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Posts for May, 2008

Transgender Advocates’ Statements on APA DSM Workgroups

Jim Burroway

May 30th, 2008

The American Psychiatric Association has convened several panels to discuss revisions to the Diagnostics and Statistical Manual (DSM), which is currently in its fourth edition (DSM-IV). It’s a standard practice for the APA to revise the manual every decade or so in order to incorporate knowledge generated by more current research.

The APA has begun the work of compiling the data for DSM-V, and that process has sparked several strange rumors around the Internet that really didn’t ring true with me. According to a few of these rumors, the American Psychiatric Association (APA) is poised to either reinstate homosexuality in the Diagnostics and Statistical Manual (DSM), or that the APA was going to decide to approve of sexual reorientation therapy. There is nothing however to suggest that anything like that will be happening.

But most of these rumors surround the diagnosis of Gender Identity Disorder (GID), which is of particular interest to the transgender community. These rumors are centered around two researchers who have been appointed to some of the working groups: Kenneth Zucker, who chairs the Sexual and Gender Identity Disorders work group, and Ray Blanchard, who chairs the Paraphilias subworkgroup under Zucker.

To understand transgender people’s concern about these two appointments, some background is in order. Kenneth Zucker and Ray Blanchard are associated with the Centre for Addiction and Mental Health in Toronto, Canada. This center resulted from the merger of four mental health centers, one of which was the Clarke Institute of Psychiatry. The Clarke Institute was the referral agency for transgender clients who wanted to surgically transition.

Many transgender clients found their treatment in the hands of the Clarke Institute degrading and offensive, feelings which were greatly magnified by the Institute’s main mission of treating sex offenders. Transgender clients often describe inappropriate and degrading tests and experiences at the institute. In fact, feelings run so deeply about the Clarke Institute that some transgender advocates have dubbed it “Jurassic Clarke.”, while others append the adjective “notorious” in front of the Institute’s name so routinely that one might be tempted to think that its official name was “The Notorious Clarke Institute.”

Because of the Clarke Institute’s history, virtually anything emanating from the Centre for Addiction and Mental Health is suspect among the transgender community, and those suspicions often radiate to the rest of the LGBT community.

Associations with the Clarke Institute however isn’t the only source of transgender advocates’ concerns. Also controversial are some of Blanchard’s theories on MtF transgender etiology that he calls “autogynephilia,”which many people find deeply offensive and off the mark. (Blanchard, on the other hand, is a leading researcher into what he believes to be the biological causes of male homosexuality.) Also controversial is Zucker’s approach to treating transgender clients, which involves counseling the client to take on behaviors and attitudes which are considered to be more socially appropriate to that person’s biological sex. This is an approach which raises alarm bells among gays and lesbians who recognize the parallels to sexual reorientation therapies, which may be the source of the rumors concerning homosexuality and sexual reorientation therapy that I mentioned earlier.

Today, we have a statement from four Transgender advocacy groups, which will hopefully provide some clarification on Zucker’s and Blanchard’s role in the DSM-V revision.


Statement from:

National Center for Transgender Equality (NCTE)
Transgender Law and Policy Institute (TLPI)
Transgender Law Center (TLC)
Transgender Youth Family Allies (TYFA)

On May 1, 2008, the American Psychiatric Association (APA) announced the composition of work groups to review scientific advances and research-based information to develop the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The composition and scope of the work group on Sexual and Gender Identity Disorders and two subgroups are of great interest to transgender people and therefore to our organizations.

Though no consensus exists among transgender people about whether and how a GID diagnosis should be in the DSM-V, there is certainly agreement that decisions made by the APA about transgender and gender non-conforming people will deeply affect the lives of millions of transgender adults, adolescents and children.

We have met with and strongly encouraged the APA to closely adhere to its stated commitment to scientific process regarding diagnosis of transgender people. We are confident that a fair, unbiased review of current knowledge can result in a DSM-V that can move society toward a more rational and humane understanding of transgender people.

We encourage our transgender brothers and sisters to approach this issue with thoughtful consideration of all available information. To that end, we encourage transgender people and allies to remember that:

The naming of this working group on May 1 was not the commencement of advocacy around rethinking or revision of the GID diagnosis. Thoughtful advocates, within and without the APA, have been working on this issue for several years and they will continue to do so for several more, through at least 2012 when the DSM-V is finalized. We look forward to strengthening our relationships and positive communication channels with the many APA-affiliated professionals who are knowledgeable and understanding of transgender issues.

It is inconceivable that in the 21st century any credible scientist or medical professional would recommend any discredited treatment that would attempt to change a person’s core gender identity or sexual orientation. Such treatments have no empirical basis and are harmful. Importantly though, the DSM consists of diagnoses and not treatments. As such, the DSM-V will not offer any treatment recommendations for transgender people of any age.

