Transition: Difference between revisions

'''Transition''' is a term that is used to describe the process that individuals typically experiencing [[gender dysphoria]] go through to reach their desired social role, and/or physicality; there is no single definition of transition as the term is based on the unique requirements of each individual.

==Healthcare Services==

A diagnosis of [[gender dysphoria]] that is congruent with the diagnostic criteria of a recognised 'gender identity disorder' is the typical prerequisite for the treatment of persistent gender dysphoria in those countries which offer such services. Healthcare professionals typically reference either the [https://psychiatry.org/psychiatrists/practice/dsm Diagnostic and Statistical Manual of Mental Disorders (DSM)] or the [http://www.who.int/classifications/icd/en/ International Classification of Diseases (ICD)] in order to confirm a diagnosis of gender dysphoria.

In [http://link.springer.com/article/10.1007%2FBF01542067 'Archives of Sexual Behaviour (Volume 16), "Heterosexual and homosexual gender dysphoria"' (1987)], Dr Ray Blanchard (who served on the DSM-IV Subcommittee on Gender Identity Disorders) wrote, ''"(there is a) well-recognized tendency of applicants for sex reassignment surgery to distort their histories in the direction of 'classic' transsexualism in an effort to gain approval for such surgery".''

===Gender dysphoria vs. gender identity disorder===

''Main article: [[Gender dysphoria]]''

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>.

===Nonbinary 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”.

“...Young people are eligible for treatment in the adult NHS clinics (once they are 18 years old) or by private practitioners (from 16 years old)”<ref>http://www.gires.org.uk/assets/DOH-Assets/pdf/doh-children-and-adolescents.pdf</ref>.

''Main article: [[Names]]''

Changing one's name within an everyday social context can be as simple as informing others of your choice, however in societies with a complex legal system (or equivalent) there can be conditions that place limitations on the individuals right to self determination which can be especially problematic for nonbinary individuals. For example, in Germany the Standesamt (Office of Vital Statistics)<ref>http://standesamtauskunft.de/Default2.aspx</ref> typically refuses to recognise in German civil registration law names that are gender-ambiguous; a given name must indicate that the owner is either 'male' or 'female'.

===State of address===

''Main article: [[Gender neutral titles]]''

Some individuals adopt a gender neutral title such as 'Mx', 'Misc', or 'Pr'. For the most part, gender neutral titles without qualification/career connotations are not recognised by the general public or businesses/organisations. Activists and supporters are working toward awareness and acceptance of alternative titles. For some nonbinary folk, being referred to with a gendered title can trigger gender dysphoria.

''Main article: [[Pronouns]]''

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.

''Main article: [[Voice and speech]]''

Many societies (human and otherwise) recognise certain rages of vocal communication as being typically 'masculine' or 'feminine', consequently a given individuals own vocal range can trigger a feeling of gender dysphoria in that individual and they may try to alter their vocal range, or 'voice', as a result.

There are several factors which contribute to how a voice is interpreted with regards to gender, and these factors vary between societies. The most commonly recognised of these factors is pitch, which can undergo a dramatic transformation during ones lifetime due to the physical changes associated with puberty or endocrine therapy, for instance. Several studies have identified a gender-ambiguous average pitch at 155-187Hz, a feminine average pitch at 220Hz, and a masculine average pitch at 120Hz<ref>Adler et al 2006, Andrews 1999, Gelfer et al 2000, Spencer 1998, Wolfe et al 1990</ref>.

''Main article: [[Legal gender]]''

== References ==

<references/>

[[Category:Concepts]]

[[Category:Transition]]