One letter writer reports receiving an email from the APA which states that:

“The Sexual and Gender Identity Disorders Work Group, chaired by Kenneth J. Zucker, Ph.D., will have 13 members who will form three subcommittees:

* Gender Identity Disorders, chaired by Peggy T. Cohen-Kettenis, Ph.D.
* Paraphilias, chaired by Ray Blanchard, Ph.D.
* Sexual Dysfunctions, chaired by R. Taylor Segraves, M.D., Ph.D.”

Additional information has come in about other participants in the Sexual and Gender Identity Disorders Work Group (which, of course, oversees the entry for GID and several other conditions). Of these, Dr. Cohen-Kettenis appears to have a trans-positive reputation, and has reportedly pushed for liberalizing the WPATH standards of care. She has studied neuroanatomy and looked particularily at differences between male and female brain patterns.

While it is encouraging to know that we have a possible advocate on this panel, we continue to be concerned. Zucker is still directing the work, and Blanchard still retains the ability to entrench “autogynephilia” as a paraphilia in the DSM-V via his position.

Other members of the Work Group have mixed backgrounds and usually some kind of tie to the Clarke-Northwestern group (as the cadre including Zucker, Blanchard, Alice Dreger, J. Michael Bailey at. al. is often called, drawn from the clinics where some of them practice). Dr. Niklas Langstrom has treated mostly sex offenders and co-authored work with Zucker about transvestitic fetishism. Dr. Jack Drescher is the editor of the Journal of Gay and Lesbian Psychotherapy (where Anne Lawrence publishes) and involved with the Intersex Society of North America (ISNA), which in turn supports the Clarke-Northwestern clique via Dreger) — although he differs with Zucker in that he opposes reparative therapy (or at least with regards to gay and lesbian persons). Others have unrelated fields, or, like Dr. Heino Meyer-Bahlburg, are completely ambivalent to whether transgender people should even receive treatment.

Getting Involved

Organisation Intersex International (OII) has become active early on, and openly opposes the Clarke-Northwestern approach, which has continued to push for “normalization” of intersex infants. Zucker himself still adheres unflaggingly to Dr. John Money’s ancient theory that gender is entirely socially constructed via conditioning — despite David Reimer’s tragic story (alternate link), and other evidence to the contrary.

TransActive Education & Advocacy (TAEA) has issued a press release which is not yet on their website, but could appear there shortly. In it, they write:

TransActive strongly opposes the appointment of Dr. Kenneth Zucker to
Chair the Sexual and Gender Identity Disorders work group that will
revise and develop the fifth edition of the American Psychiatric
Association’s (APA) Diagnostic and Statistical Manual of Mental
Disorders (DSM-V). This position is based upon his approach to
clinical treatment of transgender and gender non-conforming identity
in children & youth.

Dr. Zucker, along with colleagues Dr. Ray Blanchard (also appointed to
the DSM-V workgroup) and Dr. J. Michael Bailey are proponents of the
theory that, in the vast majority of cases, gender non-conforming
identity in children and youth is merely an indicator of an eventual
homosexual identity in adulthood.

… Again his distinctly cissexist consideration of
transgender identity in children and youth as a ‘behavior-centric”
issue rather than an core identity issue is deeply troubling.

Philadelphia’s Trans-Health Conference is planning a gathering for Friday, May 30th to discuss a plan on the GID Reform issue. The meeting will be facilitated by Kelley Winters and Jamison Green.

Arianna Davis, of TAVA (which is also likely to weigh in on the matter) and Trans Mission International (in development) has developed a group, GenderID Coalition, to bring individuals together.

Additionally, a petition has been set up at The Petition Site.

What I don’t yet see are our GLB and medical community allies (PFLAG, National Gay & Lesbian Task Force, etc.) displaying interest, but this is still the early stage. Even the national trans organizations are still formulating their response. Hopefully, our allies are interested in adding a strong voice to ours.

Destigmatization vs. Coverage II

There has also been a renewal in the drive to remove the diagnosis of GID from the DSM altogether. This is something I’ve cautioned about on a few occasions, most recently in Destigmatization Versus Coverage and Access: The Medical Model of Transsexuality.