The APA has created several mechanisms for thoughtful input into the DSM revision process from mental health professionals as well as laypeople affected by the DSM. We encourage transgender people and allies, especially mental health professionals, to utilize these systems to appropriately impact the process. In particular the APA has created a website through which written comments can be submitted. Additionally, as the DSM-V development process advances, working groups are charged with seeking the counsel and input of various advisers who will be selected from various clinicians, academics and other stakeholders. We will advocate for the inclusion of fair-minded advisors who are committed to providing only scientific, fair, reasonable and humane input. We are hopeful that these systems will help provide sufficient information to assure a fair and scientific process for the creation of the DSM-V.

Public acceptance of transgender people and anti-discrimination protections have been advancing swiftly. This is in large part due to scientific and medical advances, but also to the assertive, vigilant and intelligent activism of thousands of transgender people and our allies. While transgender people’s history with the psychiatric and medical professions has been, at times, fraught with misunderstanding and tainted by bigotry, we are optimistic that current and developing scientific research and clinical data will further the understanding of transgender issues among health care professionals and the public.

National Center for Transgender Equality (NCTE)
www.nctequality.org

Transgender Law and Policy Institute (TLPI)
www.transgenderlaw.org

Transgender Law Center (TLC)
www.transgenderlawcenter.org

Transgender Youth Family Allies (TYFA)
www.imatyfa.org

Gay Groups Ask for Leniency in Lawrence King Murder

Jim Burroway

April 15th, 2008

Lawrence KingA coalition of 27 LGBT activist organizations is urging the Ventura County, California District Attorney to charge 14-year old Brandon McInerney, Lawrence King’s murderer, as a juvenile. McInerney shot King, 15, point blank in the head on February 12th at E.O. Green Junior High School in Oxnard, California. With hate crime enhancements, McInerney faces up to 27 years in prison if he is charged as an adult. But citing an overall “climate of intolerance and fear about sexual orientation and expression,” the coalition feels that prosecuting McInerney as an adult would “compound this tragedy with another wrong.”

The press release, which is not yet available online, reads:

A coalition of 27 groups fighting for lesbian, gay, bisexual and transgender rights today is urging Ventura County prosecutors to try 14-year-old Brandon McInerney in juvenile court, and not as an adult. McInerney has been charged as an adult in the February 12 murder of his E.O. Green Middle School classmate, 15-year-old Lawrence King. Students say McInerney targeted King because the victim was openly gay and because he wore women’s jewellery and makeup.

LGBT civil rights organizations, including Lambda Legal, the National Center for Lesbian Rights, and the Transgender Law Center, have delivered a short statement to Ventura County District Attorney Gregory D. Totten, calling on him to try McInerney as a juvenile.

“We are saddened and outraged by the murder of junior high school student Lawrence King,” the statement reads. “At the same time, we call on prosecutors not to compound this tragedy with another wrong “we call on them to treat the suspect as a juvenile, not as an adult.

“The facts in this matter seem clear: one boy killed another in a climate of intolerance and fear about sexual orientation and gender expression. The alleged perpetrator, who turned 14 years old less than three weeks before the shooting, should be held accountable for his actions. But we support the principles underlying our juvenile justice system that treat children differently than adults and provide greater hope and opportunity for rehabilitation. In addition, public safety is not served by treating children as adults. According to research released by the Centers for Disease Control in 2006, children transferred to adult court are more likely to re-offend than those committing similar offenses who remain in the juvenile justice system. California law does not require District Attorneys to prosecute 14 year-olds as adults, even in circumstances such as these, and we oppose them doing so. We are issuing this joint statement because we believe so strongly in principles of justice that protect all our young people and know that, even in the face of strong emotions, we should not abandon them. We refuse to let our sense of outrage blind us to the fact that the suspect is only 14 years old.

“Prosecuting the alleged perpetrator as an adult will not bring Lawrence King back nor will it make schools safer for LGBT youth. We must respond to this tragedy by strengthening our resolve to change the climate in schools, eliminate bigotry based on sexual orientation, gender identity or expression and hold schools responsible for protecting students against discrimination and physical harm.”

The list of signatories include: American Civil Liberties Union of Northern California; American Civil Liberties Union of San Diego and Imperial Counties; American Civil Liberties Union of Southern California; Ally Action (CA); Children of Lesbians and Gays Everywhere (COLAGE; national); Community United Against Violence (San Francisco); Different Avenues (DC); Equality California; Gay Straight Alliance Network (CA); Gay & Lesbian Advocates & Defenders (GLAD); Human Rights Campaign; LAGAI – Queer Insurrection; Lambda Legal; LifeWorks Mentoring (Los Angeles); Los Angeles Gay and Lesbian Center; National Black Justice Coalition; National Center for Lesbian Rights; National Center for Transgender Equality; National Gay and Lesbian Task Force; Parents, Families and Friends of Lesbians and Gays (PFLAG) National; Safe Schools Coalition; San Francisco LGBT Community Center; Sylvia Rivera Law Project (New York); TGI Justice Project (CA); Transgender Law Center; The Lesbian, Gay, Bisexual & Transgender Community Center (NY); TransYouth Family Allies, Inc.