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Advocates for Reform of Transgender Psychiatric Classification

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Laura Acevedo Graduate Student, Chapman University, MFT Trainee San Diego, CA As a postmodernist, I believe that gender identity is not a disorder, whether one's identity conforms to social norms or not. I believe that it is an intolerant culture/society that is pathological, not a "variant" individual. It is my view that the treatment/therapy for so-called GID needs to address the problems of adjustment that result from living in a variant-hostile culture/society, not the readjustment of the individual to fit the culture/society. I advocate for the removal of gender identity disorder from the DSM as it is currently written. I don't consider that diagnosis to be therapeutic for clients, but rather a possible cause of harm.

Ana Adelstein, Ph.D. Licensed Psychologist (Georgia) 1640 Powers Ferry Road Building 7, Suite 300 Marietta, GA 30067

Margo Victoria Allen Lewisville, Texas Is it nature or nurture? From my own experience it HAD to be nature, a congenital condition. I was born in 1958, and the drug "diethylstilbestrol" or DES was given out like candy to women who were prone to miscarriage. I totally believe THAT is why I am TS. That being the case, the government should step up to the plate and MAKE the insurance companies do what is right. We shouldn't have to make special laws to protect certain groups of people from prejudice. If a person is classified as a HUMAN BEING...then, THAT should suffice!!

Rebecca Allison, MD, FACC, FACP Cardiologist, Phoenix, Arizona Board of Directors, Gay and Lesbian Medical Association American Medical Association, Advisory Committee on GLBT Issues www.drbecky.com This condition, which is one defining component of our lives, is not a mental disorder. It is a physical condition, a mismatch between brain and body. It is properly managed as are other physical conditions, with medical and/or surgical treatment. Any coexisting psychological conditions are secondary, a reaction to stress and conflict we experience from family, friends, or work. More of Dr. Becky's statement As a physical condition, this "mismatch" does not belong in a manual of mental disorders. It does properly belong in a manual of physical disorders such as the ICD, and should be removed from the DSM and placed in the ICD to allow for appropriate insurance coverage of relevant medical and surgical treatment. "It" also needs a new name. Both "gender identity disorder" and "transsexualism" carry too much historical stigma. This new name should reflect the physical nature of our condition. It should be logical and acceptable to a general audience, as well as a professional audience. "Gender incongruity" may be one option, but perhaps one of us will put forward the perfect name!

MJ Anderson Founding Past Co-chair University of Minnesota Transgender Commission Transgender Advisory Board, Program In Human Sexuality University of Minnesota

Rachel Anderson CEO - Executive Mentoring Firm Denver, CO geocities.com/rachelssoul As my journey continues, I become more passionate about this reform. I did not choose my gender gifts nor are they a result of my environment. It is rare to find that a diagnosis is actually contributing to stress, depression and vulnerability of the very people it presumes to describe. Before acceptance or tolerance can come from society, reform needs to come, based on current research and findings.

Marie-Noëlle Baechler Counsellor Memeber of the Swiss society for psychoterapy and person centered approach (SPCP) Memeber of the World Association for person centered and experiential psychotherapy and counselling, (link) www.vrais-visages.net It is my deep conviction that being gender variant is a talent and a blessing, not a trouble, even less an illness. Welcoming and respecting all the human beings with their diversity and uniqueness is a question of human rights, and an essential one. It is also essential for all human beings, families, group and countries that they do not make their own life more difficult by rejecting and stigmatizing highly talented people because of their uniquemess while it is the very reason that make them a precious present for all human beings.

Renee Baker, Ph.D., LMT Gender Power! 3530 Forest Lane, Suite 306 Dallas, TX 75234 www.genderpower.com 214-607-5620 Sometime if we ask the opposite questions, we come to some good insight. Why don't we have gender-limiting disorder? Why are there people who are not able to get past the fear of free gender expression? Why don't we have straight-identity disorder? Why are people so afraid of defining as say pan-sexual? Do we have those in the DSM? I'm not an expert on the DSM, but I do know how damaging the medical community has been to my own life. It took me years to stand tall and strong in my right for free expression. It is time that we stop making people feel crazy for being uniquely themselves. It is time to stop stereotyping and develop an attitude of truthful acknowledgment with less judgement.

Nerissa Belcher I'm an ex-podiatrist and current nursing student. Douglasville, GA GID is a normal variant which would cause very little distress for most people given adequate legal protection, particularly to concern employment. It should only remain in the DSM to characterize the individuals with GID who have emotional distress due to GID despite adequate employment and other social factors. Care should be taken to distinguish individuals for whom the distress is not due to GID but due to religious indoctrination. In such cases their appropriate diagnosis should be under pathology related to religious issues

Elizabeth Bethea, M.S.W., Ph.D. Psychotherapist I have always been categorically opposed to the stigmatization and mis-labeling of gender variant people as suffering from a psychiatric disorder and in need of adaptive therapy. I consider such labeling a subtle form of violence against the transgender community, and I wholeheartedly support the complete eradication of GID and TF from the DSM-IV. A healthy gender identity and its full expression is integral to human wholeness and should be supported and celebrated in all of its beautiful and diverse variations.

Graham N. de Bever Medical student wanting to specialise in Psychiatry South Africa Why do we 'need' to pathologise everyone who is different? Why is the public so uncomfortable in their own skin that difference in self-expression is taken as a personal affront? Transexuality is not a 'dysphoria' or a 'disorder' - it is a variance of the normal - nature creates all sorts of genders so why insist that only the [straight] 'male' and 'female' options are normal? Stop making life harder for transexuals and other gender-different [or 'gender-original'] people by labeling them with a psychiatric diagnosis!

Elizabeth Bhulem Community Activist

Marci L. Bowers, M.D. Obstetrician, Gynecologist, SRS Surgeon 328 Bonaventure St., Suite 5 Trinidad, CO 81082 719 846 4433 www.marcibowers.com

Cristin Brew Fairfax, CA I am presently working towards my MFT license and am actively involved in the LGBT community in the Bay Area. I have worked for 3 years with both adults and youth who identify as transgender and have become outraged at our society's obsession with the gender binary system. My sincere hope is that it will not be too long before diversity in gender identity and expression is celebrated and not pathologized!

Andrea Brown Ireland I believe that transsexualism should be removed from the DSM as a mental condition and all references to it should be disconnected from mental conditions such as paedophilia. I would like to see reform around the control freakery of psychiatrists who choose for the patient what their lifestyle is, where they work, what they work as, and where they socialise and live.

