Depathologisation of transsexual people and being non-binary

[andrajames.livejournal.com]

There have been some recent developments concerning the depathologisation of trans people which frankly worry me. I do agree that GID is a bad diagnosis for transsexual people, our genders are not disordered. Many of us do need hormonal and surgical treatments and felt dysphoric and unhappy with our bodies and THAT was a condition, but our genders per se aren't. The diagnoses for other transgender people are problematic too, 'crossdressing' should not be pathologised.

However I have seen people recently wishing to remove GID from the DSM/ICD entirely and not suggesting that it is replaced by something else. There is a suggestion that we should be able to change our legal genders without having already gone through hormonal and/or surgical treatments. This would then allow HRT and corrective surgery to be mandated purely on physical grounds.

This isn't the only problem with this but is what I want to talk about here:
This presents a problem for non-binary people. In pretty much every country throughout the world the choices of legal gender are male or female. A neutrois person (for example) cannot be legally recognised as neutrois, nor can any other non-binary people have their genders recognised. So where would this model leave an MTN? They could either stay legally male and therefore have no access to treatment or become legally female which would open up a treatment path, however this treatment path wouldn't be ideal for a person who wants minimal hormones and genital nullification.

The current availability of surgery for such people is still very poor (but slowly improving), however in some cases it can be made available via a GID or GID:NOS diagnosis under the radar. If GID is removed from the DSM/ICD then non-binary people will not be able to do this. Binary trans people would have their surgeries mandated by their doctor and the whole 'gender identity treatment' system wouldn't exist. This would leave non-binary people unable to access anything.


I had a disturbing conversation on facebook (in a public thread) with somebody about this, and the opinion expressed was as follows:

"But understand that if you are not gender binary then hormones and surgery are necessarily cosmetic because there is no physical pathology present. Non-binaries should expect to pay for treatment out of their own pockets, but treatment should not be denied (except for unwillingness or inability to pay for it)."

It is very worrying that binary transsexual people are publically saying such things, reinforcing the idea that non-binary people just undergo medical treatments for frivolous reasons and never experience dysphoria and discomfort. As I was reading this a neutrois friend was shouting at the screen saying that they had felt the need to remove their genitals from the age of 6. This doesn't sound very cosmetic to me!

Apparently we should be denied access to surgery on social healthcare and via medical insurance and should always have to pay out of pocket, even if we are poor and rely on state benefits to keep a roof over our heads? It is scary to think that any binary trans activists are going around trying to remove our access to healthcare. :S With friends like these... (Many binary trans people are good allies to non-binary people, however there is a disturbing vocal minority who wish to erase us lest our mere existence somehow 'complicate' things for them. This is selective transphobia)

"If you do want non-cosmetic surgery and don't want sex reassignment then you must accept mental illness. That is fine for some BUT NOT FOR TRANSSEXUAL PEOPLE, BEING TARRED WITH PSYCHOPATHOLOGY ISN'T FINE FOR THEM."

a) I am transsexual kthzbi
b) So you just have a physical problem and I'm a crazy mentalist with a deranged gender? Gee thanks.

Somebody else summed it up better than I could:

"I'm transsexual and I'd rather be labeled as mentally ill than see other dysphoric trans people denied access to hormones and surgery.

If your 'solution' to the problem of being tarred with pathologization is to leave others in the lurch, that's not any kind of solution at all. Being called mentally ill is annoying and I don't like it, but I get access to treatment. If the trade-off to getting rid of that label is to deny treatment to others, then we are prioritizing our mildly hurt feelings over the very lives of others. The dysphoria of neutrosis people is just as great as our dysphoria. You're demanding that they sacrifice themselves for us? Why would they go along with this? What we'd gain is not worth what we're asking of them.

The more I hear from the people who support the STP2012 movement, the more in favor I am of my own pathologization. If you're not transsexual, please just shut up and go away. If you are, then how can you possibly think it's ok to treat other trans people this way?"

I very much support the idea of depathologising trans people, however I think until every persons gender can be legally recognised, what some people are currently suggesting is very dangerous. I know stigmatising labels are bad, but when I compare that to the thought of people spending the rest of their lives dysphoric... I am post-op and not in need of any healthcare for being trans (except for HRT which is mandated as I'm agonadal); I don't want the stigmatising label myself, but if it allows others to access treatment then it's a small price to pay.

Full copy of the facebook thread is here: http://www.arafel.org.uk/~mandel/selective_transphobia.html