Tuesday, February 16, 2010

The year of the pathological T (Part 1)

Woman and tiger

I am not sure if this new year became any more auspicious, at least for the Chinese, with Valentine’s Day coinciding with the arrival of the Year of the Tiger (see pic above). Chinese astrologers I heard on TV, however, said that this will not be a good year for relationships. The same feng shui experts reassured people that what they say is merely a prediction based on horoscope analysis, numerology and whatnot. One’s destiny will still clearly be in one’s hands. So those who are romantically involved this year will be able to avoid break-ups and end-of-affair scenarios by simply working hard on their relationships.

Talking about relationships, there is one that I think is in need of a full divorce: transsexualism and its pathological version in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) also known as Gender Identity Disorder (GID). GID was first introduced in the DSM III in 1980, a good seven years after homosexuality was removed from the APA manual. Ever since, transgender advocacy groups have been fighting to get GID taken off the DSM and transsexualism out of the International Classification of Diseases (ICD) of the World Health Organization (WHO). While there are rumors that the WHO will reclassify transsexualism (from a mental to a medical condition) when it publishes ICD 11 in 2014, the APA came out with proposed revisions (PR) to GID, on 10 February 2010, making it clear that the fight to depathologize transsexual identity is far from over.

Rereading the PR, I just realized, being a student and teacher of language, that the new version of GID, which will be called Gender Incongruence (GI) in the DSM 5 slated to come out in 2013, is actually an exercise in linguistic trickery. The PR is below:

Gender Incongruence (in Adolescents or Adults)
A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2 or more of the following indicators:
1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics)
2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
3. a strong desire for the primary and/or secondary sex characteristics of the other gender
4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)
6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)

Subtypes
With a disorder of sex development
Without a disorder of sex development


According to the Workgroup tasked to revise the Sexual and Gender Identity Disorders section of the DSM, on the strength of A alone, a GI diagnosis can be made. On first blush, the PR seems actually like an homage to the last 30 years of transgender rights advocacy because it recognizes the stigma attached to the word disorder which many trans people have been fighting against and so therefore eliminates. It also recognizes the problems that a birth-assigned sex can pose to people especially those who will reject and abandon it, partially or completely, later in life. Lastly, the PR recognizes that gender can no longer be viewed as a binary system. Instead it is a spectrum and a person can actually identify as male, female, in-between or otherwise—a reality that trans advocates have been calling people’s attention to all these years.

But at the same time that the PR accommodates the logics of transgender advocacy, it also suggests the possibility of a clinical syndrome, in this case GI, being attributed to people who fight their gender demons by wearing the clothing of the gender not assigned to them (i.e., crossdressers) or people who reject the binary system (i.e., genderqueers) or those who altogether identify as a gender not assigned to them (i.e., transsexuals). GI here becomes, in fact, the pathological version of transgender.

I hope I am mistaken in my analysis. If not then at least there is some hope, for the PR also gives potentially GI people a way out by using a phrase that we, transgender rights activists, have all been rallying against: the tyranny of our assigned gender. The Workgroup assumes that gender, in the first place, must be assigned. And this is usually the province of medicine and the law. Doctors declare that a baby is either a boy or a girl and the law notes by recording the declaration in the baby’s medical records and birth certificate. This is why the struggle for transgender/transsexual rights have revolved mostly around amending the original gender assignment (and therefore name) in legal documents because our identities are anything but that. This is also why many of us have been calling for the eradication of gender markers in our identity papers knowing full well the oppression that those markers can bring to those who outwardly do not match them.

This latter rallying cry reflects what Phyllis Frye, long-time trans activist, said about the birth-assigned sex being merely predictive. Your assigned gender may or may not be your destiny. With gender issues intersecting with racial, economic, cultural, social, and political issues, the issue of gender assignment at birth is something that has become peripheral in the struggle for transgender human rights. With the imminent publication of the DSM 5, it is probably something that needs to be revisited and be placed front and center in our advocacy work, something along the lines of: STOP GENDER ASSIGNMENT AT BIRTH NOW!!!

In my last talk at the University of Santo Tomas (UST), the oldest Catholic University in the Philippines, with freshman Nursing students, I told them that in the future when they become Nurses, knowing the struggles that transsexual people have with their assigned gender, I hope that when they bring a newborn baby into this world, they will refrain from reflexively giving it a gender. Instead of saying It’s a boy or It’s a girl, they should just say that It’s a baby. The class laughed but I hope they did not miss the premise of my joke: that assigning a gender to someone is an issue of power.

In the first place, the new born is not consulted on the matter. In the second place, the act of assigning a person a gender at birth in fact compels that baby to embody that gender later in life. Transgender people are proof that not all people can or want to do so. So the solution to trans people’s problem seems so simple after all as the impending version of the DSM demonstrates. We must simply stop assigning newborn babies a gender. We should also start teaching people to raise children in gender-neutral ways. For if no gender assignment is done at birth, then how can people experience gender incongruence?

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