Man I Feel Like A Woman February 21, 2013

Do you feel like a man or like a woman?  What is a certain gender supposed to feel like?  How do you know?  I realize that most cisgender people have not considered these questions, but for a transgender or transsexual individual it is of constant concern.  Gender incongruency is something ~98% of the population can’t even fathom.  Consider the possibility the concept of gender as taught in the schools is inaccurate?

First understand the difference between sex and gender.  Sex is determined by the parts between the legs and gender is determined by the parts between the ears.  At least this is the modern or current understanding by science. Consider the possibility that each person is here in this world for a purpose and they have chosen the roles they are to live before they are even born.

What if in fact gender is determined by consciousness, the Source Field which surrounds the body and makes up everything in this world?  What if no one has a gender until they acquire one?  Much like sexual orientation it must be discovered by the individual.  I cannot tell my brother that he is gay or straight or if he is man or woman.  These are things he must discover.  Life is a discovery!  And we are explorers.

The prevalent teaching about God, Great Spirit, Universal Mind, Infinite Intelligence (or whatever you choose to call this energy) is that it has no sex or gender.  Eastern philosophies have known this for centuries and slowly the western philosophies are accepting that God is not a man sitting on a throne up in heaven.  Our philosophies are merging, especially here in the USA where we are surrounded by both all the time.  A new understanding is emerging and I call it Oneness.  We are all One.

The idea I present here today is that God is all there is and since God is all, so are we.  This means that no one has a gender or a sex in reality!  Those things only exist in the reality we call life on earth.  We are indeed all androgynous beings of light!  You may have seen this image presented before as alien life, for instance in the movie Cocoon (1985) or in episodes of Star Trek and in multiple instances in the media.  Everything is energy.

I mention the idea of androgyny here because I feel this is the truth of nature.  I believe that hetero, homo, bi, pan, or a sexuality are creations of the human mind or the mind of man.  This goes for the concept of man and woman also.  How do you know what a man or woman feels like?  You do not know any more than anyone else does!  Just because you seem to have been born male or female does not mean you know what a man or woman feels like. It is what you say it is.

The core of our being is pansexual androgyny, meaning we are characterized by the potential for aesthetic attraction, romantic love and/or sexual desire for people, regardless of their gender identity or biological sex.  And we are neither men nor women, but a combination of both to varying degrees across a spectrum.  In some individuals this can shift back and forth as well.  You will define it as is comfortable for you.

In the end you feel like YOU.  Accept this feeling and get comfortable with it; it is all you will ever have in this lifetime.  No matter what you change on the outside, the inner core remains the same.  The experience will change as this is the point of the material world.  Enjoy the ride, act with authenticity, and live with pride!  This is your role in life and it is mine.

Sequoia Elisabeth

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Transgender Suicide February 13, 2013

“Transgender Suicide Report

For the last five years Laura’s Playground has prevented Transgender suicides on line. (Click Here for a link) The estimate of transgender suicides in our community is between 31% to 50% depending on who in the community we talk to. Few outside our Community acknowledge or believe these numbers including Dr Kenneth Zucker and Doctors Blanchard and Baily. Until now it’s all been guesswork. Actual numbers were hard to come by as it is hard enough for families to admit there was a suicide let alone that the victims were transgender. The fact is most medical examiners do not know if a person was gay or transgender due to families too embarrassed to report it. Here we have 5 suicide prevention crisis rooms in chat that are all busy. Our staff both moderators and supervisors are certified in youth suicide prevention. The fact is we have actual numbers not just an estimate. In a 5 year period here this site handled 78,800 suicidal crisis’s online. They were of 3 types. Type 3 being suicide ideation, Type 2 being suicide ideation with a plan and Type 1 being actual suicide attempts.

Type 3 = 46933 Type 2 = 20238 Type 1= 11629

In addition, in a survey here over 50% of Transsexuals had at least one suicide attempt by their 20th birthday some as young as 7. This was also verified by chat transcripts of the crisis’s especially in the early years. Reasons given for suicide in order:

1) Problems coming out to homophobic friends, families and co-workers. Homophobia in general including slurs.