Gene Bujold Networking Consultant Las Vegas, NV www.hhplace.org/hhboard/index.php My wife is a psychologist. She looked up the terms in the latest DSM IV-TR, and discovered that the medical (psychological) literature tends to lump us into one of two very narrow categories, neither of which apply in my case, and which I sincerely doubt apply to most of the posters here on this board! And this despite the fact that this "phenomena" has been in existance, in abundance, since the 1700's (perhaps much earlier), with an outbreak in the 1970's, and resurgance between the 1990's and the present. It's against the fact that around the world, until the last 29 years, the wear of skirts or robes by men was the norm.

Sarah Burgamy PsyD student, Univ. of Denver (at present), B.A. in psychology, Dartmouth College, NH (2000) I am currently working on an ethics project addressing the inconsistencies in the ethics professed by the APA and the reality of what is listed as a "disorder" in the DSM IV and is stigmatized and submitted to rigid and stereotypic standards in the Harry Benjamin Standards of Care. As I am only one person, and still a graduate student, I am looking into joining with others working toward reform in order to add momentum to current efforts and hopefully have more of an impact as a member of a larger group of like-minded individuals.

Angie Canelli, MA Mental Health Therapist Seattle Counseling Service for Sexual Minorities 1216 Pine St., #300 Seattle, WA 98101 206-323-1768 www.seattlecounseling.org There HAS TO be a better way to help us get our needs met than to pathologize our identities.

Gerri Cannon Board Member, PFLAH New Hampshire Board Member, NH Freedom to Marry Member, NH United Church of Christ Committee for GLBT Concerns Founder and Past Director of Tri Ess New England Past Director of Chapter Development for Tri Ess International Merrimack, NH While I was a Business Professional at Hewlett Packard, my being Transgendered was perceived by some Management and Human Resource people to be a medical problem that could be "corrected." After all, it is listed as a disorder, isn't it? This was the view of my manager when said to me, "You know, the company will pay to fix this condition." How we are treated by the medical community is a good place to start. "Labels" can be just as demeaning as the comments people make about our non-conformance to gender norms. It seems that when then next round of layoffs came, I became a liability at HP. I am now self employed and much happier being free to express my true self.

Brielle Chittim Youth and Community Advocate; member of a provincial government board issuing grants to mental health consumers; member of the advisory board for a local NGO transgender program; Canada sugarandmedicine.wordpress.com In order to recieve medical care during transition, many trans people have to ‘fit’ into a category defined by the DSM-IV dictated by the American Psychiatric Association. An individual's gender transition should not need to be corroborated by a psychiatric illness in order to be authentic and treatable through health care. Gender transition does not equal mental illness or illness of any kind.

Susan G. Clark Joseph F. Cullman 3rd Adjunct Professor of Wildlife Ecology and Policy Sciences and Fellow, Institution for Social & Policy Studies School of Forestry & Environmental Studies Yale University 301 Prospect Street New Haven, CT 06511 ph: 203-432-6965

Leigha Emma Cohen Electrical Engineer and Artist Princeton, NJ http://leighacohenphoto.com/ Having lived it and listened and seen it in so many others, I have come to the conclusion that what has been defined prior as Gender Identity Disorder is more akin to being born with an inter-sexed medical condition. Insomuch the condition should not be defined in the Diagnostic and Statistical Manual of Mental Disorders. I believe as with being inter-sexed that it is the responsibility of the each individual to make choices regarding their own body including oneÂ’s gender presentation, ones gender identity and one's sexual orientation.... I strongly believe these decisions come from the individual and not that of the doctors, the state, parents and relatives or the courts. I also believe it is responsibility of all states to define certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.

Anna Conway Harrisburg, PA There need to be more sites and sources of information on this specific topic. I work in the mental health field and with GLBT teens - and entirely agree with the site. I am searching for information that perhaps I can use for youth - brochures, bibliographies, websites, etc. I am a graduate student working on my internship in an organization called Common Roads, which is a supportive agency for GLBT youth ages 14-22.

Lynn Conway, Professor Emerita University of Michigan www.lynnconway.com The Psychiatric profession's published estimate of the prevalence of intense transsexualism understates the actual numbers by about two orders of magnitude. Their gross understatement of numbers is clear evidence of how out of contact that profession is with the realities of the transsexual condition. If they are that far off in their published figures for prevalence, why should we believe anything else they have to say about the condition? -- more on this issue --

Arianna Davis, MS, MCSE Principal Moderator and Co-Founder, Gender ID Coalition; Co-Chaiperson and Founder, Trans Mission International; State Director, California Chapter of TAVA (Transgender American Veteran's Association); Member of Trans Academics.org health.groups.yahoo.com/group/Gender_ID_Coalition A working board has been formed to provide input for changes to the new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). We are forming a working committee and network of Transgender and allied voices to help mitigate the far reaching and potentially damaging influence of members of the Psychotherapeutic community who have shown an obvious disregard for the diversity and dignity of those who transitiongender roles. The entire removal of Gender Identity Disorder from the DSM is an ultimate goal.

Madeline B. Deutsch, MD Private practice 417 S. Hill St #201 LA, CA 90013 323-219-2469 www.DoctorMaddie.com "GID" re-named and re-categorized into an adjustment disorder. Full medical (hormonal) treatment and some surgery (top/chest procedures, face procedures, etc...) on demand with informed consent model and elimination of all gatekeeping. Streamlined, limited, enabling gatekeeping for genital surgery. Comprehensive insurance coverage of all transition related treatments and procedures including fertility services.

Denise "Dee Dee" Devereaux Co-President Elect, Board of Directors, First Unitarian Universalist Church Chair, Gay & Lesbian Unitarian Universalist Committee (GLUU) Director, Hate Crimes Project Vice-Chair, Amnesty International, New Orleans Chapter Secretary, Board of Directors, Lesbian & Gay Community Center Vice-President, Gulf Gender Alliance Director, Steering Committee, Safe Schools Project, New Orleans, Louisiana.

Michael DeMarco, PhD Psychotherapist, Clinical Sexologist New York, New York www.mytherapist.info/

Lore M. Dickey, M.A. Graduate Student, University of North Dakota Leading scholars couldn't find a single person to write about keeping GID in the DSM. I agree - it should be removed. This also means that we need to educate the trans community, of which I am a part, as there is some amount of disagreement about this issue.

