Analysis of APA and WHO Manuals about identity disorders

Manual of American Psychologist Association, DSM IV, consider that a gender identity disorder means a deep alteration in the sense of identity in a person in relation with masculinity and femininity, a strong and constant identification with the other sex and also a persistent disgust with the own sex (1).

For APA the diagnosis should fit with these considerations in order to identify an identity disorder (2):

• Consideration A: Should be evidence that the person felt an intense and persistent identification with the other sex, means the desire and believe to belong to the other sex.
• Consideration B: This identification with the other sex is not related with the advantages that are part of the other sex according with cultural customs. It had to be evidence that the disgust is permanent and felt uncomfortable in its own sex.
• Consideration C: The diagnosis shouldn’t be determined if the person have a physical disease as intersexuality.
• Consideration D: In order to give a diagnosis should be evidence that de disgust is significative and that exist a social damaging and problems in other kinds of its personality.

So, in order of this considerations, a person that don’t feel a significative disgust and also don’t have any social damaging, shouldn’t be considering that have an identity disorder. But APA Manual is also related with WHO Manuals and The Statistical Classification of International Disease (CIE-10) of World Health Organization (WHO) considers transvestism and transsexualism as identity disorders (3).

WHO define transvestism and transsexualism in this way:

Transvestism is the act to wearing clothes for the other sex during an important part of existence in order to enjoy the experience to belong to the other sex, but without any desire to suffer a permanent change or a surgery to be into the other sex.

Transsexualism is the desire to live and be accepted as a member of the other sex, it is usually join with the disgust feeling with the own anatomic sex and the desire to suffer a surgery in order to change its sex and had a correspondence between the identity and the sex.

This classification doesn’t give any consideration to the diagnosis of this identity disorders, only assume that any transvestite or transsexual suffer from a mental disorder. Because of the related status, APA is also taking in consideration the criteria of WHO.

In 1973, APA suppresses homosexuality from its Manual and in 1990 WHO do the same thing. They affirm that significative disgust and social damage were not inherent to homosexuality. And stop to considering homosexuality as a mental disorder. We are asking for the same thing in the case of transsexuality and transvestite. But prejudice is very strong in this case because those identities are beyond gender binarism.

Also is necessary to say that these Manuals don’t consider which the causes of the disorder are. The social damage have to be prove by their family, they should declared that their relatives have any problem with work and study, for example, and that situation limit their development. We are sure the social damage in the case of Tran’s people (transvestite, transsexual and transgender) is a consequence of the relation with society, because their identities are not accepted and that create problems in their socialization with the family, in the school, in work and in the community. So, social damage is a consequence of discrimination and social exclusion is not something inherent to be part of those identities. And consider that shouldn’t be assumed as a mental disorder.

Dania Farfán Torres

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Reference

(1) Definition include in DSM IV.
(2) Consideration that are in APA Manual.
(3) This is part of the CIE-10.