Transition: Difference between revisions

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The diagnosis of 'Transsexualism' was introduced in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-III) compiled by the American Psychiatric Association (APA) in 1980 for individuals who had experienced a minimum of two years of continuous interest in reconstructing their sex-physicality and assigned gendered identity. The criteria of the diagnosis focused on individuals whose identities resembled a male-to-female (MTF) or female-to-male (FTM) paradigm. Others experiencing gender dysphoria, but whose identities did not fit the MTF/FTM paradigms could be diagnosed with 'Adulthood Nontranssexual Type', or 'Gender Identity Disorder: Not Otherwise Specified' (GIDNOS). In 1994 the DSM-IV committee replaced the transsexual diagnosis; for individuals with MTF/FTM type identities a diagnosis of 'Gender Identity Disorder' (GID) would be applied instead. The diagnostic criteria of GIDNOS was left undefined, bar that the diagnosis be given to those whose 'gender identity disorder' cannot be defined within a MTF or FTM paradigm. Though a gender dysphoric nonbinary individual may use the term 'transsexual' to describe themselves, they are not considered to be transsexual within a clinical context.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013 which replaced the gender identity disorders with Gender Dysphoria.<ref>https://psychiatry.org/psychiatrists/practice/dsm</ref> "The new revisions for the Gender Dysphoria diagnosis in the DSM-5 are mostly positive. However they do not go nearly far enough. The change in title from Gender Identity Disorder (intended by its authors to mean “disordered” gender identity) to Gender Dysphoria (from a Greek root for distress) is a significant step forward. It represents a historic shift from gender identities that differ from birth assignment to distress with gender assignment and associated sex characteristics as the focus of the problem to be treated... In another positive change, the Gender Dysphoria category has been moved from the Sexual Disorders chapter of the DSM to a new chapter of its own. ~~Non-binary~~ queer-spectrum identities and expression are now acknowledged in the diagnostic criteria... However, the fundamental problem remains that the need for medical transition treatment is still classed as a mental disorder. In the diagnostic criteria, desire for transition care is itself cast as symptomatic of mental illness, unfortunately reinforcing gender-reparative psychotherapies which suppress expression of this “desire” into the closet. The diagnostic criteria still contradict transition and still describe transition itself as symptomatic of mental illness. The criteria for children retain much of the archaic sexist language of the DSM-IV-TR that psychopathologizes gender nonconformity. Moreover, children who have happily socially transitioned are maligned by misgendering language in the new diagnosis. More troubling is false-positive diagnosis for those who have happily completed transition. Thus, the GD diagnosis, and its controversial post-transition specifier, continue to contradict the proven efficacy of medical transition treatments. This contradiction may be used to support gender conversion/reparative psychotherapies – practices described as no longer ethical in the current WPATH Standards of Care"<ref>http://gidreform.wordpress.com/2013/06/13/gid-reform-in-the-dsm-5-and-icd-11-a-status-update</ref>.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in May 2013 which replaced the gender identity disorders with Gender Dysphoria.<ref>https://psychiatry.org/psychiatrists/practice/dsm</ref> "The new revisions for the Gender Dysphoria diagnosis in the DSM-5 are mostly positive. However they do not go nearly far enough. The change in title from Gender Identity Disorder (intended by its authors to mean “disordered” gender identity) to Gender Dysphoria (from a Greek root for distress) is a significant step forward. It represents a historic shift from gender identities that differ from birth assignment to distress with gender assignment and associated sex characteristics as the focus of the problem to be treated... In another positive change, the Gender Dysphoria category has been moved from the Sexual Disorders chapter of the DSM to a new chapter of its own. Nonbinary queer-spectrum identities and expression are now acknowledged in the diagnostic criteria... However, the fundamental problem remains that the need for medical transition treatment is still classed as a mental disorder. In the diagnostic criteria, desire for transition care is itself cast as symptomatic of mental illness, unfortunately reinforcing gender-reparative psychotherapies which suppress expression of this “desire” into the closet. The diagnostic criteria still contradict transition and still describe transition itself as symptomatic of mental illness. The criteria for children retain much of the archaic sexist language of the DSM-IV-TR that psychopathologizes gender nonconformity. Moreover, children who have happily socially transitioned are maligned by misgendering language in the new diagnosis. More troubling is false-positive diagnosis for those who have happily completed transition. Thus, the GD diagnosis, and its controversial post-transition specifier, continue to contradict the proven efficacy of medical transition treatments. This contradiction may be used to support gender conversion/reparative psychotherapies – practices described as no longer ethical in the current WPATH Standards of Care"<ref>http://gidreform.wordpress.com/2013/06/13/gid-reform-in-the-dsm-5-and-icd-11-a-status-update</ref>.

===~~Non-binary~~ healthcare (UK)===

===Nonbinary healthcare (UK)===

''Main article: [[~~Non-binary~~ healthcare (UK)]]''

''Main article: [[Nonbinary healthcare (UK)]]''

Historically, eligibility criteria for medical treatment has presented a barrier for nonbinary individuals, specifically the 'real life test' (RLT) component which was later renamed the 'real life experience' (RLE). The website of the London NHS gender identity clinic states, "There is a two year Real Life Experience (RLE) of living in the reassigned gender role at the GIC for people who want to have genital reconstruction surgery (GRS). This is dated from the start of full-time gender role transition after which they can be assessed for referral for GRS. The RLE includes at least a year in some form of agreed occupational activities." Nonbinary individuals requesting genital reconstruction surgery (GRS) are generally unable to satisfy clinicians in relation to the RLE criteria as there is little social or legal recognition of the nonbinary demographic. On the 1st December 2010, the University of Cambridge Centre for Gender Studies hosted the final public forum in its series on gender and radical biomedical advances, “Transitioning gender: the challenges of radical technologies”, in association with the Guardian and supported by Cambridge University Press. One of the speakers was Dr Richard Green, former research director and consultant psychiatrist of the London NHS gender identity clinic, who referenced “third gender or no-gender person(s)” seeking surgery to “remove breasts or male genitalia” and calls this a “medical dilemma for physicians because there’s no real life experience. Its either surgery, or not”.

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==Changing your presentation==

''Main article: [[~~Non-binary~~ presentation and expression]]''

''Main article: [[Nonbinary presentation and expression]]''

Some nonbinary individuals intentionally present an androgynous or gender neutral personal aesthetic by removing, replacing, or blending gender cues in their general presentation. For many, adopting such a personal aesthetic can ease the symptoms of gender dysphoria, while others may be motivated primarily by a desire to make a political statement; each individual typically has their own unique reasons for adopting any particular 'look'. However, it is no more true to state that 'all nonbinary individuals want to appear androgynous' than it is to state that 'all women want to appear feminine'. Though they may not apply binary-gender stereotyping to their own presentation, some nonbinary individuals seek a personal aesthetic that is considered by their own culture as being variously congruent with binary stereotypes, the affected nonbinary individual may then experience gender dysphoria triggered by the resulting cognitive dissonance.