Wednesday, May 07, 2008

Dear American Psychiatric Association: What the -hell- are you thinking?

Via Questioning Transphobia, the Bilerico Project:

A short time ago, I’d [Mercedes Allen] 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...

The call to action, thus far:

The APA press release states that for further information regarding this, to contact Rhondalee Dean-Royce ( and Sharon Reis (, 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 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.

Yeah, about that ex-gay therapy. Here's a bit of how that works, one of many such stories:

For three years I had weekly sessions with Dr. Joseph Nicolosi, president of the National Association for the Research and Therapy of Homosexuality (NARTH). Dr. Nicolosi thought that homosexuality was a pathology, a sublimated desire to reconnect with one’s lost masculinity. The theory: under-attentive fathers and over-attentive mothers create gay children. The purpose of therapy was to put me in touch with my masculine identity and thereby change my sexual orientation.

I would like to say that I resisted therapy throughout, but the truth is that I liked and respected Dr. Nicolosi. And the theory sounded plausible (I was too young to know that plausible does not mean true). It is a period in my life that I do not think about often, not because it hurts especially but because it has become increasingly irrelevant.

...Years after I stopped therapy, I requested the case notes, knowing they would be destroyed after seven years. They provided an annotated collection of long-forgotten events. Next to the description of an argument with a male friend, Dr. Nicolosi scribbled “needs to look at the real source.” This was code: whatever the problem, it would be traced back to my lost masculine sense of self; I was angry because my friend had not paid attention to me as my father had not. Much of therapy also involved uncovering the numerous ways in which my parents had cheated me (as a teenager, I was more than happy to blame things on them).

Disgust with what was termed the “gay lifestyle” was implicit in therapy. I remember Dr. Nicolosi telling me, in response to the question of whether one could easily contract HIV from semen, that if this were the case then gays would be “jerking off in hamburgers all over” to infect people.

I learned to be a man: I was encouraged to play catch with my father, work out, watch football. At one point Dr. Nicolosi assigned me a therapy partner who was my age. Ryan and I used to speak by phone (he was in Colorado, I in Arizona), gossiping about school, at one point promising to send each other pictures of ourselves (the canker was already on the rose). After not hearing from him for a few weeks I called his family, who told me that Ryan had gone to court and emancipated himself from them. His father, in tears, told me this had ruined his life...

And just in case you -still- are under the delusion that right-wing Christian fundamentalists are somehow going to be better friends to trans folk than they are to lesbigay people, in the U.S. or elsewhere:

that guy Zucker? who's on the new APA committee? Here's what you're getting in bed with, "radical feminists" who "question transgender," gay folks who believe that all this trans stuff is none of our business and a distraction from the real issues, and basically anyone who gives a damn about human rights viz a viz gender, sex, and mental health but doesn't see the problem here:

Zucker has long been a self-proclaimed "leading figure" in the care of gender variant children. Many hundreds of such children have been forced through his infamous facility (formerly known as The Clarke Institute) by their parents and by the centralized Canadian health care system, and have been coerced there into denying their innate gender feelings - at least while young and under the control of Zucker.

Zucker is widely-known for his insistence that feminine boys "drop the Barbie", and for his strict enforcement of traditional masculinity on boy children as a means of "curing GID". Zucker is especially focused on prevention of transsexualism, considering gender transition to be a very bad outcome. In the process, Zucker has become the darling of groups like the Catholic Education Center and the National Association for Research and Therapy on Homosexuality (NARTH) (more), which have highly promoted his work among their homophobic and transphobic constituencies.

In March 2007 NARTH published a report entitled "Gender Identity Disorders In Childhood And Adolescence: A Critical Inquiry And Review Of The Kenneth Zucker Research". In that report, NARTH lauds Zucker's reversion therapy at CAMH (aka The Clarke Institute), in which he psychologically intervenes to "cure" childhood GID, seeing it as a way to "cure" homosexuality too. The report concludes:

"Zucker’s priority is “helping these kids be happily male or female,” but he also acknowledges that the treatment process does, in some cases, apparently avert homosexual development . And in support of parents’ rights to avert a homosexual outcome for their children, Zucker cites a persuasive quote from Richard Green: “The right of parents to oversee the development of children is a long -established principle. Who is to dictate that parents may not try to raise their children in a manner that maximizes the possibility of a heterosexual outcome?"" -- NARTH, March 2007


Sarah J said...

Zucker was on NPR tonight as part of a story of two families with a transgender child (both six-year-old M to F).

One family went to Zucker, and their kid was miserable.

One family went to Diane Ehrensaft, and allowed their child to live as a girl, referred to her as a her, and the child was quite happy.

The family who went to Zucker had not thought anything was wrong with their son wanting to play with girl toys until he was assaulted on the playground one day...

you can find it here.

Sarah J said...

btw, I gave you a blog-award.

Brown Shoes said...