Make no mistake, the current entry is NOT perfect. What I believe that we need to do is push for an improvement on the existing model, in preparation for when the physical evidence is there (which I am certain that it will one day be), so that it can then be recategorized as a physical affliction (which shifts it to an entirely different caretaker, out of the APA’s hands — this is worth looking into down the road, as to how it would be treated as a biological issue). However, unless science really steps up research (which is unlikely, because the interest and $ aren’t there), the ability to categorize transsexuality as a physical medical issue is not likely to be there by the time the DSM-V is expected to be published, in 2012 (for those who’ve seen me write “2011,” the APA has corrected me on that). Which would leave at least some kind of gap in treatment (I also believe that when a biological trigger(s?) is found, it will be hotly contested for some time, so acceptance will not be instantaneous).

My concern is that the existing entry in the DSM-IV provides us basic access to medical services, from GPs to therapists, from HRT to surgery which could swiftly dry up without there being some medical acknowledgement whatsoever. Without legitimization in the medical community, our entire treatment becomes a “cosmetic” issue, and some could make the case that things like HRT are “harmful behaviours.” Additionally, without the existence of GID as a possible diagnosis, we will see more of our sisters and brothers (particularily the youth) diagnosed with other inaccurate things, such as Dissociative Identity Disorder.

Additionally, many of the rights and protections that we have, the financial subsidizations that we have in places of HRT meds, and those few places where surgery is covered or has a chance of becoming so — these mostly exist because of the counsel of the DSM, which is then given modern context for the legislators or accountants who address these things.

I do recommend that people consider how hamstringing a total removal can be before pushing for this. Also keep in mind that these texts often reign for decades, so it’s not simply a matter of “a little discomfort until a biological trigger is found.”

I volunteered with the Obama campaign’s Indiana LGBT Steering Committee. This was the first time I’ve ever felt so inspired by a candidate that I gave my time and effort fully to them.

In the midst of working for the Obama team, I really found a passion. In the past politics was something I watched on Sunday morning, much like football fans do. I was a watcher, but not active in it. With this campaign, that changed.

But with all the campaign work I’ve done, family events, starting a non-profit, blogging, and all the other things I’ve been doing, Transadvocate has suffered. I’ve been averaging about a post a week on Transadvocate, and that really isn’t fair to my readership or to my sponsors.

As of right now, I’m on hiatus from blogging on the main page. This hiatus will last till November. If anyone has a desire to continue blogging the main page, email me marti.abernathey@gmail.com. Most likely, I’m going to run the other Transadvocate bloggers through the front page. Getting Andre Carson, Ken Kern, and Barack Obama elected is my focus for now.

We need these equality minded people in office. And transgender people need to work hard to see that they do. I’m putting my money where my mouth is.

I’m doing it for me, for my friend Mel, and for her daughter. The next election will be historic in so many ways. We need to be present. We need to be visible. We need to be a part of history. I plan on doing my part and I hope you do too.

A short time ago, I’d discussed the movement to have “Gender Identity Disorder” (GID, a.k.a. “Gender Dysphoria”) removed from the DSM-IV or reclassified, and how we needed to work to ensure that any such change was an improvement on the existing model, rather than a scrapping or savaging of it.

Lynn Conway reports that on May 1st, 2008, the American Psychiatric Association named its work group members appointed to revise the Manual for Diagnosis of Mental Disorders in preparation for the DSM-V. Such a revision would include the entry for GID.

On the Task Force, named as Sexual and Gender Identity Disorders Chair, we find Dr. Kenneth Zucker, from Toronto’s infamous Centre for Addictions and Mental Health (CAMH, formerly the Clarke Institute). Dr. Zucker is infamous for utilizing reparative (i.e. “ex-gay”) therapy to “cure” gender-variant children. Named to his work group, we find Zucker’s mentor, Dr. Ray Blanchard, Head of Clinical Sexology Services at CAMH and creator of the theory of autogynephilia, categorized as a paraphilia and defined as “a man’s paraphilic tendency to be sexually aroused by the thought or image of himself as a woman.”

Drs. Blanchard, Zucker, J. Michael Bailey (whose work has even gone so far as to touch on eugenics) and a small cadre of others are proponents of dividing the transsexual population by sexual orientation (”homosexual transsexuals” vs. “autogynephilic”) and have repeatedly run afoul of the World Professional Association for Transgender Health (WPATH, formerly HBIGDA), and openly defied the Standards of Care that WPATH maintains (modeled after the original SoC developed by Dr. Harry Benjamin) in favor of conversion techniques. Blanchard and Bailey supporters also include Dr. Alice Dreger, who re-stigmatized treatment of intersex, controversial sexologist Dr. Anne Lawrence, and Dr. Paul McHugh, who had set out in the begining of his career to close the Gender Clinic at Johns Hopkins University and has been one of our most vocal detractors.

