"Transvestic Disorder"

It gets worse.  According to the DSM, crossdressers are sexual perverts with "transvestic disorder", which can be found in the Paraphilia section.  Paraphilia means sexual deviant -- someone who experiences sexual arousal when they shouldn't (or, at least, when a Normal Person wouldn't.)  Supposedly, crossdressers are people who become sexually aroused when they put on women's clothes (so-called autogynephilia.)  Most protest that lust has nothing to do with their dressing.  ...But that only makes them twice as dangerous, because they're repressed perverts.

The critical fact is that people with paraphilias go to jail.  They're registered as sex offenders.  They can't be around children.  Involuntary castration is a common treatment.  Crossdressing might seem to be harmless, but "experts" warn that there's a dangerous overlap with voyeurism, beastiality and pedophilia.  ...If you have one, you might have them all.  Society must keep that potential criminal on a short leash, just in case.  

This pervert myth has been used to justify Potty Laws.

Psychiatrists are willing to allow crossdressers the occasional indulgence.  But the moment crossdressing begins to affect an individual's life, then they're overcome by uncontrollable transvestic disorder.   They might as well be put away forever.

Involuntary outing is the most likely way of suddenly losing family and job.   The diagnosis of transvestism adds insult to injury.  Researchers have used these incidents to "prove" that crossdressers are incapable of forming close relationships or holding a steady job. 

For a sample of the advice commonly given, see HERE.

In practice, the diagnosis of Transvestic Disorder is rarely given, despite the relatively high prevalence of crossdressing.  Apparently there's a limit to the cruelty of the average psychiatrist.

Psychiatry's DSM:

They're out to get you.

A Short History of the DSM

The DSM dates back to World War II, when America faced a crisis of epic proportions.

The worry wasn't about how to build over 600,000 airplanes, 2300 ships and almost 5 million machine guns -- that part was a piece of cake.  The insurmountable hurdle was how to draft over 8 million men without including any gays.  That essential wartime task was assigned to Dr William Menninger of Topeka, Kansas.  The good psychiatrist was perfect for the job:   He was a devout Catholic, and he believed that mental illness was a sign of demonic possession.

The resulting work was Medical Manual 203, a list of the mental disorders that disqualified a person from military service.  ...In other words, It was a handbook for detecting gay recruits.  A person was disqualified if they looked gay.  Or if they acted gay.  Or if they visited public bathhouses or worked for "gay businesses" (such as art, music or film). ...Or if they did anything else that might be part of someone's gay stereotype.

It worked, too.  Defended by a few good psychiatrists, America crushed the fascist ambitions to achieve ethnic purity.

Remember that Psychiatry's founding fathers (Freud, et al) revered transsexuals as the poster children of normality.  In fact, the eminent Carl Jung (1875 - 1961) taught that everyone had both a male & female side (animus & anima) -- a gender spectrum.  An important lifetime goal is for each person to find & accept both sides -- that is, transition in accordance with their innate transsexuality.  But Medical Manual 203 didn't have roots in psychiatry, it traced its roots back to the Moral Reform Movements of the 19th century. 

After the war, Dr Menninger collaborated with another leading psychiatrist, Donald Cameron, to use eugenics (ie, selective breeding) to eliminate the pathological uncontrollable aggression that was supposedly a part of the German genome.  A byproduct of Dr Cameron's research was refining methods of forcing simple minds to bend to the will of superior minds -- now known as "enhanced interrogation techniques" (sleep deprivation, isolation, waterboarding, etc -- in other words, torture.)

Dr Cameron's work in social coercion & conformity led to his election as president of the American Psychiatric Association in 1952.  ...Just as the rapidly expanding medical insurance industry needed assistance:  Insurance adjusters needed an official list of mental illnesses to simplify the processing of insurance claims.   President Cameron contacted his good friend Dr Menninger:  Medical Manual 203 became the first edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM)

The detection and elimination of "homosexuality" still formed the core of the new manual.   As a result, being gay was an official mental disorder for 32 years -- between 1941 and 1973.  ...Until Dr Evelyn Hooker did the unthinkable:  She actually tested a large sample of gays, searching for any detectable defect in judgement or mental processing.  It's no surprise that she found that gays were no different from the rest of the population.

A vote was taken during the 1973 APA Annual Conference.  It was decided that being gay wasn't a mental disorder after all.

Fundamentalist psychiatrists were incensed by the outcome.  Until they remembered that effeminate gays were the people they really hated.  -- In other words, transsexuals were the Real Enemy.  Transsexuals didn't have a mental illness before 1973 -- they weren't mentioned in the original DSM.  But after 1973, all transsexuals around the world suddenly came down with "Gender Identity Disorder". 

Ever since, transsexuals have lobbying for another vote.  They want to stop being mentally ill, just like the gays were.  Unfortunately, too many people benefit from transsexual inclusion in the DSM.  The designation certainly justifies medical, religious and political bigotry.  But even supposed allies work to keep the diagnosis:

          -- They mislead the transsexual community with fables about the DSM being the only way to access medical care.  In reality, the DSM prevents access to medical care by appointing psychiatric gatekeepers, and because mental illness is a protected exclusion from insurance. 