2) Body Image Distress or disgust – puberty

3) Discrimination – Housing – Employment – Church’s

4) Victims of Hate crimes and/or violence

These are actual numbers and reflect what is really going on in the community. Many had more than 1 reason combining 1 and 2 and others. The biggest surprise was the role homophobia played in suicide ideation. If homophobia stopped tomorrow the suicide rate would be significantly reduced which means it is preventable.” (Laura Amato 2012)

The one reason I see lacking here is money.  Many transsexuals lack the money to have any treatment at all and most lack the funds to have SRS/GRS.  We are talking 50k to 150K depending on surgery, electrolysis, therapy, and hormones.  Those who are most severely dysphoric are most likely to end it all due to a lack of funds.  It is an option I keep in the back of my mind and review quite often.  Fortunately, I understand I am not my body and removing the body will not fix anything.  I even hesitate to have surgery at all knowing that ultimately it changes only my appearance.  My soul has no gender, but that is another story.

The good news is there are organizations working hard to remedy this predicament many of us face.  Advocacy groups are working to change the insurance laws and get transgender care including surgery added to most plans. The AMA has come out and stated that surgery is a medically necessary treatment for Gender Dysphoria, see my website for link to statement. As it stands now, a few carry it as a rider and most of these are because the Corporation or Municipality negotiated/demanded them into the options they offer.

Many larger communities have organizations who offer low cost therapy and Denver has several.  The Gender Identity Center, who I volunteer with, offers therapy and hormone letters to those in need on an ability to pay basis. Here is a link to therapists who specialize in gender care.  If you can’t afford them, ask for options in your area.  I am happy to help if I can, also check my website for other resources.

The Jim Collins Foundation offers a grant for surgery to those meeting their qualifications, click here for info.  Some surgeons offer scholarships or grant programs to assist their clients in payment.  Check with your surgeon to find out what they offer.  I do know Dr. Reed in Miami has a program for the first 13 per year who apply.  There are companies like Satori Medical who help clients find low cost surgery in Thailand and other locations.  Many creative solutions have been found over the years by many a resourceful individual.  Necessity is the Mother of Invention after all!

The best way to deal with a perceived lack is to help someone else fulfill their need.  This is one reason I started this website, to give what I need!  If you know of a need in the world, reach out and help, you will be helping yourself.

Sequoia Elisabeth

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Mirrors of Friendship II December 17, 2012

Transition is a long and sometimes arduous journey so it is very important to treasure each moment of Joy and each success along the path.  Doing this alone is certainly possible, but the Joy grows exponentially when there is someone who cares to share the experiences with.

Often the decision to begin the transition journey i.e. come out to your partner or parent(s) is the biggest challenge.  Will they accept you?  The real question is do you accept yourself?  The only way to know if you accept yourself is to observe how others treat you.  I know this may seem backward or strange, but this is just how it works.  Understand this… you are all there is, all else is a reflection of who you are.  This may seem odd and self-centered, but it is the Truth and it is both good and bad news.

I call this the mirror principle.  Life is often like living in a house of mirrors, and it can get pretty confusing.  This being said let’s get back to your partner who is having difficulty with your coming out news.  Each person in your life has their own vision of you… as a reflection of themselves, because from their perspective they are the only person there is!  So, be gentle with your expectations of them just as you are gentle with your expectations of yourself.  Do on to others as you would have done on to you, because they are you!  We are One.  Each person is an individuation of the whole; the One; all there is.  All those who are close to you will transition with you or they will fall out of your life.  Transition/change is like walking into a new room, if they do not come with you,… well you get the idea.

When you think about this it explains a lot about the reactions and treatment you get from others.  You may or may not be treated well, however the longer and deeper your understanding of this reality the better life gets.  Those who see themselves to be like you or see something in common are going to be supportive and understanding (and vice versa).  This is a great reason to join a support group!  The internet is a great place to look for one, or you could ask around, network with friends and if you still need help, contact me - I am here for you.  The time spent with others on a similar journey will help you to better understand yourself and give you the opportunity to grow self love.  The Love you give is the Love you receive!  Not only do support groups offer much needed information such as where to go to get the things you need, what to look out for along the path, and who can help you; they show you who you are and I find this to be the greatest gift anyone can offer!