An additional danger that gay and lesbian communities need to be cognizant of is that if Zucker and company entrench conversion therapy in the DSM-V, then it is a clear, dangerous step toward also legitimizing ex-gay therapy and re-stigmatizing homosexuality.

I am not familiar with others named to the Work Group. It would be worthwhile looking into any history with WPATH that they might have, to know if we have any positive advocates on board, or just more stigmatizing adversarial clinicians. They may be appointed primarily to address other listings categorized as “Sexual and Gender Identity Disorders,” I don’t know. They are:

• Dr. Irving M. Binik, McGill University, Montreal, Canada
• Dr. Peggy T. Cohen-Kettenis, VU University Medical Center, Amsterdam
• Dr. Jack Drescher, New York Medical College, St. Luke’s-Roosevelt Hospital Center, NY
• Dr. Cynthia Graham, Isis Education Centre, Warneford Hospital, Oxfordshire, UK
• Dr. Richard B. Krueger, NY State Psyciatric Institute and Columbia University, NY
• Dr. Niklas Langstrom, Karolinka Institutet, Stockholm, Sweden
• Dr. Heino F.L. Meyer-Bahlburg, Columbia University, NY
• Dr. Robert Taylor Segraves, MetroHealth Medical Center, Cleveland

The APA press release states that for further information regarding this, to contact Rhondalee Dean-Royce (rroyce@psych.org) and Sharon Reis (sreis@gymr.com), though it’s possible that they may govern the press release only, rather than have any involvement in the decision to appoint Zucker. The APA itself is headquartered at 1000 Wilson Boulevard, Suite 1825, Arlington VA, 22209. Their Annual General Meeting is currently being held (May 3-8, 2008) in Washington, DC.

I’m poorly situated (Western Canada, with no travel budget) to lead the drive for this, which I see as a very serious danger to the transgender community. So I am calling on the various Transgender and GLBT organizations to band together to take action on this, and will assist in whatever way that I and AlbertaTrans.org can.

I am also calling upon our allies and advocates in the medical community and affiliated with WPATH to band together with us and combat this move which could potentially see WPATH stripped of its authority on matters regarding treatment of transsexuals.

– Mercedes Allen, May 5, 2008

“Essentially it’s business as usual for HRC. Nothing has substantially changed in their lobbying efforts. They’ve had no “’rehabilitative”’ moment or change of heart. If you take Keisling’s words to heart, the only other conclusion that seems logical is that United ENDA is dead.”

Recently Matt Foreman said:

” ‘Congress is a creature of history,’ Foreman said. ‘If lightning strikes and it passes the Senate, it will more than likely be the broken ENDA that is introduced next year because it will have passed both houses. That was the tragedy of the broken ENDA passing the House in the first place.’

Even if the Frank version of ENDA does not go into 2009 with the wind at its back, Foreman is not 100 percent confident that the situation can be righted. Asked whether HRC and the 300-plus dissident groups have come to a meeting of the minds, he said flatly, ‘No. Not that I’m aware of.’‘ ”

If you take these words to heart, the future for a fully inclusive LGBT Employment Non-Discrimination Act (ENDA) is bleak. With that in mind, some really tough questions need to be asked and debated. Will organizations like the Equality Federation, National Black Justice Coalition, National Center for Lesbian Rights, National Gay and Lesbian Task Force, National Stonewall Democrats, BiNet USA, COLAGE, DignityUSA, Freedom to Marry, Gay and Lesbian Advocates and Defenders, GLSEN, Lambda Legal, Parents, Families and Friends of Lesbians and Gays, Pride At Work, Empire State Pride Agenda, Equal Rights Colorado, Equal Rights Washington, Equality Advocates Pennsylvania, Equality Alabama, Equality Arizona, Equality California, Equality Florida, Equality Illinois, Equality Maine, Equality Maryland, Equality New Mexico, Equality North Carolina, Equality Ohio, Equality South Dakota, Equality Texas, Equality Utah, Equality Virginia, Fair Wisconsin, Indiana Equality, Indiana Fairness Alliance, Michigan Equality, Triangle Foundation, or Wyoming Equality stand AGAINST a bill that will surely pass both houses and be signed by the president? Should they be expected to?