          --  Most medical authorities are fully aware of the injury done by the DSM, but at the same time serve on the very committees that establish the bigotry.  (See HERE)

             --  Most advocacy groups need transsexuals to be mentally ill in order to maintain their own gender mythology.

                                          Cassandra Branch MD

Business Model

The Diagnostic & Statistical Manual of Mental Disorders (DSM) is an insurance coding book published by the American Psychiatric Association (APA). In order to get a payment from any health insurance company, it's necessary to provide the official code number that can only be found in the book.  The copyright is closely guarded: no one is allowed to publicly disclose even small snippets.  It's not possible to operate a medical office, clinic or hospital without having multiple copies of the book.

In addition, the book undergoes periodic updates and revisions.  In the middle of 2013, every health care professional in the world paid another $120 to get the latest release, DSM-5.  It's a major cash cow for the APA, bringing in over $5 million a year.

"Gender Dysphoria"

Earlier editions called transsexuality "Gender Identity Disorder" (GID).  Advocates complained about the word "disorder", so  the name was changed to "Gender Dysphoria".  However, the diagnostic criteria remained the same.  It used to be categorized under Personality Disorders, but now it's has its own category.     Supposedly, that's progress.  

In Greek, dysphoria means "unhappy".  Therefore, a person with "Gender Dysphoria" would be "unhappy about their gender".  In psychobabble, dysphoria only counts when it's ruining a person's life.  It's possible to be a little bit unhappy about gender and still come under the wire as "normal".  But the moment a trans person is fired from their job or sued for divorce, they become "abnormal".

The following are the official diagnostic criteria:

          -- A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)

          -- A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)

        -- 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)

                                     ENTRY:  Gender Dysphoria, DSM-5  (2013)

"Gender Dysphoria" proclaims that a transsexual woman is Really a Man, but she hates being a man (that is, she has "dysphoria" about her gender.)  So she "desires" to be a woman instead, and she "claims" that she has feminine personality traits (ie, female gender), while she actually has male personality traits. 

          --  She's Really a Man because she has a penis.

          --  Not only that, but the doctor in the delivery room ordered her to be a man ("assigned gender").

          --  Supposedly transsexuality is a "desire" -- a choice, a wish or a whim.  It's not a need or compulsion.  It has no more basis in reality than a strong desire to have a million dollars.

          --  Supposedly, her innate gifts, challenges, interests, values and perceptions are Really Male, but she mistakenly believes that they're female.

Since psychiatric diagnosis is Really a Game, there's no need validate these assumptions.  The fact that intersex females are often born with a penis doesn't matter.  It seems that the assumption about personality traits would be easy to evaluate through personality testing.   But data would only get in the way.


By the way, transsexuals have never been shown to have characteristic defects in perception, judgement, mental processing, or anything else that might suggest a valid mental problem.

"Political Convenience"

Currently, few people actually believe that transsexuality is a mental illness.   In fact, there's a growing movement to vote it out of the DSM.  APA leaders justify keeping the fiction alive so that providers can get insurance reimbursement.

Of course, that argument is silly.  Since transsexuality results from a problem in brain-sex determination during the first few weeks of gestation, a medical diagnosis from the ICD-10 Intersex section would be far more appropriate (eg, Q52 [female] or Q55 [male]) 

The truth is, having a mental illness diagnosis from the DSM increases the cost of care while preventing reimbursement, because insurance plans strictly limit access to mental health care.  Insurance plans balk at treating a mental disorder with hormones & surgery.  Whereas it's expected that an intersex condition would be treated with hormones & surgery.

A Coding Book

Strictly speaking, the DSM is nothing more than a coding book.  It provides the numbers that are written on insurance forms to get reimbursement for medical visits.  This is how the process is supposed to work:

(1)  A healthcare provider finds out the patient's symptoms and history.  A physical exam is done and various tests are performed in order to come up with a Diagnosis.  Treatment is based on the diagnosis.

(2)  The medical record then goes to the clinic's business office, where non-medical administrators convert the doctor's diagnosis into a code.  The code is entered into an insurance claim form and sent to the insurance company.  ...Hopefully the insurance company will send back a check for how much that diagnosis is worth.  Big diagnoses get big checks; small diagnoses get small checks.

Gaming the System

Obviously the clinic would prefer a big check instead of a small check.  That means exaggerating a patient's diagnosis to a more serious condition.  Pharyngitis?  Strep Throat pays better.  Common cold?  Pneumonia pays better.  Bottom line:  a patient with the same symptoms and lab results will be coded differently by different clinics.

On the other hand, the insurance company prefers writing small checks.  Fully aware of the temptation to inflate the diagnosis, the insurance company adds a mountain of requirements, restrictions and horrible fines for misrepresenting the diagnosis.

