Abstract

The Workgroup on Sexual and Gender Identity Disorders, chaired by Kenneth J. Zucker, was employed by the American Psychiatric Association to update the DSM-5’s diagnoses surrounding gender and sexual disorders, if warranted by the scientific evidence. In this article, I introduce some of the political developments surrounding the diagnostic changes for transpeople who pursue gender transitions through medical technologies under psychiatric care in gender identity clinics. According to pre-publication reports and commentaries leading up to the new diagnosis, members of the Workgroup suggested that their aims were to reduce the stigma surrounding transpeople, while proposing a diagnosis that third party funders will accept for issuing payments for transitioning treatments. Against the backdrop of the sexological portrayal of Gender Dysphoria as a sense of unease or distress about one’s (original) gender, I will explore the claims made by trans advocates in the anti-pathologization movement who argue for future healthcare pathways for transpeople to move beyond the influence of psychiatric diagnoses. To explore this challenge, I will analyze some of the international representational work that trans advocates are undertaking to counter the negativity attached to trans embodiment in medical discourse. I will show through an analysis of anti-pathologization advocates’ websites, forums, and blogs that they hope for a complete removal of their transitioning desires from any mental disorder framework. They argue that the semantic change from GID to Gender Dysphoria in the DSM-5 will not lessen the perceived harms done by what they term psychiatric pathologization and its related stigmatization. One arm of the movement’s online materials cast trans identities within a biogenetic framework, or as an intersex condition, which I will critique as essentializing and problematic. The other arm of the movement describe a self-determination and human rights model. I will then illustrate how more progressive jurisdictions beyond the North American borders have removed the role of psychiatry from healthcare pathways and legal recognition.