DSM V GID DIG

LO SCAMBIO DI EMAIL TRA IL SOTTOCOMITATO SUL DISTURBO DELL'IDENTITA' DI GENERE PER LE REVISIONI DEL DSM V EDIZIONE E MIRELLA IZZO, ATTUALE PRESIDENTE DI PANGENDER E - AL TEMPO - PRESIDENTE DI AZIONETRANS/CRISALIDE
aggiornamento: giovedì 9 febbraio 2010

Secondo il quotidiano "The Economist" uscirà il 10 febbraio la quinta edizione del Manuale Diagnostico e Statistico dei Disturbi Mentali (DSM-V). L'importanza di questa revisione sta nella certa revisione di tutte le patologie riferite al "Gender" e all'"Identità di Genere".
Molto attesa la decisione che verrà pubblicata, in particolare, sulla diagnosi di DIG (Disturbo dell'Identità di Genere, in inglese GID), che fino ad oggi riguardava le persone cosiddette "transessuali" e transgender.
Il "mondo associazionistico trans" è diviso fra tre posizioni: la richiesta di totale depatologizzazione della condizione transgender (con l'uscita, quindi, anche dall'ICD 10 dell'OMS), la depsichiatrizzazione ed un diverso inquadramento più puntato sulle ricadute psichiatriche di una condizione che è socialmente oggetto di stigma.
Molto probabilmente sarà la terza ipotesi ad essere accolta dall'AMA (Associazione Medici Psichiatrici Americana) che, pur avendo nel nome un richiamo agli Stati Uniti, in realtà raccoglie il contributo della psichiatria mondiale e fa "standard" per tutto il mondo.
La presidenza di Crisalide Pangender, meno di un anno fa, fu contattata dalla Commissione del DSM che si occupava di DIG (o GID) per un'opinione da parte associazionistica rispetto alle modifiche da attuare nel DSM V. Domani 10 febbraio, forse, finalmente vedremo, con anni di ritardo, rispetto alle aspettative, cosa avrà deciso la prischiatria mondiale in merito.
Sarà inoltre interessante valutare anche altre modifiche riguardanti i "Gender Studies" e tutte le patologie psichiatriche che determinano violenza di Genere o di Identità di Genere o di Orientamento Sessuale.
Di seguito lo scambio di email (in inglese)

The DSM-V subcommittee on Gender Identity Disorders is inviting your organization to participate in a short survey to gather data regarding the diagnosis, its use, and its impact across the world. These data will be used by the subcommittee as it works on the next edition of the American Psychiatric Association’s Diagnostic and Statistic Manual of Mental Disorders.

Given our limited resources, we can only process one survey respondent per organization. The individual who completes the survey should ideally be an officially designated spokesperson for the organization.

Please read the survey carefully and return your response by October 3rd, 2008 in Word format to DSM5@VUmc.nl

Dear Peggy T. Cohen-Kettenis, Ph.D.
I'm displased to communicate that it is really impossible to give you an answer to your question in the space you leave us for replying. The question, for us and for many other international transgender organizations, is not "GID IN" or "GID OUT", nor to change or not its name. The point are criterias. After criteria we can also try to find a different name, a different position in DSM V.
I think if you really ask for a contribution of experiences coming from associations, you can give us space for an answer with explanations.
I'm not able to say "yes" or "not" becouse we are close to the Anne Vitale theory even if not completely.
We think GEDAD is close to our position but we don't think is only a question of "anxiety". It's a disphoria but originated by deprivation of Gender Identity.
Then we think that science must give some chances to studies (published) that are close to proving that something "wrong" it happens in the fetus formation between genitalia and brain developement. So we can have male body and feminine brains.
That makes transgender and intersexual conditions very close.
The first has not external body evidence (brain is body?), the second yes but in both cases there are something "phisycal". A genetic one for intersexual, an unknown (hormons in fetus? Other genetic differentiation? A mix of social, biological and psicological interaxions?).
So, we believe our psichiatric disphoria is a result of ignorance about the distonya between sex and gender in transgendered people.
Consequeces of a change of identification about transgendered origin are a lot:
It's a question of Gender and not of sex, so, the presence of genitalia surgery change is not always present but in both cases the point is: I feel myself psicologically and socially woman (or man, for FtM).
It's a psicological pain given that social negation of our condition. We have proof of that. Indian American Culture, accepted "transgendered" people and it is not reported that "two spirits" people suffered psycologically. In a different social acceptation we think "disphorya" could be reduced a lot.
It remain a part of dysphoria becouse we feel nature give us a problem, but we can find the cure at 90% in transition
Given that unknown origin of transgendered conditions, we think we must be present in DSM V in a different position. We agree with Anne Vitale PhD at 99% of her opinions.
Pregnancy is a sickness condition? No, it's a natural condition that need of medical care so the same we think for transgendered condition. We don't know exactly why we born (or evolve) with this kind of problem but we need medical care to find a solution. The same of a woman in her pregnancy and neonatality time.
We think criterias for present GID are wrong in some parts.
We have experiences (a lot) that sometimes the presence of some mental problem or ...... is not a condition to negate transition but it is the result of self negation of own problem with gender. When you have a dysphoria, it is possible to find answers in wrong experiences, or that mental sanity, in years, fall in diseases.
We have had more than a case in which the person had a diagnosis of "border line personallity" and negation of transition. In some ways, they succed in having complete transition (with SRS too), and we noted a high decreasing of "border line" behaviours.
We also think that 3-6 months of hormonal therapy is the "best" way to discover if the person is in a genuine distonia or not. Not the only one criteria, but one of the best. We find a lot of cases that "passes" through psichiatric evaluation, have had the "ok" for hrt, and leaved any idea of transition after a few time of hrt, after first "colllateral effects", specially for MtF.
We agree with a exlcluding psichiatric visit for other very hard mental diseases, but we think that presences of neurosis, or depression, or anxiety and sometimes also border line, perversions are not a absolute controindication for diagnosis.
Specially paraphilias can be a consequences of negation of gender distonia.
For a born male who negates his own gender distonia problem it is possible to SVILUPPARE, i.e. an interest for female child (pedophilia) becouse of negation, and envy towards female children. (Different case if this male has interest for male children).
Diagnosis is not so easy and rigid criteria are always wrong.
Not always people become aware of the "name" of his own problem in childhood.
Sometimes negation bring people to search a solution of a "disorder" in many wrong actions. Many true transgendered males have a past of "paracadutista", "rubgy player" and that is not a sign of a false case, but it can be also the temptation to fight against feminine "soul" an fighting to enforce masculine behaviour and sensibility.
Sorry for my broken english, sorry for late (I forgot to send the mail).
Mirella Izzo
AzioneTrans National President

----- Original Message -----
From: DSM5
To: presidenza@...trans.it
Sent: Wednesday, October 22, 2008 8:18 PM
Subject: Re: Survey questions

Thank you for taking the trouble to give us your reaction to the survey. Even though you did not fill out the questionnaire, your message is taken.