The fight for an inclusive ENDA in October and November of 2007 had a lot of support in the community because most people realized that this the bill would never make it to the president’s desk. Will these organizations stand firm in their commitment, even though gays and lesbians will be denied protections? Will gays and lesbian communities support opposing workplace protections until gender identity is included?

I ask these questions because I see on the horizon a brewing battle that could look something like Sherman’s scorched earth policy during the Civil War. There is a potential for the coming storm to rip through the community and cause irreparable damage. I hope that this is talked about long before it happens (unlike the removal of gender identity from ENDA).

For myself, I plan on moving towards allies that are more focused on gender equality and away from GLB organizations. I’ll still fight for marriage equality with these organizations (and as a member of some of them), but I believe that our most natural allies lie more with social justice organizations who are fighting for gender equality.

Many people in the transgender community are making great strides in political and business circles. With the death of an inclusive ENDA (and with it United ENDA), it would be perfect time to retool, reevaluate, and refocus our direction and our movement.

On the subject of parents, Matthew Shepard’s mom, Judy Shepard was in town as the keynote speaker at Houston’s HRC banquet. I missed out on getting a chance to touch base with her again. We met in 2000 at the Martinez vigil in Cortez, Colorado as she was there with a contingent of other PFLAG parents, including Carolyn Wagner and Gabi Clayton. She was very sweet, we chatted quite a bit about what Paula Mitchell was going through, how it touched her own life and brought back some of the memories of 1998 for her. I’d mentioned to her my own sentiments about starting a march to Austin immediately after Matthew was found, and how we’d held a vigil in Houston which I volunteered at as many of the spontaneous events sprung up around the country following Matthew’s death.

I had kind memories of Judy from that visit (and another brief encounter in Columbus, Ohio’s PFLAG convention).

Then I got wind from a media friend in Dallas about her speech in Houston (after noticing our protest line outside).

About three minutes into the speech, Judy comes around to noting that:

“Joe [Solmonese] and the other lobbyists are just stellar,” and how they are there at the banquet to “celebrate the work they do for ‘us’ on the hill.”

She then adds that theirs is work that is:

“frequently misrepresented in the press.”

Judy notes “the way that people think we should force people to vote the way we want them to…. It doesn’t work that easy. It’s not that smooth.” Heard that line before? Yeah … me too. Someone drank the Kool-Aid.

From there on, it’s downhill.

“I commend all of you for understanding how important it is to support them (HRC) even when the press begins to rail at them about things they don’t understand. [about 4:30 into the speech]“

“We have an important job and an important message to keep morale up and keep the information correct.”

“We have a job to maintain that honesty and that sincerity.”

“You need to pay attention to what’s going on.”

“Marriage is not going to change everything for you (oddly she never brought up employment issues at all).”

“We have a lot of education that needs to be done, particularly around the transgender issue.”

“We need all of you to support what HRC does and to talk in a way that shows your knowledge of a situation. We need the right information out there.”

Talking about her visits to college campuses, Shepard says she can’t relate how many times she’s heard from them: “well HRC just deserted the transgender issue.”

To that, Shepard replies to them:

“Well no, not really. They didn’t do that at all! Do you read their policy? Do you read what’s on their website? Or are you just listening to the hype the popular press is giving you misinformation?”

To the banquet attendees, Shepard implored them that:

“we have to talk to people. We have to tell our stories. We need to be … authentic about who we are.”

She wrapped up with a call to arms for all HRC members:

“Y’all need to back up what’s happening, everywhere in every situation that happens.”

In a nutshell, it’s up to all HRC supporters to go forth and challenge every claim about their disparity and disparagement of the transgender community. This will be their messaging, and they will stick to it:

It’s all been a concoction of the press’ imagination, and an attempt to create controversy from something that never happened. HRC, not the transgender community, has been honest and sincere. We trans activists allegedly don’t know up from down and right from wrong, not even understanding what has happened to us legislatively or even from out well-meaning and knowledgeable friends at HRC. We should all read their policy and their website and not pay attention to exclusion from legislation, or lack of access to legislators whom we’ve clearly failed to educate this past decade and a half.

