Task Force comments on DSM-5 revision

The Task Force submitted two sets of comments this week on the American Psychiatric Association’s (APA) proposed changes to the Diagnostic and Statistical Manual (DSM).

In the first set of comments, the Task Force applauded the APA’s proposal to move gender dysphoria into its own section and out of the section on paraphilias and sexual dysfunctions. This shift recognizes the reality of transgender people’s lives and is a step toward reducing social and cultural stigma trans people face. In its comments, the Task Force expressed its hope that “evolving social and scientific understanding of gender expression will lead to the elimination of gender dysphoria” from the DSM in the future.

The Task Force’s comments also called for the elimination of some technical language relating to who is considered “post-transition.” Further, the comments explained why it was a problem to include intersex people under the DSM’s definition of gender dysphoria, which was not done in the last DSM.

In its second set of comments, the Task Force strongly urged the APA to eliminate “transvestic disorder” from the DSM. After noting that the label of “transvestic disorder” is used to undermine social and legal recognition of transgender and gender non-conforming people, the Task Force’s comments surveyed the scientific literature and demonstrated the lack of evidence for this diagnosis.

This follows up on the Task Force’s previous comments from last year, which urged the elimination of “transvestic disorder” and “autogynephilia” from the DSM due to the underlying sexism of this category. The sexism was belied by the fact that it only categorized males who dress as women as disordered, not females who dress as men. Presumably in response to those comments, the APA included the scientifically unproven “autoandrophilia” in the diagnosis in order to make the diagnosis gender-neutral. The Task Force explained that adding “autoandrophila” — which is also not proven to exist scientifically — does not eliminate the sexism. In fact, it only masks the sexism.

The new edition of the DSM is set to be released in 2013, 40 years from the date when the Task Force worked to change the APA’s classification of homosexuality as a mental disorder, and worked with psychiatrist allies to defeat a proposed association-wide referendum to stop the declassification.