Veronica Drantz, Ph.D. Animal Physiologist and Educator Faculty of North Shore University Health System School of Anesthesia Chicago IL www.drdrantz.blogspot.com I have just completed a review of the research on sexual identity and sexual orientation. While still more brains need to investigated (e.g., lesbian brains), the work on the central subdivision of the bed nucleus of stria terminalis and the third interstitial nucleus of the anterior hypothalamus combined with the behavioral information from intersex studies makes it clear that sexual identity and sexual orientation are organized during fetal development. Transsexuals and gay people are natural variations to be expected and celebrated in any population. My views can be found at my blog on “Science & Sexuality” at //drdrantz-sciencesexuality.blogspot.com/

Mara Drummond Facilitator - Gay, Lesbian, Bisexual and Transgender Community Center of Baltimore (GLCCB) Director, FreeState Legal Project Baltimore, Maryland It is time that the psychiatric community stops treating a person with an Incongruent Gender Identity (IGI) as having a mental defect. Having an IGI causes stress, anxiety and depression in just a small subset of the transgender population, and this subset of people that suffer dysphoria need assistance from the psychiatric profession. Unless a person is diagnosed as suffering from Incongruent Gender Dysphoria (IGD), there should be no reason to consider a person with an Incongruent Gender Identity as having a psychiatric disorder. More of Mara's Statement I would like to see Gender Identity Disorder (GID) removed completely from the DSM-V. GID degrades and prejudices a large segment of the LGBT community that has no need for the assistance of psychiatric care providers. A new diagnosis, Incongruent Gender Dysphoria, is needed in the DSM-V to categorize the dysphoria caused by having an Incongruent Gender Identity and recommend appropriate treatments. I don't think Incongruent Gender Identity should be the name of the diagnosis in the DSM-V, but instead IGI should be a defined as a non-psychiatric condition that is then referenced within the definition of the dysphoria. For instance, I think "Incongruent Gender Dysphoria (IGD)" would be the diagnosis for someone who suffers anxiety, depression or unease from having an Incongruent Gender Identity. Treatment for severe IGD would include recommendations for following the WPATH standards for changing gender. Hence, only a person seeking psychiatric assistance for IGD would have mental disorder per the DSM-V. IGD, however, should not be a permanent diagnosis. If the person finds a way to overcome the dysphoria, with or without transitioning, with or without help from the psychiatric profession, that person would no longer have IGD. That person would still have an Incongruent Gender Identity, a non-psychiatric condition, unt il they transitioned or somehow found some other way to bring their gender identity and gender into congruence.

Sidney W. Ecker, M.D., F.A.C.S. Clinical Professor of Urology Georgetown University Medical School Washington, D.C., 20007 When R. J. Stoller in 1964 coined the term “gender identity” he realized that there were perinatal and prenatal factors besides genitalia and the psychosocial reinforcement of rearing that determined with whom individuals identified. Now 40 years later science is coming closer to understanding these factors. Psychologists have clearly drawn the distinction between behavior and identity realizing that identity maybe immutable as TGs mature. What is becoming clear from scientific evidence is that variant gender identity is strongly associated with the neural development of the brain in utero under the direction of our sex chromosomes and genes initially, which may be modified to some extent by the amount of sex hormones present throughout life. What is clearer in humans is that this cannot be changed by rearing, psychosocialization or psychiatry. I am working to gather and publish the scientific evidence that would provide a working scientific basis to remove GID from the DSM. I am an advocate for GID Reform.

Erica Essary current Psy.D. student, Argosy University, Chicago, M.A. Near Eastern Languages and Civilizations, University of Chicago, B.A. History, DePaul University I fully support DSM reform for GID, TF and sexual sadism/masochism. As a member of the LGBT community as well as the S&M community, I am disturbed at the thought that myself, my colleagues, and my friends are considered "disordered" by DSM classification. While I fully support enabling those to get the therapy, medication, and surgeries they desire, gender and sexuality are both continuums, a point which is ignored in the DSM. I applauded the removal of homosexuality from the DSM, and hope that we will continue to move forward by either removing or amending how we classify these differences. I also happily await the day when I begin my practice with the sensitivity, compassion, and empathy that should be extended to all individuals who seek psychological care, regardless of their gender or fetish.

Sarah Fox, Ph.D. President, Chrysalis Neurobiological Services Columbus, OH www.gendernet.org/sarah Although I once viewed the GID diagnosis as a necessary evil in the process of obtaining important medical interventions, I no longer feel that way. One does not need a diagnosis of nasal dysphoria to undergo rhinoplasty or adipose dysphoria to undergo liposuction. As a neurobiologist, I would still insist transsexualism is a disorder. However, it is not a psychological one. It is a medical disorder in which the brain and body are of opposite sexual differentiation. While the mind may be of the nonbirth gender, there is no reason to believe it is unhealthy.

Michelle Gagnon Honeywell Space Systems Quality Engineer 3923 18th St. N. St. Petersburg, FL 33714 www.geocities.com/transgender_world A non-op transsexual currently on HRT, I've been able to be quite successful in my career. Our medical and mental health community has historically viewed transgendered people in a sense, mentally ill. I have come to realize that I am no different than anyone else in my ability to become a successful and valuable member of my community. There are ways to deal with the negative effects of being transgendered, whether through therapy or HRT. Until the medical and psychological community recognizes this to be true, we will remain in this struggle to get the help we need and the peace we all can obtain through proper treatment.

Lisa C. Gilinger Attorney Santa Barbara, CA www.lisagilinger.com

Jolene Gillies, LMSW Ph. D. candidate counseling psychology, WPATH member Michigan I believe that gender variant people are a normal part of the human condition. The DSM needlessly pathologizes what is a difference among people preferring a certain type of behavior to another. As a transsexual who is hoping to make my body congruent with my gender identity I do not find a diagnosis of pathology leads to treatment. It seems to me that access to money leads to treatment in American society.

Jamison Green, M.F.A. Author, Becoming a Visible Man (Vanderbilt University Press, 2004); Gender Diversity Trainer and Policy Consultant; Gender Education & Advocacy, Inc., Board Chairman; FTM International, Inc., past President. www.jamisongreen.com Gender Identity Disorder probably does exist, but most of the hundreds of transsexual people that I've met don't have it. It is time for GID reform so that transsexual and transgendered people can access quality healthcare without being subjected to the stigmatizing diagnosis of a mental disorder that is not their problem.

Sally Goldner Spokesperson, TransGender Victoria PO Box 762 South Melbourne 3205 Australia 613 9517 6613 transgendervictoria.com Another possibility would be to have a preamble to the DSM that diagnosis of any condition listed is no excuse or reason for anyone to epxerience stigma or prejudice in any way. This could help people such as those with depression, schizophrenia and broaden our alliances.