Meanwhile, marriage is possible in the near term for gays and lesbians, and there’s not much need to even discuss employment – not an issue at all.

Pardon me, while I pick my jaw up off of the floor.

Of all the people to be public, and to issue the call to all in HRC to take up the battle and defeat the transgender bullies and the illusory press – it’s Judy Shepard!?! Folks in NTAC, most consistently mistrustful of HRC, have had precious little contact with press – you won’t see one word from me on HRC in press since 2007. Ironically, most press on HRC and Joe Solmonese has come from Mara Keisling: hands-down the best friend HRC has ever had in helping market themselves with and make serious inroads into the transgender community!

And the press and transgender community have been unfair to HRC? And they need to now fight back?!? For honesty and sincerity???

Truly I feel like I’ve just been mugged, robbed and beaten senseless by Santa and his posse of gangsta elves. It’s like finding out the tooth fairy is actually a pervert who breaks into people’s homes to rape them while they sleep. The Easter Bunny playfully nibbles all he sees and spreads MRSA – the flesh-eating staph bacteria. How did this happen? Did I really miss this one that badly?

Doubtless this will also come as a shock to Carolyn Wagner, Gabi Clayton, Courtney Sharp, Sue Null, Mary Boenke and all of the trans-supporters in PFLAG-land. I’m stultified.

This speaks to the level of HRC’s persistence and myopic focus on their singular goals, regardless of costs, damage or image. They’ll worry about that last part, Rove-style, once they’ve won all and can buy a retroactive sanitizing of their history for posterity. Until then, regardless of what it takes, HRC will ‘vanquish all foes who stand in their way and seize victory’.

In case you haven’t figured it out yet, these college challengers, the trans-friendly gay press, and we bully trannies, we stand in their way – we’re their foes too. Call the riot police ….

“It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth becomes the greatest enemy of the State.” – Josef Goebbels

“It’s partly because some of the people who are now lately to this fight weren’t there helping us through the lobbying. “

and then said:

I have been pleading with people in the gay and lesbian and bisexual and transgender communities to lobby for us. Instead, they want to strategize, many of them. Some, no. Some have done a very good job. But many of them weren’t there.

Hearing those words, I assumed that the lobby day events would get extra special attention (especially to gaining access). But since the event I’ve heard from numerous lobbyists that their access was no different than in years past. If the education that has been done in the past (the Gender Public Advocacy Coalition
has lobbied Congress since 1995, the National Transgender Advocacy Coalition since 1999, and the National Center for Transgender Equality since 2005) wasn’t good enough for Representative Frank and he wants us to be in the bill after doing the right kind of education, a little help in the access department from his office might help. And I’d think the Human Rights Campaign (HRC) would be helping out Mara Keisling, since they’re using her image on the transgender section of their website!

Transgender advocacy groups are doing the work that needs to be done. The words of those that oppose gender identity inclusion in ENDA ring hollow when they don’t expend ANY political capital or influence to see that the the educational/lobbying work is effective.

(As a post-script to this post, I’d just like to say how frustrating it is to find people still arguing that gender identity protections in ENDA only protect transgender people. The definition in the language of the inclusive ENDA bill (HR 2015) is as follows:

GENDER IDENTITY- The term `gender identity’ means the gender-related identity, appearance, or mannerisms or other gender-related characteristics of an individual, with or without regard to the individual’s designated sex at birth.

This definition would cover anyone who is gender variant.)

By calling the Houston Police, national HRC deliberately set in motion a police over response. HRC used government and taxpayer monies to intimidate the hell out of TG and gender variant people who drove in to participate, but were scared away.

I hope the Advocate or Blade or Voice do a freedom of information act request to determine how much money was used to cover the HRC “false alarm.” I think the City of Houston should bill National HRC for the knowing “false alarm.”

Only 11 folks were brave enough to show when driving in and seeing the police riot set up that HRC had triggered. Three were from out of town. A threat, we were not! THERE WERE NO INCIDENTS.

The tenor I’ve heard from other national GLBT leaders (including some leading Executive Directors) is that Phyllis Frye is either mistaken or dishonest in her belief that HRC is trying to intimidate transgender people. I’ve been told that it is S.O.P. (standard operating procedure) when there is a protest of an HRC dinner that the police are called by the local HRC that hosts the event. That being said, do you think that this is an appropriate response to 11 transactivists?