Just goes to show how deep the "health" community is in bed with the religious right, or have always been. The fact that Health Canada hasn't come down hard on this guy is a shame to me, to be perfectly honest.

Claire said...

I bitched about this over at my blog, too. I can't believe the fucking APA made such a fucking fool of me like IMMEDIATELY after I shot my mouth off defending the inclusion of GID in the DSM, thinking that there was essentially no possibility of conversion therapy making it into a future edition.


belledame222 said...

Sarah: thanks, and thanks!

Yeah, "happy," as in the KID's happiness, not just what makes the parents happy, you'd think someone might give it some thought.

"Ma Vie En Rose" ought to be required viewing for every bonehead that okay'd this task force.

belledame222 said...

and you know, this actually has more ramifications than even for LGB -and- T folk:

“The right of parents to oversee the development of children is a long -established principle."

I mean, there it is, neh? Except he doesn't mean -oversee-, he means -shape to their own liking-.

Thing is, "overseeing" the development of children isn't about -parental rights-; in theory. In -theory-, it's about what's best for the children.

anyone seriously considering otherwise does not belong in modern psychology: this is beyond sexuality and gender, this is human development 101, for fuck's sake...

Brown Shoes Don't Make It said...

You'd think someone might gave a damn about the kids, but it really does seem like so many people really don't care about their kids except for what their kids can do for how the parents look to other people - I'm positive that's at least a big part of all that Baby Einstein and early early development, pushing instruments on kids in preschool to turn them into another Mozart, etc. etc. It's not about the kids other than how they can make the parents look, and assholes like this Zucker know how to play on that to make money and get his name in medical journals, etc.

Alma Cork said...

i knew richard green on a clinical basis. he was the worst thing that happened to me in my transition. in fact, the man wasn't even aware of the actual transition protocols avaliable in his own clinic (i forget the context now, but it shocked me).

piggie1230 said...

Gah! gaaaah! (I am now a tiny black hole of infuriated anger)

GID could be included in the DSM as a way of getting insurance to pay for hormones etc, and that would be good. But there's also the whole stigmatization of people who are considered 'mentally ill' or whatever to consider. And these far right fundie christians have bitching for ages about how the APA doesn't support ex gay therapy, and have been pushing for queer-ness to be put back on the list. And they use the includes of GID in DSM to argue -against- reassignment. and it pisses me the hell off.

Ma Vie en Rose crushes my soul every time I watch it. You know what else is good? As Nature Made Him. Its a fantastic book. I wish I still had my copy :(

belledame222 said...

welcome, piggie1230

yeah, I leafed through "As Nature Made Him" in the store a few times, never did get around to getting it; and yeah, it was a grim read, or grim skim, as i recall.

...or, no, maybe i'm thinking of "Last Time I Wore a Dress." that -was- grim.

GallingGalla said...

I have both books, and they are both pretty grim.

They both also kind of blow away the whole Judith Butler "gender is just one big performance" trope.

belledame222 said...

well, in the general sense of "life's a stage," I suppose. Butler grates, though

Claire said...

I don't know, I've always found a lot of Butler's work on gender appealing. One of the most interesting puzzles in my life is how I can reconcile extreme social constructivism about gender with my severe transgender feelings. I'll work up a paper on it and have it rejected from some journals, someday. =)

Sara said...

"They both also kind of blow away the whole Judith Butler "gender is just one big performance" trope."

That's the thing I couldn't understand about Kate Bornstein's book. I got Gender Outlaw, I thought it would be a nice read, and it was actually a hard read.

I think it goes a bit too much to concur with MWMF people that "You can do whatever you want, no need to change the body" school of thought. And I have a hard time agreeing there. Sure for some people transitioning is not worth it or not good at all, but for many it's an actual need, not a whim, and that book treated it more or less like it was like fashion.

Zucker makes me shudder (here's a good slogan heh). I hear he's not as bad on teenagers, but I have my doubts. Not as bad compared to what? The ones who went there and who didn't see or hear about the situation elsewhere or think it's their only chance, yeah they'll sing praises about him.

Green makes me shudder too, he was in bed with Rekers for reparative therapy in the 70s and I think co-authored books with him...and now he's head of the UK treatment place.

This world just sucks, and I've not been lead to believe otherwise, the more I find out, the more I believe it sucks.

SunflowerP said...

"the centralized Canadian health care system"

I'm not sure where Conway gets that; it's really not centralized.

In that the Canadian federal government has a department that coordinates the provincial health departments, yeah, kinda. But the decision-making administrative level is provincial - mostly, Health Canada just distributes federal funding and makes sure no province actually violates the Health Act (basically: "No money for you, if you replace your provincial public health care system with a privatized system.")

From what I know, Health Canada doesn't have the authority to come down on Zucker; that'd be in the jurisdiction of the Province of Ontario (and, independently, any other province in which he's licensed to practice).