Essay on "Homosexuality Demedicalization of the Gender Identity Disorder"

Essay 6 pages (1703 words) Sources: 1

[EXCERPT] . . . .

Homosexuality

Demedicalization of the Gender Identity Disorder

Gender identity is a highly controversial subject. The notion that one's gender is a significant determination of personality traits, behavioral characteristics, social tendencies, romantic engagements and self-perception is a critical one. However, it is also subject to debate because of the imperatives created by the social construct of gender. This often clashes with what are, in reality, more nuanced and individualized connections to gender. The divergence between social norms on gender orientation and the actual spectrum of gender orientations that individuals experience in reality may cause some dissonance as a consequence of social or cultural pressures. The result is that, historically, the medial and psychiatric communities have conflated homosexuality and Gender Identity Disorder (GID) with medical conditions to be treated and cured.

Today, we recognize that this is not only an inaccurate way of understanding gender identity differences but also that it gives the medical and psychiatric communities and distinct set of prejudices in treating those of non-normative gender or sexual orientation. Indeed, the discussion on gender orientation differences continues to evolve along many of the same lines that helped ultimately remove homosexuality as a diagnosis of pathology form the Diagnostic and Statistical Manual of Mental Disorders (DSM). This is highlighted in particular by the release of the DSM-V, which amongst the many updates that will be made from its predecessor, will include a replacement of the GID diagnosis with a more progressive and nuanced diagnosis of Gender Dysphoria. As the discussion hereafter will show, this step of demedicalization is an important one that offers support to individuals with non-normative sexual and gender orientation without imposes the social and cultural stigmas that have historically followed such diagnoses.

Discussion:

Today, an extensive amount of debate has centered on the issuance of the GID diagnosis. Often affixed to children at young ages, the diagnosis, according to the article by Conrad & Angell, was added to the DSM-III upon its inception in 1980. The decisions to add this diagnosis was informed by the notion that certain transgendered paths of development are accompanied by emotional and cognitive differences. However, consistent with the history of medical assessment of gender-orientation differences, this approach reveals an undercurrent of prejudice in the medical community and, even more destructively, helps to reinforce broader sociological prejudices. According to Conrad & Angell, "the current debate relating to the etiology of homosexuality turns on the diagnosis of children and research claims that the majority of children treated for GID grow up to be gay or bisexual as adults. Opponents of the diagnosis claim that the disorder is medicalizing the normal development of gays and lesbians." (p. 34)

In considering the debate at hand, this position should be seen as an important one. The center of the conflict over the medicalization, demedicalization and remedicalization of non-normative gender and sexual orientations is not, as advocates of medicalization would argue, a medical issue. Instead, it is civil rights issue directly connected to today's struggles for marriage and military rights, among others. The push for equal protection and treatment of those with non-normative gender and sexual orientation includes the long-standing tug-of-war over medical perceptions. As critics of the GID diagnosis, especially in younger subjects, argue, the notion of 'treating' homosexuality or transgendered orientation defies the increasing consensus understanding that such orientation is not a choice but a genetic predisposition. By seeking to 'treat' those with this inborn disposition, the medical community poses a terrible risk to the mental health, social adjustment and self-image of those who are homosexual or transgendered.

Ironically, the text by Conrad & Angell does also point out that the growing acceptance of the genetic explanation for gender disorder or homosexuality may actually have the impact of increasing efforts at medicalization. The genetic explanation provides those with an interest in addressing homosexuality or gender orientation differences as a 'problem' with a treatment target. Accordingly, the text points out that "while the 'gay gene' is scientifically tentative, it has achieved broad public dissemination. Should a valid and verifiable gene for sexual orientation be identified, there might be considerable pressure in some quarters for genetic testing, which could engender increased medicalization of the condition. Such testing might lead to the termination of pregnancies or, if ever available, genetic therapies for the 'disorder.'" (Conrad & Angell, p. 37)

This reveals that even in the context of an objective discussion on genetic predisposition, prejudices regarding sexuality and gender orientation differences have a substantial impact on how associated pathologies such as Sexually Transmitted Diseases or socially-enforced emotionally disturbances are treated. Such is to say that medicalization of homosexuality is akin to condemnation of the same.

This argument is supported in the text by Bryant (2006), which offers a history on the DSM classification of Gender Identity Disorder with a focus on its diagnosis with children. (GIDC). According to Bryant, "critics inside and outside of the mental health professions have called for the removal or revision of GIDC, arguing that it has served to pathologize homosexuality, to enforce normative notions of masculinity and femininity, and to recast a social problem as individual pathology." (p. 23)

Here, we can begin to see how the language used by the medical community can have a direct and destructive impact on the way that individuals subjects endure the early stages of personal development. That said, the Bryant article also offers some balance on the subject, illustrating that the purpose of medicalizing such conditions is not, by itself, naturally predisposed to prejudice. To the contrary, today's discourse is truly focused on finding ways to provide target medical and therapeutic support to a distinctive demographic cross-section. The proof that this is truly the intended purpose underlying the medicalization of homosexuality is found in the current thrust toward improving the terminology surrounding the issue.

Such is to say that today, as the cultural and sociological understanding and acceptance of Gender Identity differences expands, so too does the language used to assess it achieve a certain evolution. The release of the DSM-V and its attendant alteration of the GID diagnosis is especially demonstrative of this evolutionary thrust in perspective. According to an article by Moran (2013), the update of the catalogue for existing medical and therapeutic conditions will take another step toward demedicalizing gender-orientation differences in an of themselves. Moran reports that "new criteria for gender dysphoria will emphasize the individual's felt sense of "incongruence" with natal gender, rather than cross-gender behavior. This article is part of a series on the differences between DSM-IV and DSM-5. The series will run through May, when the manual will be published. Gender dysphoria is a new diagnostic class in DSM-5 -- and a chapter unto itself -- replacing the DSM-IV diagnosis of gender identity disorder and reflecting a new conceptualization of individuals who seek treatment for problems related to gender." (Moran, p. 1)

As we can see, the approach here is designed not to treat the gender-orientation difference but to recognize the associated medical and psychological conditions that frequently associate with individuals of this disposition. This allows for treatment of the social adjustment and emotional dissonance that may be bred of personal confusion or cultural pressure, rather than a destructive attempt to train these differences out of an individual. This approach is supported by existing empirical research. For instance, according to Pheil & Pheil (2005), gender identity disorders are those which stem not from the sociological pressures of conforming to certain gender traits but, instead from an internal sense or incorrect gender assignment. As Pheil & Pheil indicate, "this cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex. There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex" (Pheil & Pheil. 1)

This helps to shift the focus of treatment on the individual's emotional struggles with gender orientation rather than to inflame these feelings of disorder. According to the article by Conrad & Angell, it may also be suggested that these changes are sharing a reciprocal relationship with the cultural perspective on differences of sexual and gender orientation. In their perception, the process of demedicalization has been a steady and encouraging one, suggesting an ever-growing appreciation amongst members of the public of the issue's relevance to civil rights, as opposed to public health.

This, in turn, has allowed for a greater balance in truly addressing the public health issues that may be associated with the specific demographic. According to Conrad & Angell, "although an increasing number of life problems have entered psychiatric jurisdiction in the past three decades, the demedicalization of homosexu- ality remains stable. The rise of the genetic paradigm and the enormous research apparatus it has spawned, makes it likely that small genetic differences will be defined as evidence of biomedical disorders." (p. 39)

Conclusion:

Here, the authors reach the same conclusion that is reached by this discussion. Namely, they pose the argument that the improved rationality of… READ MORE

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