Transgender Disorder Stigma No More

In May, 2013, the paradigm for the way the medical profession view transgender people changes -- soon we will no longer be classified as having a "mental disorder." The American Psychiatric Association's (APA) diagnostic manual is being updated and the "disorder" stigma soon to be removed.

Some call this update a historic moment, I don't agree. There's nothing historical about trans people still being labeled with a "mental disorder" this far into the 21st century.

This is the most important thing you need to know -- if you are receiving any form of medical assistance or treatment for transgender or gender nonconforming issues, ensure that your provider is aware of the upcoming gender identity update to the APA's Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-5. It is scheduled to be published in May.

Gender Dysphoria, the new name, will have it's own chapter -- a clear, black and white separation from psychiatric disorder ties. The APA also released a position statement and health guidelines on transgender care, hoping for a higher respect for trans patients from medical professionals. Although there are some aspects to the updated APA's diagnostic manual that some transgender advocates find as still harmful, but overall, a considerable improvement. Groups like the International Foundation for Gender Education will be working on our behalf to rid the DSM-5 of the dubious and potentially harmful treatments still remaining in the manual.

A concern by some in the mental health field, which might have contributed to the delay to an earlier update to the DSM, is the possibility that by removing "disorder" from the classification it could open the door for some insurance companies to deny coverage of sex reassignment surgery and perhaps other services. As a precaution, this is something you may wish to discuss with your medical provider.

As for the timing of this revision, I should note that several generations have gone by since the APA removed the mental disorder label for LGB people from DSM manual back in 1973. As a consequence, trans people today lag a decade or so behind LGB people in both the area of civil rights and general well being. By being excluded, we've still being exploited in the media and in the entertainment industry. From the motion picture Silence of the Lambs to Saturday Night Live on television, trans people are either portrayed in a severely negative light or are objects of ridicule, sometimes both, for the purpose of generating revenue for people who get to laugh at us twice -- once for the ridicule, and a second time when the check comes in.

Conservatives and so-called "family values" organizations have long used the "disorder" stigma to deny us civil rights resulting in the loss of jobs, homes, families and even our children. Cases of trans people being unfit parents still occur today. A review of the data at showed that not only are trans people sometimes denied custody, they're sometimes denied contact and in some cases when visitations is permitted, the trans person's "dress presentation" is monitored. While things have improved from perhaps a decade ago, we've a ways to go.

Finally, trans people aren't always included when gay advocates work for rights and equality. Time and time again, we'll read about gay rights or equality gains, only to find that it doesn't quite include trans people. From the Stonewall Riots to more recent congressional actions by then-Rep. Barney Frank, we've been marginalized by our own supposed brothers and sisters. (My apologies to those who DO include us, and there are a lot of you. We wouldn't be where we're at today without our allies.)

While I am always willing to work with the larger LGBT community, I feel a bit fortunate that the trans community today is not only stronger and far better organized than where we were at merely a decade ago, we're mostly no longer dependent on other entities in our fight for civil rights, equality and our overall well-being. Come May though, we will also join the 21st century with the rest of you.