Wednesday, May 6, 2009

Gender and Sexual Equality in the DSM

In regards to the impending revision of the DSM (The Diagnostic and Statistical Manual of Mental Disorders) and the concern over the expansion of the Section dedicated to Paraphilia and Sexual Disorders (presentation on this expansion can be found here).

This is a long post, and I definitely encourage you to supplement by reading Jessica's post - written by Julia Serano - at Feministing. This is choc-full of information more specific to this topic, more links, and broader discussion.

I know a lot about psychology. I studied it for the entirety of my undergraduate education, and while I chose not to complete the final semester for the Bachelor's degree I can confidently say I have a wealth of knowledge on the subject:
Psychology 101, 102
Research Methods in Psychology, 207, 208
Learning (and Lab), 304, 304L
Health Psychology, 313
Psychology of Women, 214
Developmental Psychology, 212
Child and Adolescent Psychology, 314
Child Abuse, 256
Abnormal Psychology, 302

It's not a complete list, but that gives you an idea of some of the courses I've taken.

Now, the idea of the DSM is to provide psychologists and psychiatrists - those who may be making a diagnosis for the purpose of treatment and counseling - with a textual resource for the general guidelines of the known disorders. Now, "general" means that just like with physical illness or any other aspect of everyday life, people experience things differently and that disorders may not (I dare say often do not) present in exactly textbook fashion. The DSM is a guideline for diagnosis.

It is NOT a reference book of theorems, hypotheses and psychological concepts. It is not a place to list "things I think should be a disorder" or "behavior that seems abnormal to me and i might want to diagnose as a disorder because i don't understand it". It is not a place for proselytizing or exploitation of any group of people, be it a group of conservative psychologists who would like to promote a more rigid and comprehensive list of behaviors they deem as disordered, based on their morals/ethics/religion/social structure, nor is it a place to target specific groups of people who deviate from society's concepts of what is normal on the basis of "we can't explain it so it must be a problem."

From my education, moving from a normal event to an abnormal (disordered) event occurs when an everyday behavior/thought/action/belief occurs or is carried out in such excess that it becomes disruptive to an individual's daily life. An example - with Obsessive Compulsive Disorder individuals become so consumed with counting their steps, washing their hands, doing their activities so precisely in such a particular order that they do them over and over again. This disrupts their lives because they may be so focused on doing the routine in just a specific way that they repeat the process continually and never make it out of the house. That isn't the most eloquent explanation, but you get the idea. Disorder occurs when an individual can no longer function in their environment due to a particular tendency, behavior, belief, thought, fear, obsession, or other mental (or mental/physiological combination) feature.

The field of psychology is about studying why people do the things they do, the way they do them, and what the brain/mind/body connection is in the process. Psychology as it relates to diagnoses and treatment is about helping people. It is valuable because it deals with the less tangible aspects of human beings - our thoughts, our concepts of self, our beliefs, our emotions, our conscious and conscience, and our minds (not to be confused with our brains, which are obviously tangible).

If the new revision of the DSM adopts these expanded classifications of paraphilias, who is it helping? By classifying more people as being disordered we not only put more work on psychologists, but we also put the great burden of societal stigma and personal struggle on perfectly functioning individuals and, most importantly we detract time and attention away from those individuals who truly need help the most.

My post is prompted not only by genuine interest and concern for this situation, but by the recognition of the need for feminists to circulate this story and increase our response. Any situation which perpetuates the societal dominance hierarchy, leading to depression or oppression of any group(s) of people, is relevant to feminism.

When it comes to issues of gender, gender non-conformity, transgender and transsexuality, cisgender, pansexuality, and any other non-heterosexual-man-woman-male-female spectrum sexual action or identification, the psychological community has a responsibility to provide a structure for our society to differentiate between true disorder and diversity. They should be acting to break down the barriers of society's dominance hierarchy, which leads us to stigmatize those behaviors or ideologies we don't understand and which teaches us that there must always be one group superior and one group lesser in every relationship. They should seek to educate the greater academic community about the diversity of people and their mindsets and behaviors, and about the value of embracing these differences in research and practice. They more than any others realize how destructive social stigma and intolerance can be on individuals, groups and communities. This proposed expansion would serve as an inevitable point for provocation of violence, abuse and exploitation of those who don't fit into the most specific and exclusive definition of 'normal' and would offer a free pass (nee a twinkie defense) for those who execute such abuses.

In the same regard, those psychologists, both practicing and academic, who cannot commit themselves wholly to the ethical and compassionate treatment of their fellow humans - through objective and unbiased research and diagnoses, and consistent focus on edifying their science - should not be granted the privilege of holding influence and authority over distinguishing such crucial structures within the field.

From the post at Feministing-
What you can do to help:

1) raise awareness about this issue in feminist circles.

2) contact the American Psychiatric Association and share your concern with them.

3) if you live in the San Francisco Bay Area, please come out to the protest of the upcoming American Psychiatric Association conference on Monday, May 18th between 6:00pm to 7:30pm in front of the Moscone Center. This protest will focus primarily on the removal of the trans-focused DSM diagnoses Gender Identity Disorder (GID) and Transvestic Disorder. While the GID diagnosis is of great concern to trans activists (including me), I did not discuss it here because it is not listed as a Paraphilia, and because (to the best of my knowledge) no information has been released regarding proposed revisions to GID in the next DSM.

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