Dean H Hamer, Ph.D. Molecular biologist and author of The Science of Desire qwaves.com Gender identity - just like sexual orientation - is a natural variation, not a disease.

Terry Lee Harrington, R.N., N.P. I am a psychiatric nurse practitioner. I find the DSM, a waste of time, unnecessarily stigmatizing, and not a holistic way of viewing clients. DSM is a real money maker for the American Psychiatric Association because insurance requires providers to provide a DSM diagnosis for reimbursement.

Lisa M. Hartley, ACSW-DCSW Clinical Social Worker P.O. Box 1354, Derry, NH 03038 603-434-0888 With the increasing knowldege gained from hard research in the hypothalamus and in genetics, and with awareness of my own journey and the journeys of numerous transgendered persons, I believe that transgender is a physical issue missed at birth. As the medical personnel look at the genitals for designating sex identity and ignore the real origin of sex identity which is the brain, a tragic mistake is made at birth. The mistake is exacerbated by wrong gender socialization and cultural expectations for the individual. When the transgendered person develops awareness and understanding of the primary mistake and corrects it, the culture responds in many negative ways. It is the culture that suffers from dysphoria, not the transgendered person.

Laura Herman Attorney at Law P.O. Box 14418 Tumwater, WA 98511 The present system is mired in irony and hypocrisy. If mental health professionals communicate with any honesty, they would admit that they are really screening transgender people, recommending those who are not mentally ill as candidates for surgery, and then diagnosing them as mentally ill.

Mikayla Howden Owner, Director, TS Haven House Penacook, N.H. I believe that changing the DSM has been a long time coming and that we need to be recognized as human beings, not mentally ill individuals, because of who we are as Transsexuals.

Tiana Hsu, D.C. Chiropractor Northern California I am currently in transition as a transwoman and am grateful for the help I received from my psychologists and psychiatrist regarding my gender dysphoria. My well-being has improved tremendously from being treated by my own admission. It has been noted also that during various times throughout my transition, my health care providers, my wife and my patients have also mentioned that overall, I appear much happier, the further along I get. I also agree that the DSM need to be revised and updated to reflect a more accurate description of gender dysphoria in the 21st century and beyond.

Laura Hurn Singapore Gender identity is not a mental disorder. It is inconceivable that anyone would think that it was without having a political agenda of discrimination. Such acts of discimination should be outlawed in enlightened societies. I advocate the removal of GID and TF from the DSM and the ICD.

Joe Ippolito, L.C.S.W, Pre-Doc Candidate Philadelphia Trans-health Conference, Mazzoni Center, American Psychological Association Division 44 Philadelphia, PA I am a licensed clinical social worker (LCSW) and a 5th year doctoral candidate in psychology. Currently, I work part-time as a therapist for the Mazzoni Center and run a small private practice. Most of my work, both clinically and politically, involve working with transgender clients. As a mental health provider, I am required to work within a diagnostic framework, even though I prefer not to. My p ersonal feelings about GID reform includes revising how it is presented and defined in the DSM, rather then removing it completely. I feel this should incorporate non-pathological terminology and involve a multi-axis definition. This multi-axis definition should look at social, cultural, environmental, mental, emotional, physical/biological and economic components.

Andrea James Owner, tsroadmap.com www.tsroadmap.com The mental illness model of gender variance is the greatest hurdle we face in getting full rights. We can be accommodated by helping professionals without this stigma of psychosexual pathology. ItÂ’s time that gender-variant people look to the 1973 decision to remove homosexuality from the DSM. It is clear now that this was a pivotal event in the gay rights movement, and until the pathologization of socially unacceptable gender expression ends, we will not have equal rights under the law.

Olivia Jensen, Ph.D. Professor of Earth and Planetary Sciences Department of Earth and Planetary Sciences McGill University 3450 University Street Montreal, Canada H3A 2A7 +1 514 398 3587 travesti.geophys.mcgill.ca/~olivia A great advantage will accrue to us when we, finally, remove GID/TF from the list of psychiatric disorders. The cost of the medical-disease model is to our dignity. The very fact that our self-reliance and self-will are supposedly compromised by our "affliction" brings us to be seen as weaker or lesser people. The disease model is, in my view, seriously detrimental to our acceptance by the world. To be a transgendered person is not an affliction; rather, it is the most remarkable of blessings. It is affliction only in a personal inability to take charge of issue and realize an accomplished and successful life.

Ilene Jones Owner, Genderology.org Founding member, Genderology Association www.genderology.org Being the daughter of a transsexual and the spouse of a transsexual has given me a unique perspective on the lives and the minds of transsexual persons. Our society is but one of many and to assume that every person will fit into the social norm is absurd. To feel that every person who does not fit the social norm needs to be reformed to society is equally absurd. Our society should learn more tolerance for others, just as we should learn more tolerance for other cultures.

Matt Kailey Author of Just Add Hormones: An Insider's Guide to the Transsexual Experience (Beacon Press, 2005), Activist, speaker and trainer www.mattkailey.com Before the advent of the increasingly bulky DSM, many "mental illnesses" were simply personality traits. Mental health is a serious business and is woefully underfunded. The limited resources that are available need to go toward those who actually experience the debilitating effects of true mental illness. Having "gender issues" is a problem only because society makes it so. There is a generally accepted remedy for those living with this experience, but it has nothing to do with treatment for mental illness. Most of the "mental health" issues that trans people experience are due to society's nonacceptance of us just the way we are. We do not need the additional stigma of "mental illness," and we do not need to take from the dwindling resources available to those who truly need mental health services.

Dan Karasic, M.D. LGBT Advisory Committee of the San Francisco Human Rights Commission Attending Psychiatrist for AIDS Care, San Francisco General Hospital Associate Clinical Professor of Psychiatry, University of California, San Francisco There are a lot of problems with the way psychiatry has viewed transgender folks. In labeling an identity as a mental disorder, as opposed to identifying symptoms in the same way we do for, say, major depression, anxiety disorder or other disorders in the DSM, the consequence of this is pathologizing and really hurting our clients. (Karasic & Kohler, 2000)

Scott Kerlin, Ph.D. & Dana Beyer, M.D. Co-moderators of the DES Sons online discussion network groups.yahoo.com/group/des-sons As co-moderators of an online network of persons assigned male at birth who were exposed to the drug DES (diethylstilbestrol) in utero, we are aware of the high incidence of gender variance now proven within our DES community. As persons subjected to one of the worst long-term medical errors in American history, from 1938-1971, we are especially attuned to the need for a fair and biologically-based categorization of all gender-variant persons.