I’ve organized or co-organized many a protest (see my about page for a list) and we’ve never had more than a few officers. We always alerted the ACLU and they sent monitors:

At our “Rally at the State House” in Indianapolis we had almost 1000 people, yet didn’t have six mounted police officers.

If HRC is trying to mend fences or wants to bring transgender people back into the fold, intimidation is not going to help do that. It only reinforces the idea that we are pawns, to be moved and ordered as the HRC wills us to.

Most of the conference is spent in workshops (the full list here), but there were also three luncheons, three outings, and the Gala Banquet.

Three workshops really impacted me. The first workshop I attended was Pauline Park’s “Making Diversity Real: Transgendered People of Color & the Transgender Movement”. I didn’t talk too much in this workshop, because I’m white, and I was there to listen and learn. As someone that focuses on diversity in a group setting, the workshop gave me some insight on how to make that happen without being condescending or engaging in tokenism.

The second workshop of note was Mariette Pathy Allen’s workshop entitled “The Gender Frontier: From Mainland USA to Hawaii, Thailand, and New Zealand”. Allen has been a professional photographer, writer and speaker on, and on behalf of, the TG community since 1978. Her workshop consisted of slides of her work over the years, along with a rolling commentary. It was really meaningful to me to see into a portal of the past, to those that have come before me. And as the slides and stories flew by, I was so engrossed, that I was jolted when one of those faces on the screen turned out to be someone I knew. After the workshop, I approached Allen and told her my story. She has such an engaging and personal spirit. She took me by the hand and said that she she had noticed me nodding in agreement with much of what she was saying. I was stunned by her powers of observation (especially in a low light environment). On reflection, I’m sure that her personal engagement and keen powers of observation are what make her such a powerful photographer.

I found Sam Allen’s “No Skirt, No Heels, No Service?: Addressing FTM Participation & Inclusion In The Transgender Movement” to be one of the most educational workshops I’ve ever attended, transgender related or not. IFGE’s workshop guide described it as:

“A candid discussion of topics including but not limited to FTM invisibility, where does ‘passing’ figure into the imbalance, gender roles & power dynamics, early socialization, barriers to transmen participation, and the responsibility of FTM transmen to ’step up and stand up’. Open to everyone. Bring your truth serum and a sense of humor. “

Allen’s explanation of how socialization and language affects perception of others, was especially helpful for me (I had never been able to understand why I had been perceived as gay growing up, even though I was never feminine). I was impressed with how well Allen explained the dynamics without ever engaging in blaming or shaming others. Because my best friend is F2M, I thought that I’d be free from any of the behaviors or thoughts that cause F2M identified people to feel marginalized and silenced. Allen’s nonthreatening way of communication allowed me to be able to examine my own thoughts and actions to see that I had engaged in some of the same kind of thinking and behavior.

Many new friendships were forged at the luncheon tables, but it wasn’t just a time for socializing. The Diversity luncheon speakers included Amanda Simpson, Donna Rose, and Denise Leclair. Overall, the luncheons were an inspiring and unifying. The noted exception to this rule was Cheryl Ann Costa’s acceptance speech at the Trinity Awards luncheon. Costa left more than one mouth agape, with her suggestions that F2M’s go forth and “join the Rotary” or that transwomen should break from crossdressers and have their own conference. I started my transgender journey in November of 2000, but my time on the national advocacy scene has been limited. Going into the luncheon I had no idea who Costa was. I’ve learned since how much Costa has given to the community. I was told that this was her “retirement speech” from the community, and she saw the Trinity Award as her “gold watch.” It’s unfortunate for her that many people who attended (150 people at the conference were first time attendees) who might not know what Costa has done, will be left with the lasting impression of her as a negative train wreck.

While there were many distinctions in the population of the conference, I found that those distinctions were individual in nature. I had one crossdresser tell me that even though I was “a bit overweight” that she’d still “do” me. She also told me that women have more power than men. If I took her words as representative of the entire crossdressing community, even I would want some separation between the crossdressing and transsexual communities. Fortunately, I also came into contact with wonderful crossdressers like Lena Dahlstrom. Lena was in many of my workshops. She was one of the few people (besides myself) in Sam Allen’s workshop that wasn’t F2M identified. The chasm between these two people really delineated the weakness in Costa’s call for spitting off the community. You’ve probably heard it said that our strength is in our diversity, but I’d contend that our weaknesses of binary thinking, bigotry, and misogyny, are spread out among the different sections of the transgender community too.

