.” Clearly, the medical fraternity is moving in the direction of normalising transgender, albeit that the “system” requires a diagnosis in order that the transitioning person can have access to care. However, most of the distress that we experience as gender variants is to do with non-acceptance. Perhaps it’s those people in society who can’t accept diversity who have the problem and need treatment.

I would like to get to a stage where we can, if we wish, make a decision to transition via SRS and/or HRT and have that decision supported by appropriate provision of resources without having someone else tell us that we are, or not, eligible.

Still, the situation is improving. Earlier today I was looking through my old Abnormal Psychology textbook from the 60s and any form of gender diversity was regarded as a serious mental illness – as was homosexuality.

[Anonymous]

I really think the greatest component of GID is sociiety’s reaction to it So many intersex girls wind up under ‘ treatment ‘ by shrinks and on medication because of their non acceptance by those around them .Thats why (in the past i HOPE ) there was so much emphasis placed on being passable and living as a woman for 1 or 2 yrs by the medical crowd .Hopefully that will all change
I live in hope
Suzz

[Anonymous]

The poor use of a diagnosis is not a reflection on the scientific method and the poor application of the diagnosis for treatment reflects not on the diagnosis but one the quality of the practitioners involved. The failure of the medical fraternity to educate its members on the needs of the gender diverse community is something that is to be addressed.

I would suggest that personal opinion on the matter at hand such that we exclusively believe that we and only we have the answers is detrimental to the long term goal of education. Our diversity of gender is only reflects the continuum of diversity in humanity as a whole.

We must be mindful that this truth about ourselves that we may know is not to be taken lightly. There is good reason for ensuring that people who are not of sound mind do not have easy access to treatment that could kill them . These treatments can cause DVT , liver damage, osteoporosis and accentuate depression. Suicide is an ever present danger with the high levels of depression among gender diverse people.

I believe that you will normalized transgender / gender diversity in the wider community with public contact through media and by not being ashamed of who you are . I remember a comment by a successful person who has cerebral palsy he said he had to own his diagnosis and not let the diagnosis own him. I am of a similar mind for if I am in possession of the facts I am able to ensure the best way forward for myself.

A diagnosis is like a hammer give it to the wrong person all it will do is damage but used properly it can build for the future. Now I believe that I have not inflected to much personal opinion into what I’ve written at least I hope it is not taken that way.

[Anonymous]

Australia is way behind other countries in it’s recognition that Transgender is nothing more than just a natural variance of the human species. Other leading countries medical societies have already changed their outlook on the way we are viewed and have changed the access of appropriate “life enhancing” tools/methods and ease of changing identities etc.

The UK no longer identifies Transgender as being a mental “disorder”, only a gender “dysphoria” and in doing so has changed their access to HRT by allowing Transgender people to acquire various medication through their GP without having first visiting a psych although to have GRS a Psych is still required. GP’s are being educated in Transgender “issues’ and although it will be a slow progress towards a better system it is a great leap forward.

From the US:
Transgender people no longer considered “mentally ill” to American Psychiatric Association

By Kelly Craig http://dot429.com/articles/1119

In my opinion Australian politicians tend to follow rather than lead by example, hopefully we are not too far away from younger and more accepting and understanding leaders to lead Australia into a more humane society.

Cheers…Karly

[JaneS]

I think it’s possible that sometimes we see problems where none exist. Perhaps it’s worth considering that “diagnosis” is merely the identification of the nature and cause of anything. It doesn’t need to be a negative thing. Whether the ’cause’ of transgenderism is genetic, psychological, environmental or any other factor then any effort to work out what that cause is becomes a diagnosis.

Cate McGregor is working within a system that provides medical care as part of its conditions of employment. For her to receive the medical assistance she requires (medication, surgery, whatever) like most other people she needs a professional to prescribe it for her. That professional must make a ‘diagnosis’ to be able to prescribe treatment/assistance.

There is certainly greater acceptance of ‘variation’ nowadays and a lot of that is due to better education. That isn’t a bad thing.

[Anonymous]

For me personally, a piece of paper stating that I was legally female was no substitute for the breasts, hips, and vagina that I have now.

Actually I think giving people the legal status of a female without an adequate hormonal transition is a good excuse for a Doctor to prescribe low doses of hormones or not at all, which could frustrate a person with a diagnosis of GID and cause a suicide.
The decision to take hormones and the rate of hormonal transition should lie with the client and the request for hormones and what their end goal is can be the key to the diagnosis.

[Anonymous]

This interesting discussion would appear to have two sides, both using the same set of facts but with a different spin depending on whether you’re a glass half full or half empty person. I don’t wish to appear glib in this opening paragraph but I agree with all the facts presented and this is my bottom line.

I sought professional advice to determine if I was truly transgendered. When those whose advice I sought could not diagnose anything was actually wrong with me we all agreed that I was transgendered.