Heidi Marie Kirsch Incoming freshman at Bennington College Gender Identity Disorder is not a "disorder," and anyone who thinks it is should do more research on the subject. I think society's expectations of what it means to be a girl or a boy are unreasonable. Every human being should be embraced...but people are still treated differently, and that is sad.

Peter Klevius http://klevius.info/sexsegregation.html?1104498467093 I'm a "straight" anthropologist and gender criminologist and I lost my "manhood" long ago and now propose using the concept sex segregation (see my site and From Klevius without love) as a means for deconstructing gender, femininity and masculinity. I have two happy "straight" "tomboy" daughters.

Barbie Lee Minister, PhD Theology, novelist Elk City, Oklahoma www.BarbieLee.com As I scrolled down the list of advocates I was impressed. Many of those names are pioneers in raising awareness of transgender issues. Never have I ever heard or read anyone saying they want to be transgendered as if it was a choice. The brain doesn't match the body. We can blame Mother Nature or we can thank God for the gift. Until we stop laying a guilt trip on the individuals who happened to be so blessed, society as a whole is going to be short changed. Some of those gifted people have contributed to mankinds greatest leaps in art, science, literature, etc. And sadly, many have died because it's okay to kill or discard those whom the Medical community labels with GID. Thank you to all those who stand up and tell the world it's okay to be us. An especially thanks to those who stand up and tell the kids who were blessed inside the boy-girl gender blender, look we made it and so can you.

Arlene Istar Lev, LCSW, CASAC Choices Counseling and Consulting 321 Washington Ave. Albany NY 12206 518.463.9152 www.choicesconsulting.com The DSM has a long history of diagnosing oppressed people with mental disorders. In order to receive medical treatments, transgender and transsexual people have historically had to prove themselves to be mentally "disordered"; in order to be granted civil rights, transgender and transsexual people must show the world that they actually quite sane. Approval for medical treatments must not depend on being mentally ill, but on being mentally sound enough to make empowered and healthy decisions regarding oneÂ’s body and life.

Jack Roy Linker Baldwin, NY

Savannah Nicole Logsdon Youth Voice Advocate, Venango County, PA The very idea of denying validity of one's declaration of gender or orientation bothers me on both professional and personal levels. I am a Youth Advocate in Venango County, PA. In my work, I advocate for and foster self advocacy skills in youth, ages 14-25, who have contact with the "System" on the county and state level. I find a lot of youth who are trans-gendered or even alternatively orientated are stigmatized by the system, and in some cases are denied appropriate services by private providers who insist that it's a mental illness or sinful. I personally Identify as internally non-gendered (I'm fine with my physical gender, but I'd be fine with another gender as well), Pan/Bisexual, and Polyamourous.

Patricia Susan Martin President e-transmall http://www.geekbabe.com/patti I have suffered throughout life trying to be something I am not, a man. I have tried to be the gender that I appeared to be at birth. I am now in transition and find so many blocks in my way due to the classification GID falls under. All that is needed is a small change of wording to allow us to be medically treated properly, so our insurances will cover part of or all of the transition. It is time to legitimize the medical necessity of sex reassignment surgeries (SRS) and procedures for transsexuals who urgently need them.

Lisa Maurel, MFT 1400 Bristol Street, Suite 250 Newport Beach, CA 714-390-8189 http://therapy4oclesbians.com http://genderpath.com In my work as a therapist, I have come to understand that the phenomenon of gender variance that has been labeled as disordered in the DSM is simply the expression of gender outside of our culturally limited understanding. The disorder is in our culturaly bias of two genders, not in the individual who displays the beautiful and unique expression of their own experience of themselves. Working with my gender variant clients, it is my goal to assist in removing the barriers and unburdening my clients, so that they can fully express who they are. That is why I am an advocate for DSM reform. Its time to remove the label as a psychological disorder. Its time to provide insurance coverage for any and all medical assistance that is needed to achieve wholeness and health.

Deirdre McCloskey, Ph.D. UIC Distinguished Professor of Economics, History, and English, University of Illinois at Chicago 720 S. Dearborn St., #206, Chicago, IL 312-435-1479 www.uic.edu/~deirdre2 Taking the "diagnosis" out is a matter of civil rights. One could just as appropriately have a "diagnosis" for people with optimistic personalities or red hair.

Jodie R. Miller Graduate student, McNeese State University Lake Charles, LA Traditional psychology states that children and adolescents with GID adopt cross-sex behaviors and choose opposite-sex play partners due to maladaptive processes. Though these behaviors may open youth up to social ridicule and ostracism, the very fact that they avoid same-sex play activities and gravitate toward opposite sex-typed play and partners demonstrates their efforts to adapt to social distress. It simply does not seem correct to classify adaptive behavior that causes no harm to self or others as indicative of a disorder.

Sheila Mink Former Chairwoman, Board of Directors Gender Identity Center of Colorado, Inc. Certainly, those of us who are transsexual can find solace in the way that this very important issue is being dealt with via this web site! I continue to be saddened by how far we have yet to go, but gladdened by how far we have come towards letting the truth be known!

Rev. Linda Miskimen Ph.D. Retired, Doctor of Philosophy In Religion Bloomington, MN circleministries.org First, I do not believe that HBIGDA works in the best interests of human-beings with GID. The DSM is nothing more than a political document, that is used for selecting who gets what conditions and what degree of medical care. There are members, people in power, who are practicing junk science, and it has not taken long for the religious right to jump on the band wagon. I have not seen one paper nor much come out of HBIGDA or APA to refute this junk science. To avoid taking a stand against junk science or the religious right's misuse of the Bible, medical organizations hide behind "do no harm," which is doing harm.

Nancy L. Morgan, M.S., Ph.D. Organizational Consultant/Mental Health Outreach Specialist/Clinician Portia Bell Hume Behavioral Health and Training Center Concord, CA 94520 Phone: (925)825-1793 ext. 384 I am the author of the first Ph.D. dissertation advocating GID reform. Defining normal gender behavior: Therapeutic implications arising from psychologists' sex-role expectations and attitudes toward lesbians and gays.

Joanna Morse Michigan I have been to at least four so called mental health professionals prior to the person I am currently under the care of to "fix me". Without exception nearly every one I seen before now would either not get it right or they would try to get me to correct what they considered a behavior problem. The lack of effective treatment, the stigma of being considered disordered is perhaps the biggest problem I still need to overcome. I know I am not crazy and I certainly think the biggest disorder is how someone tends to look at me as being such. I even have problems with the personal relationship with my sister on these points because she was taught in her psych classes that I am suffering from an illness. No, Paul Fink does not speak for me!!!