Sequoia Elisabeth

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What Does It Mean To Be Transgender November 14, 2012

What does it mean to be Transgender?  While this is a personal question it does apply to at least 3% of the population.  The LGBTQ population is estimated to be around 10% so let us take a closer look to see the relevancy of the “T”.

First off the term transgender is fairly new being coined in the Sixties and meaning simply a person appearing to or attempting to be a member of the opposite sex, such as a transsexual or habitual crossdresser.  It is an umbrella term often used to include the entire community of individuals who cross gender boundaries on a consistent basis.  This brings us to a terminological issue.  There are many terms being used these days with new ones popping up frequently.  Just to name a few, Transsexual, Crossdresser, Gender Queer, Gender Variant, Gender Bender, and Misogynist. (see TransTerminology for definitions)  The point is we each have a different view point on identity, so take this blog as my view and adapt it to yours, … or not.

Gender Identity is an innate trait expressed with terms and understandings available to the individual at the time.  So, those who haven’t the education on such things have no way to express in words how they feel.  They can of course dress and present how they want given the social fortitude to do so.  Which is precisely the point most meaningful to all of us, Are you comfortable in how you present to the world?  Do you present your comfort to the world or do you conform to social pressures?

Understand there is a big difference between conformity and comfort.  Authenticity is another level of expression often over looked.  I think the process often runs the gamut from conformity when young and first dealing with society, comfort when alone or in a safe space, and then extending out as the “safe space” extends.  The end goal is comfortable authenticity at all times which is no small task to a person who perceives themself as different.  While this is painfully true with Transgender individuals it is often a “rite of passage” for everyone to some degree, shape or form.  The awkwardness of adolescence is only compounded by a variant gender identity, often without the individuals even realizing it.  This is something peers and family usually bring to issue.

Authenticity is expressing your true self in a comfortable and honest fashion.  It requires a complete acceptance of who you are and total honesty with both yourself and others.  On one level you do not concern yourself with others, while at the same time you pay attention to how you are treated because you know this is a valuable clue to how you feel about yourself.

The meaning of being Transgender undergoes an evolution then from simply being different and separate …to total acceptance of being just one of an infinite array of unique individuals unified as a whole of mankind.  It is important to understand that everyone is unique and offer wonderful gifts of their own, just as you do.  There is no shame in celebrating these gifts with all the world, in fact the shame is in not doing so!  Be easy with yourself and get help along the path.  Reaching this point sometimes takes a lifetime or more.

Sequoia Elisabeth

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What Is Your Story October 5, 2012

We are each on a carousel ride, the same carousel.  The ride goes round and round while we each view and experience things differently.   Even if you are sitting in my lap, you experience it different.  What this boils down to is we each have our own story, the story of our lives.  The part we share is the carousel!

What if you were to take your story and toss it in the trash?  You think it is inseparable?  You are not your story, just as I am not my story.  What makes a story?  Is the story ever complete?  Is it ever over?  Do the stories interconnect?  You know, like a TV series with successive stories, one episode after another?  The characters are the same in each episode, just as they are in your story.  If a character loses a contract they are written out of the story, just as people sometimes leave our lives either by dying or by situation, like divorce or simply moving away.

The stories will interweave as characters cross paths, sometimes staying for a while and sometimes only for a brief smile.  The paths can pass close without touching or they can collide head on!  What does it all mean?

The answer is up to you because there is no meaning until you give it some.  The simple fact is there is no story but the one you create by living your life!  So is your life living your story or your story living your life?  Which came first the chicken or the egg?  Funny how we love that question, or at least I do.

I wrote my gender focused story and published it as part of a larger story of Sex and Sexuality.  It was therapy for me because I did not understand my own story.  I needed to step back and get a bigger picture.  It all seems like a dream to me now, in some ways maybe a nightmare.  None of it seems real anymore, because I have awoken to a different reality and yet I have only awoken within a dream.  A dream within a dream!

