December 27th, 2012
10:46 AM ET

Being transgender no longer a mental 'disorder' in diagnostic manual

By Moni Basu, CNN

(CNN) - The American Psychiatric Association announced this month approved changes in its official guide to classifying mental illnesses.

Among the major announced revisions to the manual, known as DSM-5, is that Asperger's syndrome will now be included in the diagnosis of autism spectrum disorder "to help more accurately and consistently diagnose children with autism," the association said in a statement.

But the group made another big change that did not make as many headlines, though it is considered by many to be important.

The new DSM eliminates the term "gender identity disorder," long considered stigmatizing by mental health specialists and lesbian, gay, bisexual and transgender activists.

That old diagnosis meant that a man who believed he was destined to be a woman was considered mentally ill.

No longer so.

The new DSM refers to "gender dysphoria," which focuses the attention on only those who feel distressed by their gender identity.

"I think it's a significant change," said Jack Drescher, a member of the American Psychiatric Association group that made the recommendation after working on it for four years. "It's clinically defensible, but it reduces the amount of stigma and harm that existed before."

Drescher said there had been calls to remove the diagnosis altogether just as homosexuality was removed from the DSM in 1973. Drescher said he believes that removal changed world opinion on homosexuality.

But gender dysphoria was left as a diagnosis to ensure that a transgender person could still access health care if needed. Hormone treatment would be one example. Another would be counseling for those who need help dealing with their emotions.

Many LGBT activists felt that the gender dysphoria diagnosis could be a powerful legal tool when challenging discrimination in health insurance plans and services.

The National Center for Transgender Equality said it was pleased with the change.

"It will mark a significant lowering of the stigmatization that many trans people have faced," said Mara Keisling, executive director of the center.

"The changes help make clear that there is nothing pathological about having a transgender identity, and that the role of the mental health profession is to affirm and support individuals in being themselves in the face of societal misunderstanding," she said.

But others were not satisfied.

Transgender activist Kelley Winters, founder of a group calling for the reform of gender identity disorder, said the new DSM does not go far enough.

The new criteria "represent some forward progress on issues of social stigma and barriers to medical transition care, for those who need it," Winters wrote on her blog.

"However, they do not go nearly far enough in clarifying that nonconformity to birth-assigned roles and victimization from societal prejudice do not constitute mental pathology."

The greater issue, though, may be the larger sociopolitical impact the new category will have, wrote Dr. Dana Beyer, a public health and LGBT civil rights advocate who also served on the American Psychiatric Association's working group.

"Our greatest accomplishment on the Working Group was reconceptualizing the state of 'being trans' from a mental illness to a normal human variant," she wrote on The Huffington Post.

She noted that back in 1990, trans persons were lumped together with pedophiles in the Americans With Disabilities Act. The new DSM, she said, "finally brings trans persons into the light with the rest of the community of humanity."

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Filed under: Gender • Health • Who we are
soundoff (327 Responses)
  1. TransInsight Canada

    Don't ask yourself "why would I cut off my penis?". If you are a man, that would make no sence. Ask however, if you (ie. your brain) were the same person and you woke up without a penis, would you miss it? would you want to have one? That is how a transman like Chaz sees things.

    December 30, 2012 at 12:00 am | Report abuse |
  2. TransInsight Canada

    My birth certificate says I'm British, but I've lived in Canada since I was 4, so WHO I am is Canadian. The fact that the two disagree is not a mental dissorder. Likewise my BC says Male, but WHO I am is a woman named Heather. It's just a fact. It's not WHAT I was, but it is WHO I am.

    December 29, 2012 at 11:47 pm | Report abuse |
    • Jasper

      This is actually the best explanation I've seen. Thank you =)

      June 25, 2013 at 8:40 am | Report abuse |
    • Alex

      That's an idiotic analogy. A better one would be if you were born black, but kept insisting that you're white. It certainly would be a mental disorder. You could act like a the queen of England and speak with a flawless British accent but you would not BE white – you would be black, and it would be obvious to everyone that you have some serious mental issues when it comes to dealing with your birth race.

      July 9, 2013 at 8:20 pm | Report abuse |
  3. luvey

    What is wrong will become right and what was once right will become wrong.

    December 29, 2012 at 11:29 pm | Report abuse |
    • Jasper

      Well since wrong and right are relative, that's ok!

      June 25, 2013 at 8:42 am | Report abuse |
  4. Richard

    Once again, poltical-correctness trumps medical reality. What next? Every genetic disorder is now "normal?" Will that mean all the money directed toward fixing them will be stopped?

    December 29, 2012 at 9:22 pm | Report abuse |
  5. Lord Yabu

    You bring out Chaz Bono as evidence there is no disorder ? Too funny. Never.

    December 29, 2012 at 12:02 pm | Report abuse |
  6. Hitsteria

    300+ opinions and counting and only a handful of people who know anything about what they're talking about.

    December 29, 2012 at 1:21 am | Report abuse |
    • Reality

      Since when is knowledge of the subject a prerequisite for posting online?

      February 27, 2013 at 10:46 am | Report abuse |
  7. Joanna Clark

    It is disappointing to see all of the ignorance posted here. We all started out life as female. It isn't until about the sixth week that the fetus begins to differentiate when the SRY gene tells the fetal gonads to differentiate into testis. The number of errors that can occur are monumental. The difference with transgender is that it is not visible like a cleft lip, or a missing arm. With the visible there is compassion, with the invisible only ignorance and disgust.

    December 28, 2012 at 11:36 am | Report abuse |
    • Wayne Fontana

      "The number of errors that can occur are monumental."

      Glad to see you admit that it's an error.

