Classification of transsexuals
From Wikipedia, the free encyclopedia
Classification of transsexuals and people with gender identity disorder has been attempted by many over the course of its medical treatment.
| "Transsexualism" | ||
| ICD-10 | F64. | |
|---|---|---|
| ICD-9 | 302.5 | |
| OMIM | 600952 | |
| eMedicine | med/3439 | |
| MeSH | F03.800.800.800 | |
Contents |
[edit] Nomenclature
Harry Benjamin agreed with German sexologist Magnus Hirschfeld that transsexuals were a form of neurological intersex.[1] Hirschfeld coined the term "Transvestite" in his seminal work on the matter, Die Transvestitien. In this work, he describes what is now known as transvestic fetishism as well as transsexualism.[2] In 1930, he supervised the first known sex reassignment surgery on Lili Elbe of Denmark.
The term "Transsexual" was coined by Harry Benjamin during his work of the 1950s and 1960s, which culminated in The Transsexual Phenomenon in 1966. This term continues to be used by the public and medical profession alike.[2] It was included for the first time in the DSM-III in 1980 and again in the DSM-III-R in 1987, where it was located under "Disorders Usually First Evident in Infancy, Childhood or Adolescence".
The terms "Gender Dysphoria" and "Gender Identity Disorder" were not used until the 1970s[2] when Laub and Fisk[3][4] published several works on transsexualism using these terms. "Transsexualism" was replaced in the DSM-IV by "Gender Identity Disorder in Adolescents and Adults".
[edit] Harry Benjamin Scale
Harry Benjamin's Gender Identity Scale was a first attempt to classify and understand various forms and subtypes of gender variant behaviors and expressions, made by Dr. Harry Benjamin. It was a 6-point scale, similar to the Kinsey scale of sexual orientation, which had 7 categories. Much like Kinsey's understanding in the field of sexual orientation, Dr. Benjamin understood that the nature of gender identity and gender expressions is not a discrete scale, but a spectrum, a continuum with many variations, much more than those featured in the scale. But the scale he developed seemed to be an easy, rational and clinically useful way to diagnose different forms of transsexualism and to distinguish between those who needed surgical and/or hormonal treatment and those who didn't.
Benjamin noted: "It must be emphasized again that the remaining six types are not and never can be sharply separated."[5]
[edit] Gender identity screening tool
This scale was developed in order to help professionals differentiate between transvestitism and transsexualism. It is currently the only verified assessment tool used in diagnosing transsexualism.
Several criticisms of this tool have been noted:
- It only applies to male-to-female transsexuals
- It assumes "attracted to males" status, ignoring transsexuals who are attracted to females
- It is biased towards later-presenting transsexuals who may have had more time and freedom for body modification prior to presentation such as electrolysis, surgery, spending time "Full-Time" in the desired gender role
The tool is scored in four axes.
[edit] Diagnostic Criteria
[edit] Diagnostic and Statistical Manual
"Gender Identity Disorder" Was a term created in the DSM-III in regards to transsexuals, and the categories were "GID/Childrem Transsexualism"; "GID/Adolescent and Adult, Non-transsexual type" and "GID/Not Otherwise Specified". Notably, this did not address Late-onset transsexualism, where patients may not have had symptoms as children. Interestingly, in the major revision of the DSM, DSM-III-R, They were placed in the category "Disorders Usually First Evident in Infancy, Childhood or Adolescence". The problem was that it got lost here, as well as the issue of adult onset explained above.[2]
In the DSM-IV-TR, the current version, GID is placed in the category of Sexual Disorders, with the subcategory of Gender Identity Disorders. This is perhaps distasteful to some transsexual people, as it is right next to transvestitic fetishism, Pedophilia, Fetishism, Orgasmic, Arousal and Erection disorders, and other similar categories.[2] The disorder names were changed in DSM-IV to "Gender Identity Disorder in Children", "Gender Identity Disorder in Adolescents or Adults", and "Gender Identity Disorder Not Otherwise Specified".
Additionally, Both the DSM-III and DSM-IV differentiate based on sexual attraction. In the DM-III, the terms "Homosexual", "Heterosexual", and "Asexual" were used - with quite a bit of confusion[2]. Currently the terms "Attracted to males", "Attracted to Females", "Attracted to Both" and "Attracted to neither" are used in the DSM-IV-TR.
[edit] References
- ^ Detail of conversation between Benjamin and Hirschfeld re. neurological intersex
- ^ a b c d e f Pauly MD, Ira B. (28 May 1993). "Terminology and Classification of Gender Identity Disorders". Journal of Psychology & Human Sexuality 5 (4): 1-12. ISSN 0890-7064. Retrieved on 2007-02-26.
- ^ Laub, D. R.; N. Fisk (April 1974). "A rehabilitation program for gender dysphoria syndrome by surgical sex change". Plast Reconstr Surg. 53 (4): 388-403. PMID 4592953. Retrieved on 2007-02-26.
- ^ Fisk, N. (1974). "Gender Dysphoria Syndrome. In D. Laub & P. Gandy (Eds.)". Proceedings of the Second Interdisciplinary Symposium on Gender Dysphoria Syndrome: 7-14.
- ^ Benjamin, Harry (1966). "2", The Transsexual Phenomenon. Julian Press, New York. ISBN B0007HXA76.
[edit] See also
- American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders 3rd ed. A.P.A.: Washington D.C.
- American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders 3rd ed., revised A.P.A.: Washington D.C.
- Benjamin, H. (1953). Transvestism and Transsexualism. International Journal of Sexlogy, 7, 12-14
- Benjamin, H. (1966). The Transsexual Phenomenon. Julian Press: New York
