Psychiatry Group Eliminates 'Gender Identity Disorder' From Diagnostic Manual

December 5, 2012 — The American Psychiatric Association on Saturday announced several changes for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, including replacing the term "gender identity disorder" with "gender dysphoria," AP/CBS News reports (AP/CBS News, 12/3).

The condition gender dysphoria will be defined as emotional distress over one's gender identity, whereas gender identity disorder described all individuals "whose subjective experience of gender does not match their biological sex," according to Slate (Lowder, Slate, 12/3).

The DSM serves as the definitive diagnostic handbook for mental health clinicians, and it also is used by health insurers to determine coverage and by schools to allot special education resources, according to AP/CBS News. The new version, to be published in May, is the first major rewrite of the manual in 20 years (AP/CBS News, 12/3).

In a 2010 interview, Jack Drescher, a member of the APA subcommittee that examined the issue, said the panel's recommendation that APA change the term aimed to stop "pathologiz[ing] all expressions of gender variance just because they were not common or made someone uncomfortable."

Potential Impact

Slate notes that the 1973 removal of homosexuality from the DSM helped catalyze social and legal progress by neutralizing the argument that being gay or lesbian is a pathology. Members of the transgender community hope the latest change will have similar positive effects.

However, Drescher noted a significant difference is that some transgender individuals need hormonal or surgical gender affirmation interventions. Currently, insurance coverage for these treatments is justified on the basis that gender identity disorder is a medical problem, and changes in the DSM might lead insurers to deny such coverage.

To address the issue, the APA Task Force on Treatment of GID has recommended that APA develop standard treatment guidelines, as well as adopt policy statements supporting the "rights of persons of any age who are gender variant, transgender or transsexual" (Slate, 12/3).