I made personal connections at the conference that have and will continue to change my life. I’ve always enjoyed reading Joelle Ruby Ryan, but meeting her in person really heightened that appreciation. She’s not only someone that I respect, but someone that I’d like to get to know more as a friend.The names that I’ve seen and heard for years became much more meaningful and dynamic. And I’d be remiss if I didn’t talk about finally meeting Monica Helms and my stunning come from behind arm wrestling victory.

As much as I loathe to admit it, I was wrong. I let the conference in, and I was changed. I’ve I’ve returned to Indiana with a renewed spirit, with new friendships, and a renewed outlook on my activism and my life. Next year, look for me at the 2009 IFGE conference. I’ll be the one saying “this conference will change your life, if you let it.”

Granted, there are concerns about the current classification as a “mental disorder,” and certainly as a transgender person myself, it’s quite unnerving that my diagnosis of GID puts me in the same range of classification as things such as schizophrenia or even pedophilia. And when the emotional argument of “mental unfitness” can lead to ostracism, discrimination in the workplace or the loss of custody and / or visitation rights of children, there are some very serious things at stake. But when the lobbies are calling for a reclassification — or more dramatically a total declassification — of GID, one would expect that they had a better medical and social model to propose. They don’t.

Basic Access to Services

The argument for complete declassification is a great concern, because unlike homosexuals, transgender people – especially transsexuals — do have medical needs and issues related to their journey. Genital reassignment surgery (GRS), mastectomies and hysterectomies for transmen, tracheal shave, facial hair removal and breast augmentation for transwomen… there are clear medical applications that some require, even to the point of being at risk of suicide from the distress of not having these things available (which is an important point to keep in mind for those in our own communities who assume that GRS is cosmetic surgery and not worthy of health care funding). And we need to use caution about taking psychiatry out of the equation: GID really does affect us psychologically, and we do benefit from having a central source of guidance through the process that keeps this in mind, however flawed and gated the process otherwise might be.

Declassification of GID would essentially relegate transsexuality to a strictly cosmetic issue. Without being able to demonstrate that GID is a real medical condition via a listing in the Diagnostic and Statistical Manual (DSM), convincing a doctor that it is necessary to treat us, provide referrals or even provide a carry letter that will enable us to use a washroom appropriate to our gender presentation could prove to be very difficult, if not impossible. Access to care is difficult enough even with the DSM-IV recommending the transition process — imagine the barriers that would be there without it weighing in on that! And with cases regarding the refusal of medical services already before review or recently faced in California, Ontario and elsewhere, the availability of services could grow overwhelmingly scarce.

A Model of Medical Coverage

And then there is health care coverage, which often causes a lot of issues of itself, usually of the “not with my tax money” variety. But no one just wakes up out of the blue and decides that alienating themselves from the rest of the world by having a “sex change” is a good idea. Science is developing a greater understanding that physical sex and psychological gender can, in fact, be made misaligned, causing a person to be like a stranger in their own body. In extreme cases (transsexuals), this often makes it impossible to function emotionally, socially, sexually, or to develop any kind of career — and often makes one constantly borderline suicidal. The medical community currently recognizes this with the existing medical classification, which is why GRS surgery is the recognized treatment, and why it (GRS, that is, and usually not things like breast augmentation) is funded by some existing health plans.

Canada provides an interesting model on this, as the nation has universal health care, and several provinces fund GRS with some limitations (British Columbia, Newfoundland, Saskatchewan and Quebec fund vaginaplasty, hysterectomy and breast reduction for FTMs, Alberta funds those plus phalloplasty, and Manitoba funds 60% of GRS-related costs). Funding may be restored in Ontario and gained in Nova Scotia, pending some ongoing activism.

