Home » Public » Trans Political Issues » Blanchard et.al. reveals changes for the DSM
| Blanchard et.al. reveals changes for the DSM [message #57119] |
Tue, 28 April 2009 18:34  |
 CarolynnL 
Messages: 1817
Registered: October 2007
Location: Central Time Zone |
Senior Member |
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April 22, 2009
Transvestic Disorder and Policy Dysfunction in the DSM-V
Filed under: Uncategorized — gidreform @ 6:36 am
Kelley Winters, Ph.D.
GID Reform Advocates
www.gidreform.org <http://www.gidreform.org/>
At the Annual Meeting of the Society for Sex Therapy and Research this
month, a "Provisional Report by the DSM-V Workgroup on Sexual and
Gender Identity Disorders," was presented by Chairman Kenneth Zucker
and a panel of workgroup members. (1) Ray Blanchard, who chairs the
Paraphilias Subcommittee, summarized proposals for "Pedohebehpilic
Disorder" and "Transvestic Disorder" in the DSM-V.(2) While Charles
Moser, Ph.D., M.D., and others have long raised concern about all
paraphilia diagnoses in the DSM,(3)the current diagnostic category of
Transvestic Fetishism is particularly stigmatizing and defamatory for
male-to-female (MTF) cross-dressers as well as many transsexual
women.(4) Unfortunately, Dr. Blanchard's proposal of Transvestic
Disorder offers little to allay these concerns.
First, Dr. Blanchard broadly expanded the definition of paraphilia to include,
"any intense and persistent sexual interest other than sexual interest
in genital stimulation or preparatory fondling with phenotypically
normal, consenting adult human partners."
This would appear to implicate masturbation and erotic stimulation
without a partner as paraphilia and sexual deviance: a proscription
rooted in religious dogma rather than science. Moreover, no
clarification is given for "phenotypically normal" Although Blanchard
notes that he would exclude same-sex adult partners from his
paraphilia definition, it is not clear whether anyone attracted to a
trans or intersex partner with atypical physiology or social role
would be labeled as paraphilic under this definition.
Blanchard did however make a distinction between paraphilia as sexual
phenomena and paraphilic disorder in diagnostic nomenclature. The
latter, he noted, "causes distress or impairment to the individual or
harm to others," If applied to the DSM-V, this would narrow the scope
of paraphilic diagnostic nomenclature to a degree by tying it to the
definition of mental disorder.
Second, Dr. Blanchard proposed that the diagnosis of Transvestic
Fetishism in the DSM-IV-TR be renamed Transvestic Disorder. While
somewhat less perjorative than the current title, Transvestic Disorder
would still imply that all cross-dressing represents mental disorder.
It would continue to perpetuate this defamatory stereotype.
Unfortunately, Dr. Blanchard proposed to retain the current diagnostic
criteria (5) for Transvestic Fetishism:
A. Over a period of at least 6 months, in a heterosexual male,
recurrent, intense sexually arousing fantasies, sexual urges, or
behaviors involving cross-dressing.
B. The fantasies, sexual urges, or behaviors cause clinically
significant distress or impairment in social, occupational, or other
important areas of functioning.
Criterion A is grammatically ambiguous (6). The phrase, "or behaviors
involving cross-dressing," implies that all cross-dressing, whether or
not it is erotically motivated, represents paraphilia and mental
disorder. Criterion B fails to make any distinction between distress
or impairment directly caused by cross-dressing from those caused by
social intolerance and prejudice. Thus, all transwomen, including
transsexual women, who are birth-assigned male, attracted to women,
wear clothing that is typical or ordinary for other women, and are
distressed by social or familial prejudice would perpetually meet both
diagnostic criteria. Under Blanchard's proposal they would be subject
to diagnosis with Transvestic Disorder for the rest of their lives,
regardless of how happy and well adjusted they might be with their
lives and gender expression.
Furthermore, these diagnostic criteria define the proposed Transvestic
Disorder as a gender-reparative therapy diagnosis, engineered to
facilitate psychological "treatment" to suppress gender expression
that differs from assigned birth sex. Only by hiding gender
nonconforming expression deep into the closet, may a gender variant
individual be emancipated from these criteria and paraphilic
diagnosis.
