A diagnosis of "gender identity disorder" or "authenticity?"
The DSM-IV diagnostic criteria for GID is:
A strong and persistent cross-bender identification (not merely a desire for any perceived cultural advantages of being the other sex). Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that that sex. The disturbance is not concurrent with the physical intersex condition. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
Ugh. I will admit my bias here, I am not sure as to why not being able to be who you truly is classified as a disorder.
What I can see how the pain of not being able to be our authentic selves can lead one to feeling a type of suffering that would lead to a disordered life.
A recent study published in the journal Pediatrics outlines how children who push the arbitrary boundaries of gender, classified in this study as gender nonconformist, are at risk for suffering from PTSD and child abuse. They include children who just push the edges of what toys they want to play with and what they want to wear in this study.
The social punishment for not conforming starts early on and when it does the effects are devastating.
Into adult hood it can sink a life. One study found that those who are struggling with claiming their gender identity are more likely to suffer from substance abuse disorders. Another found that consider and even attempt to end their lives.
These reports should be of no surprise since we know that living outside of one’s true self can bring up levels of anxiety and pain that are so severe that sickness is a guarantee.
What can be done to help them? It may take more that just have a DSM diagnosis and even the slight alteration that is being offered in the new edition.
It would require that we as society continue on a path of understanding the spectrum of the human experience.
Gender Identity is more than just a dealing with the specifications of biological gender. Gender identity includes the social norms of what it means to be (in the constraints of our current system) male of female.
Our overall identity in our society is dependent upon our biology, our social and economic status, our education level, where we live, who we love and what we think. Standing in the face of all of this in order to claim self is hard and amazing work for all of us to do. In the case of those who are at odds with the biology of their gender, as the research shows, the work can be even harder.
Until that miraculous day, in the field of psychology, the work can be done at the level of the therapy. Any therapy that is based on compassion and empathy can only serve to giving someone the safe space to the explore who they are free from judgment. Therapy that includes forgiveness can help to heal the pain of broken relationships that may happen along this journey. Therapy that includes the energy of social change would be helpful in that in this case the therapist is acutely aware of the social implications of what “coming out” means and what battles they clients may be up against. Finally, therapy that includes a search for self through meaning could be helpful in that a client can spend the time finding meaning behind their personal journey --- that meaning may be the light that keep them from giving up in times of adversity. Of course therapists will need to deal with the consequences that sometimes befall those on this path, the anxiety, isolation, depression, desperation and pain. All of these must acknowledged and worked with in therapy.
This is a long road for many but in the end it the hope that their lives will be full and truly theirs. I recall a colleague described his experience with finally making become who is today – he said this with a smile; it was like having the puberty that I never got to have.
This made me smile.
As a therapist I hope to be able to provide a space for everyone that I work the opportunity to finally walk in the world as themselves. Imagine how much more we all add to our society when we are fully in ourselves.
-- Makenna Berry