Michele O'Mara, LCSW Psychotherapist, TransgenderIndiana.com 6450 West 10th Street, Suite 7 Indianapolis, IN 46214 317.517.0065 www.TransgenderIndiana.com The numbers of men and women affected by gender concerns are signficant, and it seems to me that the stress of their gender differences stems not from how they feel about their condition, it stems from their discomfort around how they believe they are (or will be) perceived by loved ones and society at large. The stress of potential rejection for not being "normal" seems to contribute to the bulk of the stress I see with transgendered clients.

Annalise Ophelian, MA Filmmaker Doctoral Candidate in Clinical Psychology San Francisco, CA www.gidthemovie.com As a queer woman, a trans ally, and an early career psychologist, I am heartened by the work of people like Katherine Wilson and others in advocating for GID/TF reform. I am currently in pre-production on a film documenting the psychosocial impact of the GID diagnosis on those who receive the diagnosis, and welcome interested individuals or organizations who would like to participate to contact me. For more information, please visit www.gidthemovie.com.

Daniel Ouellette Community Mental Health Worker Montreal, Canada The continued pathologization and medicalization of natural variations in the foundations and expression of gender identity is counter-productive. It harms individuals by condemning them to experience the psychological distress that follows from being ostracized or from being labeled as deviant. It harms society as a whole by robbing it of the opportunity to exhibit the full richness of its fabric were only the individuals so distressed be given a chance to fully participate in its weaving as but one colourful thread among many. Gender-normative thought is, by nature, political and morally prescriptive; it's of little value in any discussion taking place in a cultural context where tolerance, openness, and the espousal of diversity are upheld as social values. The DSM-V's GID/TF diagnostic ought to be revamped in order to reflect this.

Pauline Park, Ph.D. chair, New York Association for Gender Rights Advocacy (NYAGRA) www.paulinepark.com I do not have a gender identity disorder. It is society that has a gender identity disorder. Removing the GID diagnosis from the DSM will help liberate thousands of transgendered and gender-variant youth from the psychiatric abuse to which they are currently being subjected as well as helping to advance a progressive agenda for social justice and social change. We must embrace a wholistic concept which recognizes transgender as simply a natural variant in gender identity. For a complete analysis of the politics of GID, read the closing keynote speech ("Transgender Health: Reconceptualizing Pathology as Wellness") that I gave to the Trans-Health Conference in Philadelphia (4.7.07): -link-

Sally Payne Birmingham, UK sallypayne.co.uk I have never understood why I should be classified as mentally deficient, just because I have suffered distress regarding my gender. My distress was so great that I went into deep denial for more than 40 years and did the usual things that a male would do, married, had and raised 4 children, ran a very successful business etc. This does not seem to me to be the actions of someone who is mentally deficient. I am now happily transitioning (non-op) and I object strongly to being classified as having a mental disorder. I help run the largest trans support group in the Midlands and give a lot of time and support to trans people - again hardly the actions of someone who is mentally deficient. I applaud your efforts to bring about reform.

Trey Polesky, B.S., MSW candidate More of Trey's Story I received a diagnosis of Gender Identity Disorder as a 9 year old child from a psychiatrist my parents took me to due to my distress about being a girl, desire to live as a boy, and aversion to female clothing, activities, and toys etc. Upon being given this diagnosis, it was recommended that I be sent to Forrest Hospital in Des Plaines, IL in order to "help me become more in touch with my feminine side." I was admitted to the psychiatric unit there for several months and was subjected to reparative therapy in which I was forced to grow my hair out (I was not allowed a haircut like the other children on the unit), I was forced to wear pink or purple dress or skirts 4 days per week, and part of my therapy was to read magazines such as "Teen" and "Seventeen" in order to learn how to dress and behave like a girl. At first I refused to follow my "treatment plan" but I quickly learned that by refusing, I was viewed as being non-compliant with treatment and lost privileges on the unit such as movie night, access to eating in the cafeteria with peers etc. I finally learned to fake my way out in order to be released, though the reparative therapy did nothing but shatter my sense of self confidence in who I was. Essentially, they taught me to hate who I was. To say that gender identity disorder does not stigmatize transgender clients is a huge slap in the face to my experience. It took me years to overcome the trauma and nightmares that I experienced after having been given that diagnosis and institutionalized against my will for simply being true to myself. Just because my gender identity is different from yours doesn't mean I am "disordered," it simply means it is different. Diversity should be embraced, not construed to be a disorder.

Julie M. Praus, MD Psychiatrist, Brattleboro Retreat Brattleboro, VT Going through my transition, I've discovered that trans people are legitimate and whole, healthy people, as they are. We live in a very transphobic culture, but that is not evidence that we are abnormal. There is a lot of good thought coming out as to what constitutes a disease, and unfortunately none of the proposed DSM categories come close to those new models. Remember, Primun non nocere.

Stella Purvis Trans Editor, GScene Magazine 16 Locks Crescent, Brighton BN41 2AD United Kingdom www.gscene.com Normal variation rather than nosology and pathology.

Kathrin Raymond, B.S. Doctoral Student, Counseling Psychology Colorado State University Fort Collins, CO In my opinion, the diagnostic label of "Gender Identity Disorder" adds insult to injury by pathologizing the individual and not addressing the key issue of social prejudice and discrimination. With regard to the DSM-V it is my firm belief that the diagnosis needs to be reworked or even omitted. The only potential purpose for the diagnosis would be ensuring access to the relevant medical options available.

Dr. Pega Ren Registered Clinical Counsellor (British Columbia, Canada) Board Certified Sex Therapist (USA) Vancouver, British Columbia, Canada 604-269-2692 www.smartsextalk.com I view my role in working with transgendered people as one of supporting them through their transition process to make it as smooth and painless as possible for them and those who love them.

Kate Richmond, PhD Private practice 1845 Walnut Street Philadelphia, PA 19104

Susan P. Robbins, Ph.D., LCSW, LCDC Associate Professor, University of Houston Graduate School of Social Work Houston, TX 77204-4013 www.susanrobbins.com The continued inclusion of GID and TF in the DSM serves to bolster psychiatry and related mental mental health professions by pathologizing human difference as psychiatric disorder. Removing these diagnoses from the DSM should be inextricably linked to the concepts of social justice and human rights. With the generous assistance of Arlene Lev, I have included a section on transgenderism and transgender identity development in the 2nd edition of my human behavior theory textbook that will be available in Summer 2005.