Finally, Dr. Blanchard proposes to change the Specifier Options to the
diagnosis. The current Transvestic Fetishism diagnosis has a single
specifier, "With Gender Dysphoria: if the person has persistent
discomfort with gender role or identity."(7) Blanchard's proposal would
replace this with a specifier of "Autogynephilia (Sexually Aroused by
Thought or Image of Self as Female)."
The term, autogynephilia was coined by Blanchard in 1989 ( , not merely
to describe a phenomenon of human sexuality, but rather to promote his
derogatory theory that all lesbian, bisexual and asexual transsexual
women were motivated to transition by a narcissistic sexual
obsession.(9) This word was subsequently associated by author J. Michael
Bailey with profoundly defamatory remarks and stereotypes in his 2003
book, "The Man Who Would be Queen: The Science of Gender-Bending and
Transsexualism."(10)
It is difficult to imagine how a term that has become so offensive and
so damaging to the dignity of transwomen (11) could serve any
constructive clinical purpose in the DSM-V.(12)
To summarize, Dr. Blanchard's proposal for Transvestic Disorder in the
DSM-V fails to address serious issues of unfair social stigma and
stereotyping that surround the current Transvestic Fetishism
diagnostic category. Moreover, it would worsen these concerns by
adding the pejorative term "autogynephilia" as a specifier to the
diagnosis.
I ask the elected leadership and Board of Trustees of the American
Psychiatric Association to affirm in a public statement that gender
identity and expression which differ from assigned birth sex do not,
in themselves, constitute mental disorder and imply no impairment in
judgment or competence. I ask the DSM-V Task Force to honor this
principle in the DSM-V by removing the current category of Transvestic
Fetishism and rejecting Dr. Blanchard's proposal to replace it with
Transvestic Disorder. Finally, I invite members, allies and affirming
care providers of the transcommunity to voice their concerns by
publishing comments to this essay at gidreform.wordpress.com. I will
forward these postings to the APA and DSM-V Task Force at the APA
Annual Meeting in May.
1) Society for Sex Therapy and Research, "Program Schedule: SSTAR
2009," April 2009,
http://www.sstarnet.org/download/20090402ProgramSchedule.pdf
2) R. Blanchard, "DSM-IV Paraphilias Options: General Diagnostic
Issues, Pedohebephilic Disorder, and Transvestic Disorder," Annual
Meeting of the Society for Sex Therapy and Research, Alexandria VA,
April 2009, http://individual.utoronto.ca/ray_blanchard/index_files/SSTA R.html
3) C. Moser and P. Kleinplatz, "DSM-IV-TR and the paraphilias: An
argument for removal." Journal of Psychology and Human Sexuality
17(3/4), also published in Sexual and Gender Diagnoses of the
Diagnostic and Statistical Manual (DSM), Eds. D. Karasic, and J.
Drescher, Haworth Press, 2005, p. 106.
4) K. Winters, "Disordered Identities: The Ambiguously Sexual Fetish,"
GID Reform Advocates, November 2008,
http://www.gidreform.org/blog2008Nov02.html,
http://gidreform.wordpress.com/2008/11/02/disordered-identit ies-the-ambiguously-sexual-fetish/
5) American Psychiatric Association, Diagnostic and Statistical Manual
of Mental Disorders, Fourth Edition, Text Revision, Washington, D.C.,
2000, p. 575.
6) K. Winters (published under pen-name Katherine Wilson) and B.
Hammond, "Myth, Stereotype, and Cross-Gender Identity in the DSM-IV,"
Association for Women in Psychology 21st Annual Feminist Psychology
Conference, Portland OR, 1996, http://www.gidreform.org/kwawp96.html.
7) DSM-IV-TR, 2000, p. 574.
R. Blanchard, "The Classification and Labeling of Nonhomosexual
Gender Dysphoria," Archives of Sexual Behavior, v. 18 n. 4, 1989, p.
322-323.
9) K. Winters, "Autogynephilia: The Infallible Derogatory Hypothesis,
Part 1," GID Reform Advocates, November 2008,
http://www.gidreform.org/blog2008Nov10.html
10) J. Bailey, The Man Who Would Be Queen: The Science of
Gender-Bending and Transsexualism, Joseph Henry Press, 2003, pp. xii,
172, 178, 183-185, 206.