Love to hear your story or at least your comments on these thoughts.  Maybe you have shared these thoughts or parts of them.  I love how a million people can see a beautiful vista and see it differently every time!  Maybe your story is more meaningful when it is shared.  Maybe it is not yours till you give it away!

Sequoia Elisabeth

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Humility Revisited September 4, 2012

Each person has their understanding of what humility is and it will depend greatly on the traditions in which you are raised.  Let’s face it, we are the culmination of our beliefs and our beliefs are handed down from our forefathers.  With Loving care and diligence these beliefs can be shifted and molded to direct your life in the direction of the most high.

The origin of the word humility is “early 14c., from O.Fr. humilité , from L. humilitatem  (nom. humilitas) “lowness, insignificance,” in Church L. “meekness,” from humilis  ”humble.” In the Mercian hymns, L. humilitatem  is glossed by O.E. eaðmodnisse” (Online Etymology Dictionary, 2010).

Look now at the dictionary meaning of Hum·ble, which is the root word for Humility.

–adjective

1. not proud or arrogant; modest: to be humble although successful.

2. having a feeling of insignificance, inferiority, subservience, etc.: In the presence of so many world-famous writers I felt very humble.

3. low in rank, importance, status, quality, etc.; lowly: of humble origin; a humble home.

4. courteously respectful: In my humble opinion you are wrong.

5. low in height, level, etc.; small in size: a humble member of the galaxy.

–verb (used with object)

6. to lower in condition, importance, or dignity; abase.

7. to destroy the independence, power, or will of.

8. to make meek: to humble one’s heart.

(humble. (n.d.). Dictionary.com Unabridged. Retrieved December 02, 2010, from Dictionary.com website: http://dictionary.reference.com/browse/humble)

Now that you have a good feel for the word, consider how this feeling serves you in transition.  Most people and especially the transgender community are well familiar with the feeling of embarrassment, disgrace, and humiliation.  These are typically emotions we avoid like the plague!  When you do experience them it is painful and the effects last for days if not longer.

What if instead of getting upset about these events you choose to be grateful for them and accepted them as a gift?  How is this possible you ask?  Quite simply shift your perception and see these events in their true light.  The truth, by the way, is always humbling.  As an example, assume that you are wearing a wig (because you feel your hair is too thin) and in full view of public your wig falls off.  Several people turn and see you, including a cute person behind the counter who you like.  The first reaction is to panic, grab the wig and run!  This would of course make things worse.  Instead consider the possibility of breathing deeply, moving slowly, picking the wig up, and carefully putting it back in place, asking for help if need be.  Feel the humility of such an event and do not run from it.  Allow that cute person behind the counter to see the real you, the part that God sees, the lovable part in God’s eyes.

So often in life you allow the ego to run your life and this is where the fear and discomfort comes from in the first place.  When Spirit is what animates you then Love is behind every action and even if you fall flat on your face in a restaurant full of people, Loving care, and concern is what reflects back because it is Spirit that fills you.  You see – whatever you experience is a reflection of what flows through you.  If it is ego, then pride fills you and your experience is that of embarrassment, however if it is Great Spirit/God/Universal Intelligence that fills you then Care and Compassion is your experience.  This is the gift of humility!

  Sequoia Elisabeth

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Pain and Suffering August 13, 2012

The road is what you make it; however anyone can navigate a straight and level path.  Perhaps the journey is not meant to be easy, but instead to be challenging, eventful, and fulfilling.  Pain is inevitable, suffering is optional.

This is an important distinction which I wish to make clear.  Suffering is optional!  My definition of suffering is avoidable pain.  The example that best explains it is a pebble which has gotten into your shoe.  It is large enough to cause a blister and perhaps eventually break the skin, whether you stop and remove the pebble or not is up to you.  Leaving it in all day is suffering.  With this said let us now consider muddier examples.