This exists specifically because it is classified as a medical issue, and is treated according to the recommendations of WPATH. There are some idiosyncracies, of course — a diagnosis of Intersex, for example, overrides a diagnosis of GID, and if someone is diagnosed as IS, the treatment is different (namely, GRS is not covered). Phalloplasty and metoidioplasty (FTM surgeries) are not covered in several areas because they are considered “experimental.” Some provinces insist on treatment only in publically-funded hospitals, resulting in the rather unusual situation of Quebec sending patients to the U.S. or overseas, even though one of the top-rated (but privately-owned) GRS clinics in the world is located in Montreal. And many provinces direct transsexuals to the notoriously restrictive and obstacle-laden Clarke Institute (CAMH in Toronto) for treatment. Waiting lists can be long, and only a select few GID-certified psychiatrists are able to be a primary signature on letters authorizing surgery and funding. Still, the funding provides opportunity that many non-Canadian transsexuals would leap at within a moment, if they could.

Future Considerations

This possibility, remote as it may seem, is also out there for future American transsexuals. Both Democratic Presidential nominees have discussed developing a national health care program. The time is now for the trans, gay / lesbian / bisexual and allied communities to lobby insurance companies to develop policies that cover GRS. The time is now to lobby companies to seek out group policies for their employees with such coverage, and with more emphasis than the HRC’s impossibly easy Corporate Equality Index (CEI), in which providing mastectomies for breast cancer patients qualifies as “transgender-related surgeries.” The more prevalent health care coverage is for transgender persons when a national program is developed, the more effective the argument is that a national program should include it. Certainly, it will be much harder to lobby to have it specifically added later.

This possibility, remote as it may seem, exists because of the current classification. Even some existing coverage of and access to hormone treatment is called into question in a declassification scenario. And certainly, where coverage is not available, it is the impoverished, disenfranchised and marginalized of our community – who quite often have more to worry about than the stigma of mental illness – who lose the most.

So a total declassification is actually not what’s best for the transgender community. Too, if anyone had been thinking that proclaiming that “transsexuality is not a mental disorder” would magically change the way that society thinks about transfolk, then they are spectacularly and embarrassingly wrong.

The Question of Reclassification

At some point in the future, I expect that we will find more biological bases for GID, and that transgender people will perhaps become a smaller part of the larger intersex community (rather than the other way around). Recent studies in genetics have demonstrated some difference in chromosomal structure in male brains versus female brains, and the UCLA scientists who conducted the study have also proposed that their findings demonstrate gender dysphoria as a biological characteristic. Other studies into endocrine disrupting chemicals (EDCs) could open new discoveries related to variance in gender correlation. A reassessment of GID is almost certainly something that will be on the medical community’s table at some point in the future, but it definitely needs to be in the DSM somewhere. But for now, GID is not something that can be determined by a blood test or an ultrasound, and is not easy to verifiably place with biological conditions. The science is not there; the evidence and solutions are not yet at hand.

This is why reclassification is not yet feasible. It’s difficult to convince scientific and medical professionals to move a diagnosis when the current model is workable in their eyes (even if not perfect), while the alternatives are not yet proven, cannot be demonstrated as more valid than the current listing, and no modified treatment system has been devised or proposed. Any move of the diagnosis is not likely to be very far from the current listing, and from the literature I’ve seen, I doubt that those in the community who advocate to changing or dropping the current classification would be happy with that. For some, even listing it as a “physical disability” could constitute an “unwanted stigma.” I have heard one WPATH doctor suggest the term “Body Morphology Disorder” – for many, I suspect, this would still be too “negative.”

“Unnecessary Mutilation”

That’s not to say that complacency is an answer. In the face of conservative reluctance and new activism on the left by the likes of Julie Bindel, claiming that GRS is “unnecessary mutilation,” we need to demonstrate the necessity of treatments, in order to ensure that any change would be an improvement on the existing model, rather than a scrapping of it. This is, of course, something that affects a small portion of the transgender community in the full umbrella stretch of the term, but the need for those at the extreme on the spectrum is profound — not simply a question of quality of life, but often one of living at all – or at least a question of being able to function. If and when a reclassification occurs, it will need to be this sense of necessity that will determine the shape of what will be written into any revision.

The solution isn’t to destroy the existing medical model by changing or eliminating the current classification of “Gender Dysphoria.” Collecting data, demonstrating needs, fighting for inclusion in existing health plans, examining verifiable and repeatable statistics on transgender suicide and success rates and other information relevant to the medical front is where medical-related activism should be focused, for the moment.

(Crossposted to Bilerico.com and Dentedbluemercedes.wordpresss.com)