Gender Identity Disorder and the DSM
Respectfully, the National Association of Social Workers (NASW) National Committee on Lesbian, Gay, Bisexual, and Transgender Issues (NCLGBTI) holds a position that Gender Identity Disorder, Gender Incongruence, Gender Dysphoria, Transvestic Fetishism and, Transvestic Disorder should not be considered as mental health diagnosis and therefore should be eliminated from the Diagnostic Statistical Manual (DSM).
The NASW-NCLGBTI holds the position that the Gender Identity Disorder, Gender Incongruence and, Gender Dysphoria should be viewed and approached from the perspective of a medical model rather than that of a mental health model. Many anatomical inconsistencies now can be corrected surgically or chemically to align with the experienced true self. A medical diagnosis for transgender individuals, whose self-experienced gender does not match the sex assigned at birth and who require medical services to align the body with the experienced self, is more appropriate and consistent with research and best practices than a mental health diagnosis.1
Further, it is the position of NCLGBTI that this population already is stigmatized by society due to myths and misunderstandings, and victimized by intolerance and prejudice. The effects of this stigma are profound and longstanding, resulting in increased risks for a host of negative, health, mental health, educational, professional, and social outcomes2. Continuing to include the diagnoses in the DSM contributes to the sustained oppression of a marginalized group. In fact, doing so has a particularly potent and pernicious effect given the esteemed and authoritative nature of the DSM, and its pervasive use.
Including Gender Identity Disorder, Gender Incongruence and Gender Dysphoria in the DSM and assigning a mental diagnosis to individuals with these conditions is misguided and harmful. More appropriate is a medical diagnosis and support for mental health and life coping issues related to the diagnosis. Also appropriate are efforts to address ignorance, intolerance, discrimination and oppression related to gender identity and expression.
1Social Work Speaks. (2009) Transgender and Gender Identity Issues. NASW Press; Washington DC.
2 Erich, S., Tittsworth, J., & Kersten, A. S. (2010). An examination and comparison of transsexuals of Color and their White counterparts regarding personal well-being and support networks. Journal of GLBT Family Studies, 6, (1), 25-39.