Michael Rogers, M.A. Doctoral Student in Counseling Psychology Santa Barbara, CA Gender variance is a natural condition and should be respected in the same way as other differences. As a future psychologist, I am disappointed in the way that my profession has handled GID in the past and the way some members continue to do so today. I support everyone's full right to the gender expression of their choice.

Kim Schicklang Germany www.mut23.org The DSM-IV stands in opposite to human rights and it's important to spread this message all around the world. A transsexual woman's sex of birth is female (with transsexual men vice versa), because her brain is female. The sentence "I am born with the wrong body" is true (the sentence is not a phenomenon of a psychiatric disease).

Sarah Marie Schmidt PFLAG The real choice here is, do we accept who we are and be happy, or do we choose to ignore it and maybe kill ourselves because we can't stand the bodies we were born in? The surgeries on infants to CHANGE them -- whose bone head idea was that? Did the term, if it aint broke don't fix it, come to mind? To those parents who are worried about what kind of ridicule their child MIGHT receive as an adult -- let your children decide that for themselves when they are older. What all parents should do is LOVE, PROVIDE, and NURTURE their children. Parents should not play God when it comes to their childÂ’s sex or their orientation; that should be left up to child when they grow up. This is my view on GID Reform; it needs to happen NOW.

Dylan Scholinski Author of The Last Time I Wore a Dress Artist, Sent(A)Mental Studios Denver, CO Founder, the Sent(A)Mental Project, A Memorial to GLBTIQA Suicides sentamentalstudios.weebly.com At the age of 15, primarily because I lacked signs of being a 'heterosexual female,' I was labeled 'mentally ill' and confined to a psychiatric ward. I lost over three years of my youth. I consider all of my art to be autobiographical. I tell stories about my life: what I am thinking, feeling, experiencing; creating a sort of map of living and breathing emotions. I rarely hold my breath in a painting. Unlike in real life, where the simple process of breathe, the literal proof of my own existence, poses a daily challenge. The content of my paintings deals with the experiences I had leading up to and during my years in the hospital and continues on to reflect the struggles I face being transgender, gay, human, as well as an ex-mental patient.

Julia Serano, Ph.D. Biologist, Univerisity of California at Berkeley Writer, Spoken Word Artist, Gender Activist Oakland, CA www.julieserano.com It is time for the psychiatric community to stop pathologizing healthy, sane transgendered people and instead focus their efforts on treating the people who truly suffer from the "gender disorder": those who become irrationally uncomfortable, upset or angered by other people's gender identity or expression.

Robin E. Sexton, B.S.I.E.,MA Counseling Livonia, MI I completed my master's thesis on transsexualism in 2007. The research is generally pathetic, with some exceptions. Blanchard is transphobic or he wouldn't have pathologized a phenomena that is explainable using common sense. So sad that he is on the committee.

Alexus Sheppard, B.S.E., D.D.S., F.A.G.D. Social Consciousness Practitioner Pleasanton, CA www.alexussheppard.com Who I AM is not (and never was) pathological. The DSM is, quite simply, incorrect and needs to be changed. Only when we take these matters into our own hands will the medical/psychological communities begin to respect and honor the true strength of our conviction.

Ms. Stephanie Shockley Field Services Representative / Founding Board Member - TransGendered Kansas City (Missouri Charter) and TransGendered Kansas City Union (Kansas Charter). Board Member Four Freedoms Democratic Club 207 Westport Road, Kansas City, MO 64111 http://transgenderedkc.org The time has come to boldly come forth to demonstrate the value and importance of individuals whose only real obstacle in life is an incongruous existence due to abnormalities in vitro.

Gwen Smith Columnist, Transmissions Founder, Remembering Our Dead project Founder, Transgender Day of Remembrance www.gwensmith.com The current GID and TF definitions do not serve those they purport to treat; it is high time these were reformed.

Megan Smith, MS, LMHP, LPC Psychotherapist Omaho, NE www.gwensmith.com

Debra Soshoux Attorney and Advocate, TransYouth Family Allies Sherman Oaks, CA The psychiatric/psychological profession must remove gender identity and expression from the DSM now. It's a false diagnosis that mistakenly focuses on the transgendered individual, identifying him/her as "disordered" when in fact the person is simply expressing who he or she is. The "disordered" element among us an uncomprehending public that demonizes and persecutes people innocent individuals just because they're different, refusing to acknowledge a now overwhelming body of medical and clinical evidence that identifies transsexuality as a birth condition.

Jennifer Souder www.myspace.com/cherryfreak24 My point about GID is that I do understand why it CAN be seen as a mental disorder- However I don't agree with it. One might say.. well, how do you know? I would say- because I live with it every day of my life. I personally think that the only PART of the "disorder" that they are focusing on is that it can cause a mental strain on those who have it. Well no, duh! You try waking up and having the wrong parts. You wouldn't be too thrilled either. This doesn't make us( those who have GID) Mental. Now I am working off of the claim that it is a disorder. Lets explore why it's not. There is in fact nothing wrong with my brain. I dont see it as one. I will never see it as one. I do, however, think that there is a physcial problem with me. The physical issue is the wrong sex parts that were given to me at birth. So one has to ask, do we label it as a disorder because we afraid that " god " screwed up? OR do we just label it as a disorder and let them ( the almighty ones ) prove us wrong? I don't know about anyone else; I'm all for proving people wrong. This is why I do education lectures about it, to show people I'm not a person with a " mental disorder." I am Jennifer - a woman - who happens to be born with the wrong physical parts. Life happens to alot of us, but don't you dare tell us that we have a mental disorder just because you can't explain it.

Ingrid Swenson, MSW Mental Health Therapist Seattle Counseling Service for Sexual Minorities 1216 Pine St., #300 Seattle, WA 98101 206-323-1768 www.seattlecounseling.org There HAS TO be a better way to help us get our needs met than to pathologize our identities.

Wynelle Snow, M.D. Association of Gay and Lesbian Psychiatrists

Renee Michelle Thomas, RA, IESNA Licensed Registered Architect Phoenix, Arizona Current research in molecular genetics and developmental neurobiology is pointing ever more conclusively to the emerging fact that GID is a naturally occurring developmental variation of the human being. Far too many examples exist of talented, creative and accomplished people who have been diagnosed with GID who have made and continue to make enormous contributions to their communities and to the world to persist in erroneously continuing to define GID as psychopathology.