      December 28, 2012 at 1:40 pm | Report abuse |
    • Larry

      No, everyone did not start as female. Everyone started as undifferentiated. And if you have a Y chromosome with all associated genes, you're a boy.

      December 28, 2012 at 4:27 pm | Report abuse |
    • Joni Christian

      Thank you for the insight. It is clear that people who are not affected think that somehow this is funny. I suppose if they really understood the complexity of human life, it just might have a positive effect. Acceptance always comes before understanding.

      June 25, 2013 at 7:31 am | Report abuse |
  8. Susan

    Does this mean that taxpayers are off the hook when it comes to paying for 'gender reassignment' surgery for inmates?

    December 28, 2012 at 8:34 am | Report abuse |
  9. rickster

    @Steve - So some poor kid who at the age of three or four years old realizes "hey everyone wants me to be a boy but I really, really feel like a girl". This is not a mental disorder AS SUCH it's more of a physical disorder - the brain develops OPPOSITE of what the physical body gender is. The brain cannot be changed so the body must be. Make sense? I know it totally disgusts you, sure, but would you prefer all the kids - when they hit teenage years - to just go ahead and kill themselves like they used to do? Would be way more convenient for you and easier for you to deal with, wouldn't it Steve. Suicides of thousands to trans teenagers would suit you just perfectly, I bet.

    December 28, 2012 at 8:24 am | Report abuse |
  10. Steve

    So it's not a mental disorder despite there being no clearer example of one, so will insurers be forced to cover the "treatment" for this non existent mental disorder or will liberals force that upon the taxpayer? How many other non mental problems will insurers or taxpayers be forced to cover?

    December 28, 2012 at 8:05 am | Report abuse |
  11. kyla

    The comments here show me how uneducated people are and i blame the Schools and parents. The fact that you can't even talk about Transgender topics in schools confuses me to no end and just makes me sad for the Human race.

    We need to educate our Kids at a young age about the many different genders and show them that it's not (black and white)
    The sad part about all this is the fact it's very easy to understand, Think of gender as sliding scales "Not just 1" but many, And the scales can be moved in so many different ways.
    But even i myself have a basic understanding of it, But that's more then enough to understand it's not something that's Bad,wrong or any kind of mental illness.

    December 28, 2012 at 2:06 am | Report abuse |
    • hardtobeme

      The problem with all you adults that want to be "all you were meant to be" is that the kids get ignored and end up shooting kids in a school. Wake up.

      December 28, 2012 at 2:54 am | Report abuse |
      • TransInsight Canada

        Wow. You are so despirate to keep you "toys" that you will put the blame on anything but the 300 million guns in the US. Insane people are everywhere. Only in the US can they kill 20 kids in minutes because only the US has as many guns as people.

        As for "being all we can be", would you want your children kept from being the best person they can be simply because people are too stupid to understand them?

        December 30, 2012 at 12:06 am | Report abuse |
    • SAWOLF

      Many different genders?????? So what is there other than male or female?

      December 28, 2012 at 8:58 am | Report abuse |
      • Jasper

        There's a spectrum. Some people identify as both or neither male/female, others changing between the two, and pretty much anything you can imagine =)

        June 25, 2013 at 8:45 am | Report abuse |
    • Wayne Fontana

      In Kyla's world, nothing is ever abnormal. If you're born with 8 legs, that's just a "variation" and JUST AS NORMAL as someone born with two legs. Yep. And if you're deaf, that's just an "auditory variation." It's BIGOTED to say there's anything wrong with that person's ears. Shame on you for even thinking such a hateful thing!!!!

      To be consistent, Kyla should work to repeal the Americans with Disabilities Act, because they're not disabled!!!! How offensive!!! Those quadriplegics are just a "variation", right Kyla??

      And then there are normal people who understand that abnormality exists in the world.

      December 28, 2012 at 9:32 am | Report abuse |
      • Know some stuff

        Thank you , Wayne

        December 28, 2012 at 9:48 am | Report abuse |
      • kyla

        wow.. so much stupidity in one place.. I am at a lose of words on the very stupid comment you just wrote.

        December 28, 2012 at 12:30 pm | Report abuse |
      • Fevrier Honnete

        Nailed it.

        March 18, 2013 at 1:46 pm | Report abuse |
    • Warbo

      Ah, but if we had to educate everyone about every illness in the world and to treat them like it's not an illness at all, we'd have far more material than we could cover in a K-12 education. You can't raise everyone to be doctor.

      June 12, 2013 at 3:22 pm | Report abuse |

    Sad to see this

    December 28, 2012 at 1:21 am | Report abuse |
  13. lovemygirl

    Wow, PC has got to go.
    To further an agenda and make people feel good they reclassify something. Sorry, if you are born a man or a woman that is what you are. Believing you are not a man nor a woman is no longer classified as a mental disorder, but it is nuts.

    December 28, 2012 at 12:51 am | Report abuse |
  14. SingAPsalm

    Steve, In fact I have met transgender people. You obviously didn't read my post thoroughly or misinterpreted it. I was criticizing CNN for posting the type of article that always have the readers going at each others throats instead of sharing opinions that are constructive. I don't know why you've chosen to insult me to defend CNN, but I find you offensive and pathetic, as well.

    December 27, 2012 at 10:01 pm | Report abuse |
    • iluvpurple

      Can't say I agree. CNN's only job is to inform. CNN can put any topic about transgender issues on their website and the same kind of replies will surface. Sadly, it's too be expected. Too many people are misinformed about our issues or have no clue what transgender means. The replies reflect that clearly.

      December 27, 2012 at 10:37 pm | Report abuse |
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