Gender Identity “Disorder”? A Critique of the Binary Approach to Gender

Abstract

Homosexuality was listed as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) up until 1974 (Pillard, 2009). The process of expunging the controversial label was highly political. There were many people who felt labeling and treating homosexuality as a disorder was degrading and hurtful. Currently, as revisions are being made to the DSM once again, controversy arises about gender identity disorder (GID). The question becomes, in relation to GID, "What is the distinction between a violation of social norms and mental disorder?" It was determined that homosexuality, despite being statistically infrequent, is not a disorder. There is nothing intrinsically distressing about being homosexual. Likewise, it is argued that a person is not mentally ill just because they do not identify with the gender that was assigned to them at birth (Allison, 2010; Butler, 2004; Ross, 2009). Some, such as Dr. Rebecca Allison (2010), have argued that if anything, the desire to alter one's body to match the gender they identify with should be listed a medical condition, not a mental one, because it is the body that is treated, not the mind.GID is defined in the DSM as follows:A. A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex.) [sic] In children, the disturbance is manifested by four (or more) of the following: 1) repeatedly stated desire to be, or insistence that he or she is, the other sex; 2) in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing; 3) strong and persistent preferences for cross-sex roles in make-believe play or persistentfantasies of being the other sex; 4) intense desire to participate in the stereotypical games and pastimes of the other sex; 5) strong preference for playmates of the other sex. B. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex. C. The disturbance is not concurrent with a physical intersex condition. D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. (American Psychiatric Association [APA], 2000, p. 581)GID, VIOLATING A SOCIAL NORMThe "disorder" aspect of GID is predicated on the violation of social norms. There is a binary approach to gender in Western society. Every person, with the exception of those born with physical intersex complications, is assigned a gender-either male or female-based upon the biological parts they have at birth. GID occurs when an individual does not agree with the gender they were assigned. There are many people all over the world that do not fit into the Western concept of male or female, and for many cultures, they are placed into their own category (Lang & Kuhnle, 2008). The idea that everyone has to be either male or female and that which category they are in can be determined at birth is a Western concept. Lang and Kuhnle (2008) review anthropological literature of gender categories in other cultures. They point out that even trying to study gender and sexuality in other cultures is problematic because Western notions of such categories and ideas do not exist in the same way in non-Western cultures. There are many instances in which more than two genders are present in a given culture. The Navajo, for example, traditionally had five gender categories and three sexes (Lang & Kuhnle, 2008). These other cultures do not appear to treat gender variation as a concern that needs correcting. This is opposed to Western society in which it is viewed, based on the fact that it is in the DSM, as a problem in need of correcting.In Western society, if one does not identify themselves with their assigned gender they are violating a social norm (Butler, 1988). Gender variation violates the norm of having two distinct genders (Butler, 1988, 2004). …