Say you were born with a birth defect like a cleft lip or missing fingers.  The pain is indirect now and so the suffering is harder to avoid.  Or say the defect is more profound such as Down’s syndrome.  In these situations the pain is often more for the family than it is for the individual.  The opportunity to grow extends to all those around this person.  From my perspective it is a larger gift, if used in this way.  The point here is each challenge is an opportunity to share Love (God’s Unconditional Love).

Now let us consider gender dysphoria or transgender/transsexual.  The pain from this condition is often mental/psychological and so it is even further removed and harder to avoid.  It is possible to go your entire life avoiding this gender confrontation, and some do this very thing.  However now a days the treatment of hormones and surgery have become available to remove the physical distress this condition offers up.  Since this is really a mental/psychological condition do the physical changes remove the pain or simply remove the obstacles associated with it?  The latter would be my answer and so any treatment that does not include psychological therapies is useless in my opinion.  Perhaps the psychological therapy is all that is really needed!

After many years of walking this road of gender dysphoria I have concluded the real message here is about Love and acceptance of the self.  If you cannot accept yourself as you were born then accepting the body after surgery is simply another delusion.  With this in mind, to run off and have surgery early on is simply perpetuating the problem instead of healing it!  At some point surgery is a viable option, but not till and unless the individual is able to comfortably express love for the self.  Perhaps this is the gift a therapist can most assist the individual with!  The road to self-love is often a long one, however if gender dysphoria or any dysphoria for that matter is being experienced this is a sign, a call for help if you will.

When I first entered therapy for gender dysphoria I was told only about 5% of people successfully transition from man to woman or vice versa.  This is because many are comfortable somewhere in between, so this is not to say they are unsuccessful, but simply they did not realize where balance would be achieved or that the journey was really about learning to love the self!

  Sequoia Elisabeth

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Are You Transgender July 31, 2012

How does one know they are transgender?  The answer to this question is both easy and complex.  Easy in that only the individual knows they are transgender by how they self-identify and complex in that identities often blur together.

Transgender – A person appearing to or attempting to be a member of the opposite sex, such as a transsexual or habitual crossdresser.  This is an umbrella term often used to include the entire community of individuals who cross gender boundaries on a consistent basis.  Dressing as the opposite sex for a school play, at Halloween, or once or twice as a youngster does not make you transgender.

A person can identify with many others who are important in their life.  Gender is not always important, meaning they may identify with both men and woman and sometimes other beings as well, such as animals, plants, or insects.  We do it all the time, it is called anthropomorphication, projecting human characteristics on to things other than human.  Pets are a favorite subject for this.  Identity is a fluid thing, because we are all connected through Great Spirit.

Getting back to self-identity, gender identity is usually apparent by the age of 3-6.  For this reason historically the Native Americans and recently some modern families are choosing to allow their child to tell them how they identify instead of looking between the legs and then pasting them with an identity of boy or girl.  Certain characteristics such as toys chosen, behavior in certain situations, and how the child interacts with others can be indicators of masculine or feminine characteristics.  However just because a boy likes to play with dolls does not make him transgender either.

Gender is a spectrum not a binary and in fact 80% of the population falls somewhere in the middle of the bell curve.  It is rare to be totally male or completely female in gender.  Just think back about your life and whether you enjoyed doing things which were considered opposite of your gender?

The main gist of the growing numbers of Transgender identified individuals is equality.  Everyone no matter their gender, race, orientation, status, finances, appearance, mentality or any other characteristic deserves to be treated as an equal.  Each person in their own way is an expression of God, Great Spirit, or Infinite Intelligence.  And it is up to the individual to decide how they identify!  Our job is to lovingly accept them.

Doctors, Lawyers, or parents do not have the right to impose their interpretations on any other person.  Now they can and will offer their expertise, but it is still up to the individual to take that information and do with it what they will.  Even a child 3-6 years old can tell their parents how they feel.

The parent can then provide opportunity for the child to explore their feelings, and with love and support the child will fulfill their destiny.  And for those individuals who have suppressed these feelings for decades it is never too late to give yourself permission to be true to you!!  Ultimately, Love is the answer to every question.

