04 December 2012

What The DSM-V Won't, And Can't, Address

Yesterday I discussed, briefly, the possible implications and effects of removing "transgender" from the list of mental disorders for the upcoming DSM-V.

As I mentioned, this de-classification of us as mentally ill may not turn out to be an entirely good thing unless other changes are made.  In the post, I talked about the fact that some medical and psychiatric care is available to us on the premise that our identity is a "disorder". The good news is that while changing such a circumstance won't be easy, it can at least be done through a few very specific actions, such as changing some health care, governmental and insurance policies.

On the other hand, there's another problem that will take longer and could prove even more difficult:  changing the attitudes of some health professionals and others on whom we depend.  While efforts to educate them about homosexuality have eliminated or lessened at least some of the homophobia found among such professionals, there is still some bigotry against non-heterosexual people.  And, where there's homophobia, there's usually even more transphobia.

Fortuanately for me, I have not experienced transphobia from health care professionals since the time, early in my transition, a group of nurses at the New York Eye and Ear Infirmary mocked me when I came in for an appointment.  I was ready to walk out and file a complaint when the doctor with whom I had the appointment walked in, apologized for the nurses' behavior and treated me with courtesy and respect.  While that incident turned out well and I have not had difficulty with health care professionals since then, many other trans people are not so fortunate.

As an example, a trans man I know told me about an LGBT health fair he attended.  One of the presenters was a doctor with a large number of transgender patients.  In fact, he was my first doctor when I started my transition.  According to this friend--and others who attended that fair--this doctor disparagingly compared trans people to Michael Jackson and even said, in essence, that there's not much that can be done to help trans people; all anyone can do is to medicate them.

Now, if a doctor with transgender patients can make such comments, you can only imagine how much transphobia still exists, even if it's less openly expressed.  It can be mitigated, of course, through education:  Some aspiring doctors are learning about trans issues as part of their training.  Others are doing residencies or internships with clinics and other institutions that serve large numbers of LGBT people.  And, of course, some experienced doctors and nurses are open to change, or weren't bigoted to begin with.  But while I am confident that others  can and will change, de-classifying us in the DSM-V won't be enough.