Wanted: New Word for Transgender

We need new words for what we do.

Most of them have come out of the heads of psychiatrists. They do some good work with people who have identifiable organic, biological problems. But you also know them, as the guys who diagnosed people as being mentally ill for all sorts of behaviors that culture deemed inappropriate. They followed the trendy ideas of the time to give transgender people aversion therapy (based on Pavlov’s dogs), operant conditioning and cognitive therapy (based on B.F. Skinner and his pecking pigeons), psychoanalysis (based on Freud’s sexualization of the unconscious), electric and insulin shock therapy (based on supposed dissociation of pathology and epilepsy), isolation, padded cells and imprisonment (getting people off the street so they were not visible to culture), and the “champagne” of horrible treatments, the prefrontal ice pick lobotomy to sever brain connections (based on behavioral changes after brain injuries). These unsuccessful treatments were all being practiced on transgender people while I was growing up and some even are in use today in the form of “reparative” treatments.

Psychiatry now currently focuses on drugs that affect the brain and therefore behavior (based on pharmaceutical research). Many of these drugs are blunt instruments which have undesirable side effects, but some provide actual help to some patients. The purveyors tinker with various drugs and dosages in treatment. At least these psychotropic drugs got people out of mental hospitals where the worst atrocities were committed. Some of these drugs have also been administered to transgender people in a futile attempts to “cure” them.

In the latter half of the 20^th Century the psychiatrists discovered children who violated gender behavior categories, and applied various operant conditioning and bullying tactics to prevent children from growing up gay or trans. As far as we know, all of these failed; some of these procedures undoubtedly inflicted physical and psychological damage.

I could go on, but psychiatry’s history is less than ethical and largely unsuccessful. They certainly have not followed the maxim of “first, do no harm.” And we use their words to describe transgender behavior? It is time to cut the cord.

The American Psychiatric Association keeps an iron hold on the Diagnostic and Statistical Manual of Mental Disorders. As I have told you, when they could no longer treat pre-homosexual kids because homosexuality had been dropped from the DSM, they treated them using billing codes which seem to be for transgender children, even though transgender kids did not present in the way described. When I was preparing my new book, The Handbook of Transgender Medicine and Health, which should come out in June, their professional organization would not let me use an image from the DSM-1, written in 1952. This, even though their copyright should have lapsed by 2008. (The passage is quoted below.)

They still negatively influence our reputation through the DSM but have been recently outflanked by the acceptance of the World Health Organization International Classification of Diseases (WHO-ICD) which this year put transitioning transgender treatments in the non-pathological sexual health section and deleted other categories like “gender identity disorder.” Enemies of being transgender, still take great delight in the DSM and it is the basis for current discrimination against transgender people in the military and elsewhere. It is time for all mention of being transgender to be expunged from the DSM.

When I was researching my forthcoming book, I respectfully requested their guidelines for transgender treatment from several of their officers and members. These requests were summarily dismissed as asking for proprietary information. All the other professional organizations serving transgender people openly publish such standards and guidelines: WPATH, American Psychological Association, American Academy of Pediatrics, The Endocrine Society and even the Royal College of Medicine. Why are similar psychiatric treatment documents and the DSM held as proprietary secret?

By now, you are probably saying “Dana, tell us what you really think.” Sorry about popping off that way but their track record is out there; read it for yourself; we should not forget it. I am sure that there are some well-meaning psychiatrists who sincerely want to help people with problems related to being transgender, but they should confine themselves to counseling without the psycho-babble claptrap and the damaging treatments.

So, we are really going to continue to use words from these guys to describe our behavior and our demographic and social groups? We need new words.