I encourage those with gender doubts or questions to explore their feelings by looking deep within the heart.  The only way to know for sure is to try different gender role expressions.  When you arrive at a conclusion it will feel right.  Of course, this is for the moment because life is filled with moments and this feeling may change, although the wiring of the brain is fixed at birth.  Ultimately life is an exercise in discovery and forgiveness.

Sequoia Elisabeth

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Gender Incongruency Part 2 April 11, 2012

Gender Incongruency part 2 is the continuation of the simple straight-forward definition provided previously and now we delve into why Gender Incongruency is the preferred term verses Gender Identity Disorder.

The documentation provided on the different views of Gender Identity Dysphoria sound complex, but really it is not that complicated when you break it down.  I will do my best to provide clear reasoning to explain it.  First of all everyone has Gender Identity, just as they have a sexual orientation.  When this identity is incongruent with the natal sex and established stereotypes a diagnosis of Gender Identity Disorder is given.  Since this is really an issue of incongruency and not necessarily a dysfunction the term disorder is inappropriate.

Think carefully about the term disorder.  Most allopathic treatments use a chemical and/or a surgical approach by prescribing a medicine or surgically altering the body to treat the illness or disorder.  Medicines are intended to be temporary till the body heals itself.  Gender Dysphoria is based on an incongruency from birth.  Some feel it is a birth defect, depending on how it manifests.  Often, if the patient is born completely male or female they do not deal with the issue due to societal and peer pressure until later in life. They have dealt with this condition all their life because they do not know any better.  Since there are many things in this world that do not make sense we all deal with incongruences.  Is it so hard to believe that a person cannot live with these feelings?

“Principle 18 of The Yogyakarta Principles states that “Notwithstanding any classifications to the contrary, a person’s sexual orientation and gender identity are not, in and of themselves, medical conditions and are not to be treated, cured, or suppressed.” According to these Principles, any gender identity of a transsexual or transgendered person is neither “disorder” nor mental illness, thus the diagnosis “gender identity disorder” can be contradictory and irreverent.” (Wikipedia.com, 2012)

Given this fact and the fact that physicians need a way to treat patients who request it the term Gender Incongruency seems very appropriate, thus the Concerned Professionals proposal.  The other issue is treatment and payment.  In our present system insurance usually picks up the bill but many specifically exclude transgender/transsexual treatments.  This trend is shifting however and it is because they have a diagnosis in the DSM to use along with the ICD-10 that insurance is willing to cover hormone therapy, although most do not cover surgical interventions.  Lobbying by activist groups, LGBT awareness groups, and allies have helped increase awareness of the need a great deal.

Eventually Gender Identity will not be pathologized and people will be free to live outside the gender binary.  This is another trend that is promising at the moment.  However there will still be individuals who feel they need to change their sex and who benefit from hormone treatment, so the health care system needs to be prepared to address these needs.  Insurance needs to cover this simple and relatively inexpensive treatment, esp. when compared to other sophisticated medical treatments.  Gender Incongruency conveys the essence of this condition quite nicely.

Sequoia Elisabeth

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Gender Incongruency April 10, 2012

Gender Incongruency may be unfamiliar to some of our readers so I will take the next two Transitions Blogs to explain it further.  I will first give the simple straight-forward definition of it and then in the next part explain why it is the preferred term now verses Gender Identity Disorder.

Incongruous or Incongruent:

— adj

1. incompatible with (what is suitable); inappropriate

2. containing disparate or discordant elements or parts (Dictionary.com)

Thus applied to gender it means the individual feels certain parts (gender and/or sex) are incompatible, inappropriate, disparate, or discordant.  The definition of transgender varies a little from transsexual so I will simply say that transgender is an umbrella term that covers all gender non-conforming identities, while transsexual is more specific to a feeling of marked incongruity requiring both hormone therapy and sexual reassignment surgery.  The diagnosis of gender incongruency would apply to all transsexuals, and some but not all transgender individuals.

Treatment is the way I discern the difference between transgender and transsexual.  Many transgender individuals need no treatment at all other than the acknowledgement of their gender expression and role.  Sexual orientation or sexual pleasure type are separate issues and are not discussed here.  The following definitions from the American Psychiatric Association, Concerned Professionals, and The Yogyakarta Principles are offered in regards to Transsexualism mainly, but also pertain to Transgender, esp The Yogyakarta Principles.