11) J. Serano, "Autogynephilia' and the psychological sexualization of
MtF transgenderism," International Foundation for Gender Education
2009 Conference, Alexandria VA, March 2009,
http://ai.eecs.umich.edu/people/conway/TS/IFGE2009/Disordere d_No_More.html#Julia
12) K. Winters, "Autogynephilia: The Infallible Derogatory Hypothesis,
Part 2," GID Reform Advocates, November 2008,
http://www.gidreform.org/blog2008Nov19.html
http://gidreform.wordpress.com/2009/04/22/transvestic-disord er-and-policy-dysfunction-in-the-dsm-v/
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| Re: Blanchard et.al. reveals changes for the DSM [message #58096 is a reply to message #57119 ] |
Thu, 14 May 2009 00:32  |
KayA
Messages: 1318
Registered: October 2007
Location: Honolulu, Hawaii |
Senior Member
BL3d
Official Sassy Read-head Emeritus |
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I was talking to Milton Diamond last night and we got on the discussion of Zucker, Blanchard and company and their "PROPOSAL"
I was doing some research to get Mickey the links and came across this info in the Society for Sex Therapy and Research website that had the final program for the April conference.
http://www.sstarnet.org/download/2009FinalProgram.pdf I direct you to the following paragraph on page 32
| Quote: |
Re-Naming and Re-Specifying Transvestic Fetishism: One option here is to replace the current term Transvestic Fetishism with the DSM-III label—Transvestism—and replace the current specifier, With Gender Dysphoria, with two others: With Fetishism and With Autogynephilia. There is evidence that within the transvestitic population, autogynephilia is associated with a higher risk of gender dysphoria and fetishism is associated with a lower risk of gender dysphoria.
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So if you are a Transvestite (we all are according to the definitions) then you have only two choices for a diagnosis and that is Fetishism or Autogynephilia.... Gender Dysphoria will be removed from the specifiers... So we are going backwards
PARAPHILIAS VS. PARAPHILIC DISORDERS, PEDOPHILIA VS. PEDO- AND HEBEPHILIA, AND AUTOGYNEPHILIC VS. FETISHISTIC TRANSVESTISM
Ray Blanchard, PhD
Ray Blanchard, PhD
Centre for Addiction and Mental Health
250 College Street
Toronto, Ontario, M5T 1R8, Canada
Telephone: (416) 535-8501, Ext. 6228 Fax: (416) 979-6965 E-mail: ray_blanchard@camh.net
Introduction: The DSM-V Work Group for Sexual and Gender Identity Disorders includes a Subworkgroup focusing on potential changes to the various Paraphilia diagnoses. This brief talk describes four of the options to be considered by that Subworkgroup.
Distinguishing between Paraphilias and Paraphilic Disorders: The Subworkgroup will consider distinguishing between paraphilias and paraphilic disorders along the following lines. A paraphilia is any powerful and persistent sexual interest other than that in copulatory or precopulatory behavior with phenotypically normal, consenting adult human partners. A paraphilic disorder is a paraphilia that causes distress or impairment to the individual or harm to others. One would ascertain a paraphilia (according to actions and self-report, e.g., sexual attraction to amputees or inanimate objects) but diagnose a paraphilic disorder (on the basis of distress and impairment). In this conception, having a paraphilia would be a necessary but not a sufficient condition for having a paraphilic disorder. This approach leaves intact the distinction between normative and non-normative sexual behavior, which could be important to researchers, but without automatically labeling non-normative sexual behavior as psychopathological.
Absolute vs. Relative Criteria in Ascertainment: Another issue concerns the quasi-quantitative criteria for ascertaining paraphilias. In DSM-IV-TR, Criterion A for every single paraphilia contains the phrase, "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors." An alternative approach to quantification is based on the notion of paraphilias (like sexual orientations) representing erotic preferences. This approach to quantification was used in the DSM-III diagnostic criteria for pedophilia, for example. Criterion A of DSM-III reads, "The act or fantasy of engaging in sexual activity with prepubertal children is a repeatedly preferred or exclusive method of achieving sexual excitement." Both approaches make implicit comparisons, but with different points of reference. The first approach relates a patient's degree of variant sexual interest to the absence of that interest; the second approach relates a patient's degree of variant interest to his or her degree of normative sexual interest. It is possible that different approaches to quantification would work better for different paraphilias.
