48 - Restoring Sanity - Re-psychopathologizing Transgender Identification

In September of this year, Genspect held its fourth Bigger Picture Conference. Genspect “is an international organization promoting evidence-based, non-medicalized approaches to gender distress. Active in 25+ countries, we defend biological reality, support families and detransitioners, and advocate for healthier outcomes for individuals and society.”[1] On the first day of this conference, Genspect Canada Director Mia Hughes announced the launch of their campaign to re-psychopathologize transgender identification.

In their press release, they note:

The 2010 declaration by the World Professional Association for Transgender Health to “de-psychopathologize” gender variance was not based on scientific discovery but on political advocacy. This campaign has caused catastrophic harm by removing essential psychiatric guardrails, fueling a social contagion, and exposing vulnerable people to experimental medicalization.

Re-psychopathologization is not a call to re-stigmatize or marginalize individuals who identify as transgender. It is a call to restore compassion and clarity: to understand that this condition is pathological, not innate; to treat it as an all-consuming fixation requiring careful, appropriate, ethical psychological intervention, and to prevent the unchecked spread of this harmful belief.

They call upon governments and medical and mental health care organizations to update their policies and procedures accordingly.

Gender ideology is the belief that one has an innate sense of “gender” that supersedes one’s actual physical body, and steps should be taken to medically and socially address the body rather than the mind. This is a disastrous concept, leading to irrevocable changes to the bodies of children and adults who later come to regret buying into this idea. In truth, this feeling is more akin to body dysmorphia disorders, where one does not have an accurate view of their physical being. (I.e. – anorexia nervosa, where one incorrectly believes that they are obese and limits their intake of calories in an effort to lose weight.)

In 1987–1994, the DSM[2] revisions, including ICD-10, led to the consolidation and revision of names and subtypes. Specifically, ICD-10 (1992/1993 rollout) used “gender identity disorders” and included diagnostic subtypes (e.g., transsexualism, dual-role transvestism). Activists and some clinicians found these classifications to be stigmatizing and began working on their campaign to change the way mental and medical health care professionals understood these experiences.

The World Professional Association for Transgender Health (WPATH) released its 7th Standards of Care (SOC) in 2011. It emphasized informed consent, client-centered care, and removal of pathologizing language. This was the first organization to separate gender identity from mental illness explicitly. WPATH also introduced “gender nonconforming” as an umbrella term.

Impacted by WPATH, there was a shift from identity being a disorder to a focus on the distressful feelings one experiences when they don’t believe their body aligns with their inner sense of gender (Gender Dysphoria) in the DSM-5 in 2013. The APA removed the label “gender identity disorder” and introduced “gender dysphoria,” explicitly refocusing diagnosis on the distress or impairment that can accompany incongruence between assigned sex and experienced gender — not on the identity itself. Some type of diagnosis was required for those who sought medical interventions to change their bodies via hormones or surgeries.

WPATH released an even more radical revision in their SOC8 in 2022, which R4R covered in depth.[3] It included a chapter on men who had voluntarily castrated themselves, recommending that these “eunuchs” be considered as an identity category:

Eunuch individuals will present themselves clinically in various ways. They wish for a body that is compatible with their eunuch identity—a body that does not have fully functional male genitalia. Some other eunuch individuals feel acute discomfort with their male genitals and need to have them removed to feel comfortable in their bodies…

Like other gender diverse individuals, eunuch individuals may be aware of their identity in childhood or adolescence. Due to the lack of research into the treatment of children who may identify as eunuchs, we refrain from making specific suggestions.[4]

This edition of WPATH’s “Standards of Care” also removed the chapter on ethics and any age restriction references after mental health care professionals had signed the document![5]

Restoring the concept of gender identity disorders will allow for improved mental health services for those who are confused or insecure in their bodies. It will usher in a return to sane standards of care for these individuals. Up to 90% of those who experience distress about being born male or female as young children will find these feelings dissipating as they go through puberty. Supplying support without making drastic changes to their bodies or requiring society to go along with a lie is what will make a great difference in their lives.

Some readers may know that trans-identifying activists were following the example of gay and lesbian-identifying activists who campaigned to have homosexuality removed from the DSM as a disorder in 1973.[6] We will continue to explore this in the next edition of R4R.

[1] https://genspect.org/genspect-calls-for-re-psychopathologization-of-transgender-identification/

[2] DSM is the Diagnostic and Statistical Manual of Mental Disorders, a handbook published by the American Psychiatric Association that provides a common language for healthcare professionals to diagnose mental disorders. It specifies diagnostic criteria, symptoms, and other features to help clinicians make consistent and reliable diagnoses.

[3] WPATH, Part I – History, R4R, Jan 24, 2023

WPATH, Part II – Activist Ideology Replacing Therapeutic Psychology, R4R, Jan 26, 2023

WPATH, Part III – Lack of Research, R4R, Jan 31, 2023

WPATH, Part IV – Bizarre Recommendations, R4R, Feb 2, 2023

WPATH, Part V – More Bizarre Recommendations, R4R, Feb 7, 2023

WPATH, Part VI – Resources Revealing the Truth, R4R, Feb 9, 2023

[4] https://andrewsullivan.substack.com/p/the-gender-identity-of-eunuchs-d4d

and WPATH, Part IV – Bizarre Recommendations, R4R, Feb 2, 2023

[5] WPATH, Part V – More Bizarre Recommendations, R4R, Feb 7, 2023

[6] Gay rights advocates began protesting the American Psychiatric Association (APA) at its annual meetings. In 1972, Dr. John Fryer, speaking in disguise as “Dr. Anonymous,” gave a historic address to the APA, describing the discrimination faced by gay psychiatrists and calling for reform.