The American Psychiatric Association (APA) is in the process of changing the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM is a list of all billable mental disorders. You know that numbers that you see on your medical bills? Well if it is in the DSM that therapist or the International Statistical Classification of Diseases (ICD) that health care people use to look up the billing numbers, the therapist or doctor gets paid. If it is not then they do not get paid. An example is that I have diagnosed with ICD code 272.0 or high cholesterol, if you look at your bill you will see the code number on it. The therapist uses the DSM to look up the best diagnoses that fit the patient symptoms and bills the insurance company, not everything in the DSM is a mental illness. The DSM contains such things as bed wetting as a mental disorder (307.6). Why? Because you might suffer some form of stress over it and go to a therapist about the stress but it does not make you mental ill and the therapist wants to get paid for threating your anxiety so there has to be a code number for bed wetting (Enuresis).
Therein lies the problem, the standard of care (SOC) requires that before hormones are prescribed to us or before we have surgery we have to see a therapist and if we want the therapist to get paid by the insurance company it has to be listed in the DSM. Therefore, I believe that it should be removed from the DSM all together and placed in the ICD, because there is enormous stigma that is tied to having it in the DSM that is used against us.
Therein lies the problem, the standard of care (SOC) requires that before hormones are prescribed to us or before we have surgery we have to see a therapist and if we want the therapist to get paid by the insurance company it has to be listed in the DSM. Therefore, I believe that it should be removed from the DSM all together and placed in the ICD, because there is enormous stigma that is tied to having it in the DSM that is used against us.
Transgender Advocates Seek New Diagnostic TermsIt is a step forward, I believe that it still does not go far enough. The Medical Press reports that the APA Task Force has recommended that…
Associated Press
By Lisa Leff
July 21, 2012
Does a woman who strongly believes she was meant to be a man have a mental condition or a medical problem? Is a man who cross-dresses in need of psychological help? What about a boy who pretends to be a girl in make-believe games and chooses only female playmates?
The nation's psychiatric establishment is wrestling with these questions, among others, as it works to overhaul its diagnostic manual for the first time in almost two decades. Advocates have spent years lobbying the American Psychiatric Association to rewrite or even remove the categories typically used to diagnose transgender people, arguing that terms like Gender Identity Disorder and Transvestic Fetishism promote discrimination by broad-brushing a diverse population with the stigma of mental illness.
What does it mean to have GID listed in the DSM? Well a friend in another state is applying for a gun permit and on the form it asks, “Have you ever been diagnosed with a mental illness?” and she will have to answer yes. Also when we try to pass gender inclusive anti-discrimination laws the opposition uses the DSM against us…
The most symbolic change under consideration so far for the manual's fifth edition, known as the DSM-V for short, is a new name for Gender Identity Disorder, the diagnosis now given to adults, adolescents and children with "a strong and persistent cross-gender identification." In the manual's next incarnation, individuals displaying "a marked incongruence between one's experienced/expressed gender and assigned gender" would be diagnosed instead with "Gender Dysphoria," a term that comes from the Greek word for emotional distress.
The task force was charged with reviewing the scientific literature regarding gender identity disorder at different stages in a person's life. It examined the research and clinical evidence relating to treatment, and provided an opinion as to whether or not the APA should develop practice recommendations. The literature regarding treatment of gender dysphoria, or discomfort about one's own gender, in individuals with disorders of sex development was also assessed.While this report did not deal with the DSM revision, it does lend support to changing the DSM to make positive changes to the DSM but still didn’t go far enough. I will not be satisfied until GID is recognized for what it truly is, a nature biological diversity.
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In addition, the report recommended that the APA provide statements clarifying its positions on several issues. These include supporting the medical necessity of treatment for GID, defining the ethical issues regarding treatments for minors with GID or other manifestations of gender variance, and supporting the civil rights of persons who are gender variant, transgender, or transsexual.
Hi there, new to your blog.
ReplyDeleteAre you saying that GID should be coded as a medical disorder? Rather than a mental disorder? I can see how the Gender dysphoria can be useful for mental health diagnosing and coding, and perhaps GID or some other term could be used for medical diagnosis. In your opinion would something like that work?
Now that I'm getting ready to teach Psychology and Advanced Placement Psychology, I'm becoming much more aware of the DSM. So, I actually get what you're talking about. And I agree, it's time for a change.
ReplyDeleteCait
ReplyDeleteI believe in Europe they are already doing it. They treat transsexualism medically. I believe you shouldn't have to go through gatekeepers.