The WPATH Standards of Care Version 7 gives us some hope. It defines being transgender as “non-stereotypical gender behavior.” (NSGBP). But plopped into this definition is the old psychiatric catch phrase of “including gender identity.” Yikes! That phrase comes from Freud, Erikson, Richard Green (all psychiatrists) and was used to pathologize people as “gender identity disorder” starting with in the DSM-III in 1980. By the way, Richard Green recently passed away and it was interesting to see how he was treated in his obituaries. Although he was a supporter of same-sex marriage, he also advocated for gender change procedures (reparative “therapy”) on children and practiced them. Yesterday was Mothers’ Day and my momma always told me not to speak ill of the dead but I am just stating some of the facts. Transgender people are doing their best to redefine and de-pathologize such terms as “gender identity” and “gender dysphoria” and even “transgender.” itself, but our enemies are using these terms to pathologize us.

The WPATH definition of NSGBP does seem to indicate that gender behavior norms are culturally derived and stereotyped by people and culture, not derived from biology. That is some progress.

Still NSGBP is unwieldy; we need a new term. Crossdresser won’t exactly work for everyone because it is used to self-refer to those whose congruent gender is the same as that assigned at birth but such people feel moved to express themselves in the other gender category as well without claiming its congruency. Bigender won’t work because some of us only practice one gender which just happens to be the one which we were not assigned at birth according to cisgender cultural rules based on sex assigned at birth. Gender fluid does not work as an umbrella term because some of us actually settle on a gender, just not the one prescribed by cisgender culture. Genderqueer might work, but it brings sexual orientation into the definition; I think we want to confine ourselves to gender behavior. Gender Deviant might work mathematically but it has a lot of connotative pathological and negative baggage starting with the DSM-1 category in 1952:

000-x63 Sexual Deviation

This diagnosis is reserved for deviant sexuality which is not symptomatic of more extensive syndromes, such as schizophrenic and obsessional reactions. The term includes most of the cases formerly classed as “psychopathic personality with pathological sexuality.” The diagnosis will specify the type of the pathological behavior, such as homosexuality, transvestism, pedophilia, fetishism and sexual sadism (including rape, sexual assault, mutilation).

You may know that homosexuality and even BDSM (bondage, discipline, sadism and masochism) are no longer pathological categories in the DSM but being transgender remains. Gender Non-Conformity is already a pathological term, so that is out. Gender Diversity is already used in the debates over sex differences of salaries and the glass ceiling, so that would be confusing. Another case of conflating sex and gender. Because of her book, Kate Bornstein probably would support Gender Outlaw which might work; it certainly fits, but may not encourage cultural rapprochement and change.

So, my current pick for an umbrella term, is Gender Distinctive. The first dictionary definition of distinctive is “marking as separate or different” and we are certainly different. And with the second definition “having or giving an uncommon and appealing quality, we get a little positivity after all those years of dark pathology. With a little work, all of the above discarded words, and some more, would fit under this umbrella as self-selected categories of gender distinctives and the pathological terms could gradually fade away.

Of course, WPATH would have to drop transgender from its title, but it has changed its name before. The World Professional Association for the Health of Gender Distinctive People is a little awkward but so was its previous name until 2007, the Harry Benjamin International Gender Dysphoria Association (HBIGDA).

I have written about Louise Lawrence, a gender distinctive woman back in the 1960s who set us on our medical and advocacy paths by helping Harry Benjamin, Virginia Prince, San Francisco transgender community organizers, UCSF Medical Center, and others. The Louise Lawrence International Professional Association for Gender Health. It has a nice ring, but it does not make for a good acronym or initialism (but neither did the previous titles.) Unfortunately, very few people have bothered to learn about the history of gender distinctive people and do not know who Louise Lawrence was. If we are actually going to have a gender distinctive movement, we will need to recapture that history and rally behind a new name. We are a diverse lot, having only about 25 genes in common out of about 20,000 so any movement would be tenuous but we may need to pursue one.

So, what do you think. What is a good umbrella term for us non-stereotypical gender behavior people? Do you like gender distinctive?

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Tags: featured, Identity, opinion, Transgender

Category: Transgender Opinion