First let us consider in the United States, the American Psychiatric Association permits a diagnosis of gender identity disorder if the four diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4thEdition, Text-Revised (DSM-IV-TR) are met. (There is a proposal to change this GID diagnosis term to Gender Incongruence in the new DSM-V, of which I will discuss further in the next blog)

The criteria are:

• Long-standing and strong identification with another gender
• Long-standing disquiet about the sex assigned or a sense of incongruity in the gender-assigned role of that sex
• Significant clinical discomfort or impairment at work, social situations, or other important life areas.
• The diagnosis is not made if the individual also has physical intersex characteristics.

If the four criteria are met under the DSM-IV-TR, a diagnosis is made under ICD-9 code 302.85.   The International Classification of Diseases (ICD-10) list three diagnostic criteria:

Transsexualism (F64.0) has three criteria:

1. The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment
2. The transsexual identity has been present persistently for at least two years
3. The disorder is not a symptom of another mental disorder or a chromosomal abnormality (Intersex).

Mental health and medical professionals, clinicians, researchers, and scholars are concerned about psychiatric nomenclature and diagnostic criteria for gender-variant, gender-nonconforming, transgender, and transsexual people in the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and call themselves Professionals Concerned About Gender Diagnoses in the DSM. Below are their suggestions for the Gender Incongruence (in adults) diagnosis in the DSM V.

A. A distressing sense of incongruence between persistent experienced or expressed gender and current physical sex characteristics or ascribed gender role in adults, as manifested by at least one of the following indicators for duration of at least 3 months. Incongruence, for this purpose, does not mean gender expression that is nonconforming to social stereotypes of ascribed gender role or natal sex.

1. A distress or discomfort with living in the present gender or being perceived by others as the present gender, which is distinct from the experiences of discrimination or the societal expectations associated with that gender.

2. A distress or discomfort caused by deprivation of gender expression congruent with persistent experienced gender. Experienced gender may include alternative gender identities beyond binary stereotypes.

3. A distress or discomfort with one’s current primary or secondary sex characteristics that are incongruent with persistent experienced gender.

4. A distress or discomfort caused by deprivation of primary or secondary sex characteristics that are congruent with persistent experienced gender.

B. Distress or discomfort is clinically significant or causes impairment in social, occupational or other important areas of functioning, and is not due to external prejudice or discrimination. (Professionals Concerned with Gender Diagnoses in the DSM, 2010)

The Yogyakarta Principles on the Application of International Human Rights Law in relation to Sexual Orientation and Gender Identity is a set of principles relating to sexual orientation and gender identity, intended to apply international human rights law standards to address the abuse of the human rights of lesbian, gay, bisexual, and transgender (LGBT) people, and issues of intersexuality.

“The Principle 3 of The Yogyakarta Principles on The Application of International Human Rights Law in Relation to Sexual Orientation and Gender Identity states that “A person of diverse sexual orientation and gender identities shall enjoy legal capacity in all aspects of life. Each person’s self-defined sexual orientation and gender identity is integral to their personality and is one of the most basic aspects of self-determination, dignity and freedom” and the Principle 18 of this states that “Notwithstanding any classifications to the contrary, a person’s sexual orientation and gender identity are not, in and of themselves, medical condition and are not to be treated, cured or suppressed.” According to these Principles, any gender identity of a transsexual or transgendered person is neither “disorder” nor mental illness, thus the diagnosis “gender identity disorder” can be contradictory and irreverent. As well, The Activist’s Guide of the Yogyakarta Principles in Action states that “It is important to note that while “sexual orientation” has been declassified as a mental illness in many countries, “gender identity or gender identity disorder” often remains under consideration.” (Wikipedia.com, 2012)

To read the entire publication “An Activist’s Guide to The Yogyakarta Principles” please click here, although be warned it is quite lengthy.  More on Gender Incongruence in Part 2, pleasant reading till then.

Sequoia Elisabeth

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