Adding a Separate Diagnosis of Hebephilia or Replacing Pedophilia with Pedohebephilia: The DSM-IV-TR defines pedophilia as sexual attraction to prepubescent children. A substantial body of evidence indicates that this definition excludes from diagnosis a sizable proportion of those men whose strongest sexual feelings are for physically immature persons. These are the hebephiles, that is, men whose strongest sexual feelings are for pubescent children (roughly, ages 11–14). One possible solution is to add a diagnosis of Hebephilia; another is to replace the diagnosis of Pedophilia with Pedohebephilia and offer three subtypes: Pedophilic, Hebephilic, and Pedohebephilic.
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Re-Naming and Re-Specifying Transvestic Fetishism: One option here is to replace the current term Transvestic Fetishism with the DSM-III label—Transvestism—and replace the current specifier, With Gender Dysphoria, with two others: With Fetishism and With Autogynephilia. There is evidence that within the transvestitic population, autogynephilia is associated with a higher risk of gender dysphoria and fetishism is associated with a lower risk of gender dysphoria.
Behavioral Learning Objectives:
After attending this presentation, the participants will be able to:
1.
Compare quantification strategies for ascertaining a paraphilia.
2.
Define the term hebephilia.
3.
Discuss the relations of gender dysphoria to autogynephilia and fetishism.
References:
Blanchard, R. (1991). Clinical observations and systematic studies of autogynephilia. Journal of Sex & Marital Therapy, 17, 235–251.
Blanchard, R. (1993). Varieties of autogynephilia and their relationship to gender dysphoria. Archives of Sexual Behavior, 22, 241–251.
Blanchard, R. (2005). Early history of the concept of autogynephilia. Archives of Sexual Behavior, 34, 439–446.
Blanchard, R. (in press). Reply to letters regarding Pedophilia, Hebephilia, and the DSM-V. Archives of Sexual Behavior. DOI: 10.1007/s10508-008-9427-9
Blanchard, R., Lykins, A. D., Wherrett, D., Kuban, M. E., Cantor, J. M., Blak, T., Dickey, R., & Klassen, P. E. (in press). Pedophilia, hebephilia, and the DSM-V. Archives of Sexual Behavior. DOI: 10.1007/s10508-008-9399-9
Biography:
Dr. Blanchard (http://individual.utoronto.ca/ray_blanchard/) received his PhD in psychology from the University of Illinois in 1973. He is Head of Clinical Sexology Services in the Law and Mental Health Program at the Centre for Addiction and Mental Health in Toronto, Ontario and a Professor of Psychiatry at the University of Toronto.
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[Updated on: Thu, 14 May 2009 17:40]
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| Re: Blanchard et.al. reveals changes for the DSM [message #58103 is a reply to message #58096 ] |
Thu, 14 May 2009 06:08 |
ZoeB 
Messages: 1921
Registered: September 2007
Location: Canberra, Australia |
Senior Member
@ |
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| KayA wrote on Thu, 14 May 2009 17:32 |
A paraphilia is any powerful and persistent sexual interest other than that in copulatory or precopulatory behavior with phenotypically normal, consenting adult human partners.
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As in
- a wife staying with her husband after he's been maimed in a war.
- holding hands under the moonlight, unless it is intended to immediately result in foreplay and/or copulation
- anyone attracted to someone who's TS
This has gone over real big with advocates for the disabled, as you can imagine. Pitchforks and Torches are being prepared. It is, however, entirely in accordance with the most extreme paleo-conservative views within the Vatican, though not the majority.
Someone who has no problems with any of the above behaviours will be assessed as paraphiliac. Someone who has problems - for example, suffering social ostracism because their wife is TS - will be diagnosed with a paraphiliac disorder, just like a child molester. This may not be Blanchard's intent, but it's what he's actually recommending.
I suspect that when the full ramifications of this little group's recommendations are known within the APA, that they will realise that what TS people have been saying about Blanchard et al is, if anything, an understatement. It promises to be quite a scandal, unless they can hush it up.
Hugs from the Zoe of Oz
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