Steve Toby Licensed Marriage and Family Therapist Richmond, CA 94805 510-236-1063 jtoby.homestead.com I tell transgender clients that being trans is NOT mental disorder and that our work together is counseling (not therapy) for the purpose of making sure, before I write a letter, that they are knowledgeable and making an informed choice. To those who say one has to have a diagnosis to get hormones and surgery, I reply that pregnant women get medical attention without having a DSM diagnosis.

Wal Torres BS Philosophy, MS in sexology, PhD in engineering. WPATH/HBIGDA titular member, OII board member, WGC board member. Brazil www.gendercare.com Sex and gender are natural expressions of diversity. In nature, diversity is normal.In nature, as a primate species living in a limited planet, we have fractal distributions and not Gaussian ones. The "normal" is a myth - the fractal with its extreme conditions is the normal.

Rachel Tortolini M.D., M.A., LLC. Family Medicine and Psychiatry Ewa Beach, HI www.myspace.com/dr_rachel Reform is urgently needed before the window of the transgendered closes and it is no more fashionable to the media to be one. History repeats itself and though the next cycle will be like the last in the late 20th century. It will also be different. Let us hope that persecution by our society's reactionaries will be silenced by fiat. It starts with de-pathologizing transsexualism and looking at it as just another part of the spectrum of intersex disorders. To transition from one gender should be a natural act of finding one's true self. There should be no stigmas or shame attached.

Anne Vitale Ph.D., Lic. Psychologist D Street Counseling Group 610 D Street San Rafael CA 94901 414-456-4452 www.avitale.com I have long since considered the problem of sex/gender incongruity to be better described as Gender Expression Deprivation Anxiety Disorder. I have written extensively about my ideas on my web site http://www.avitale.com. I am currently writing more about this.

Rachael Wallbank Accredited Specialist Family Lawyer - undertook Re Kevin PO Box 1331 Burwood NSW 1805 Australia 612 9747 7944 www.wallbanks.com In the case Re Kevin, the court accepted that the only reasonable explanation for transsexualism is that it is a biological phenomena, a natural variation in human sexual formation and properly seen as part of the intersex continuum. Both adults and children with transsexualism suffer loss of human and legal rights whenever they are able to be written off as the products of mental illness or confusion. The time has past for deferring our human rights for the sake of the ignorance, sexual bias and plain fear of difference inherent in the association of transsexualism with the terms gender identity disorder and gender dysphoria and its inclusion in the DSM.

Lisa Wilson UK I was born a transsexual female and very early on (aged 13) recognised my condition and sought medical/surgical help. This help was denied to me and instead I was subjected to an extensive program of enforced social conditioning by psychiatrists the UK National Health Service over many years. This treatment was against my will, no doubt expensive to the taxpayer and in the end completely pointless. I was eventually cured through surgery & hormone treatment, just as I'd always known that would be the only solution. If a man has a rotten tooth he doesn't need a psychiatrist to 'explore the issue' with him over years, he needs a dentist. Likewise, a transsexual person needs a surgeon not a shrink. Take the shrinks out of transsexualism; we need our bodies fixed not our minds. I support reform of the Gender Identity Disorder and Transvestic Fetishism diagnostic categories in the DSM.

Miriam Stone Wilson, MSW, MA Clinical Social Worker, Psychotherapist 1914 N 34th St, Ste. 401, Seattle, WA 98103 www.miriamstonewilson.com While I recognize the need to provide means by which transgendered individuals can continue to safely access hormones and SRS, I support the removal of the GID/TF diagnoses from the DSM-IV in an effort to depathologize gender variance.

Kelley Winters, Ph.D. Founder, GID Reform Advocates gidreform.org It is time for medical policies which, above all, do no harm to those they are intended to help. -- bio --

Sachi Wilson Assistant Attorney General, State of Washington I do not mind having a reference to Transsexuality in the DSM, because even though it may not be psychological in origin, other conditions that are psychological may mimic it. I do think it would be better not to use Gender Identity "Disorder" or other term that indicates a dysfunction. When I first looked into transitioning 27 years ago, one shrink told my father and me that I was "very sick." I was intensely offended then and I am offended now at any indication that I or my trans sisters and brothers are sick or mentally ill. I am just trying to be myself, and to have the world accept me as a happy human female.

Wallace Wong, R. Psy. Psychologist Adolescent Sexual Health Program/Mental Health Clinician #200 - 13630 - 72nd Avenue Surrey, B.C. V3W 2P3 Canada Telephone: (604) 501-3122 Fax: (604) 501-3137

Madeline H. Wyndzen, Ph. D. Psychology of Gender Identity & Transgenderism www.genderpsychology.org In 1998 I transitioned from male to female. Today I have wonderful friends and the most perfect life-partner, Lisa. I recently completed my Ph.D. in Developmental Psychology. Someday I hope to teach college students and study how children learn and grow. I write essays about transgenderism to share with others what I have learned from being educated in psychology and growing up with gender dysphoria. I write personal accounts about my gendered experiences that use the metaphor of puzzle-pieces "all mixed up" to more fully capture my own experiences than the historical metaphors "woman trapped in a man's body." I also write academic essays about systemic biases in psychopathological research into Gender Identity Disorder and Transvestic Fetishism.

Jessica Xavier Gender Education & Advocacy Transgendered and transsexual people bear an intense, pervasive social stigma in western culture. Besides the modern western religions, the origins of transphobia lie in the psychopathologization of gender variance by science. The linchpin of this psychopathologization is GID. Therefore... It's time for the American Psychiatric Association to assume full responsibility for the human misery it perpetuates by providing a ready apologia for those who perpetrate acts of hatred against gender variant people. It's time for the caregivers to really start caring. It's time for GID reform NOW !

Teo Yother University of Hartford, PsyD program (ABD) King's College, BA, Psychology Training Consultant for health care professionals and educators on transgender issues, especially adapting care to be welcoming to trans clients. I have often wondered why what happens to my liver or kidneys is classified under one manual while what happens between my ears goes into the DSM. The sad truth: the politics of a turf war. I remember being told in graduate school that the DSM is the backbone of the American Psychiatric Association. As an FTM seeking medical intervention for what I am willing to see as a likely endocrine anomaly, the push to be diagnosed as mentally ill was alienating and insulting. The process by which one has to "prove" the need for intervention is unprecedented. Go out, try to live like a man for a few months and if you survive we'll get you some medical help. Thank god no one suggested I "prove" my need for antidepressants.