As a result, the coding process has become ever more disconnected from the illness a patient is really suffering from.  The tail has started wagging the dog.  In order to achieve a high-paying diagnosis, a doctor must stretch the patient to fit the criteria for that diagnosis -- electronic records are even programmed to automatically insert the necessary findings.  Often the patient doesn't really have the symptoms, or even the diagnosis entered into the form.

The DSM-5 is a product of the Reimbursement Wars.  It lists every diagnosis'  rules and requirements for reimbursement.  Meanwhile, psychiatrists write fictional accounts that meet those criteria.  ...While trans patients invent stories to satisfy the rules to get past the gatekeepers in order to receive medical care.  Patients, providers, coders and insurance clerks are fully aware that it's all fiction.

Since DSM diagnosis is only a game, it doesn't bother the APA to vote a diagnosis in or out, arbitrarily change a "perversion" into a "dysphoria", and to include diagnoses that everyone knows is normal human behavior.

Psychiatric Diagnosis

The general view is that the Diagnostic and Statistical Manual of Mental Disorders (DSM) is The Book that determines whether someone has a mental illness or not.  It's published by the American Psychiatric Association (APA) and revised every few years.  The current version is known as DSM-5. 

Whereas most of medicine is based on physical malfunctions that are plain to see (for example, a heart or liver not working; germs destroying tissue, etc,) psychiatry is dedicated to deciding whether a person's thoughts, beliefs and behavior are "normal" or "abnormal".  In other words, it's somebody's moral code.   And psychiatric treatment doesn't entail killing germs or removing diseased tissue, it's forcing someone labeled "abnormal" to adopt someone else's supposedly "normal" values and perspectives.

For example, the DSM's authors have recently determined that premenstrual syndrome is a "mental disorder" (code 625.4).  On the other hand, someone who spends months planning a mass murder, someone who's a serial rapist, or a predatory stalker supposedly does NOT have any mental disorder.  They're not listed anywhere in the DSM.

The Rosenhan Experiment

In 1973 the psychologist Dr David Rosenhan sent 8 normal functional middle class people to 12 psychiatric hospitals.  All 12  institutions diagnosed a chronic mental illness (usually schizophrenia) and admitted the patient for an average of 19 days (maximum 52 days).  All of the "pseudopatients" were placed on life-long psychiatric medications.

Interestingly, 38 other psychiatric patients who happened to be in the hospital during the experiment were able to detect the impostors..

When the results of the study were published, one of the hospitals demanded a rematch:  Send another normal person; we'll find them this time! 

Out of 193 subsequent admissions, 41 patients were determined to be normal and part of the Rosenhan Challenge.  They were sent home by the gloating hospital staff.  ...When in fact, Dr Rosenhan didn't send anyone to test the hospital.

Dr Rosenhan demonstrated that, at best, psychiatric diagnosis is arbitrary and based on personal opinion.  Different providers give the same patient different diagnoses.  No objective tests have ever been developed.   Normal people are often labeled with dire diseases.

Concessions (sort of)

In 2012 the American Psychiatric Association issued two statements to absolve them from the injury & damage caused by having transsexuality in the DSM:

"Position Statement on Access to Care for Transgender and Gender Variant Individuals:

(16 August 2012)

Therefore, the American Psychiatric Association:

(1)  Recognizes that appropriately evaluated transgender and gender variant individuals can benefit greatly from medical and surgical gender transition treatments.

(2)  Advocates for removal of barriers to care and supports both public and private health insurance coverage for gender transition treatment.

(3)  Opposes categorical exclusions of coverage for such medically necessary treatment when prescribed by a physician."

Similar policy statements had already been issued in 2008 by the American Medical Association, the American Psychological Association, and the World Professional Association for Transgender Health (WPATH).

"Position Statement on Discrimination Against Transgender and Gender Variant Individuals

(16 August 2012)

Being transgender gender or variant implies no impairment in judgment, stability, reliability, or general social or vocational capabilities. ...

Therefore, the American Psychiatric Association:

(1)  Supports laws that protect the civil rights of transgender and gender variant individuals

(2)  Urges the repeal of laws and policies that discriminate against transgender and gender variant individuals.

(3)  Opposes all public and private discrimination against transgender and gender variant individuals in such areas as health care, employment, housing, public accommodation, education, and licensing.

(4)  Declares that no burden of proof of such judgment, capacity, or reliability shall be placed upon these individuals greater than that imposed on any other persons."

Similar nondiscrimination statements had already been issued by the National Association of Social Workers (1999), by the American Psychological Association (2008), and by WPATH  (2010).

COMMENT:  These proclamations suggest that the APA is at least aware of the harm they cause.  And perhaps they wish that their opinions & policies didn't have such terrible consequences for their patients.  But public opinion is far more swayed by their endorsement and encouragement of the overtly demeaning writings of gender extremists such as Drs Michael Bailey, Ken Zucker & Ray Blanchard.

Tirelessly tracking down Abnormality

Acute Severe Gender Dysphoria

The New Gender Paradigm