Translation from the French original by Suzan of Woman Born Transsexual :
Transsexuality will no longer be classified as a mental disorder in France
05/16/2009 — Suzan
France announced that transsexuality will no longer be classified as a mental disease.
Concerned associations announced the historic government decision regarding the declassification of transsexuality as a mental disease on Saturday, the day before the World Day to fight Homophobia and transphobia.
The Minister for Health, Roselyne Bachelot, chose yesterday to issue the decree removing transsexualism from the category of psychiatric afflictions, said a spokesman for the ministry.
The Ministry of Health’s action sent a powerful signal to the transsexual community that it recognised inclusion in ALD23 (their DSM) was stigmatizing.
This classification, rising from that of the World Health Organization (WHO), was also related to the fact that transsexuality was included in the pathologies listed in the medical handbook DSM (Diagnosis and Statistical Manual of Mental Disorders) which the medical community uses as a reference, just like homosexuality used to be until a few years ago.
In a political statement published in Le Monde last Sunday-Monday, many noted individuals including first secretary of the PS Martine Aubry, Marie-George Buffet of the Communist Party, Daniel Cohn-Bendit of the Greens, the Nobel Prize winners Francois Barred-Sinoussi (medicine) and Elfriede Jelinek (literature), all asked WHO to no longer regard transsexuals as having a mental disorder.
So I'm not bonkers in France, though I am elsewhere. Yet it seems crazy to me that this was a political decision, rather than one arrived at by medical authorities.
Never mind. Remember I'm legally female in Australia, and legally male in the UK. Except when it comes to my UK passport. This seems equally Pythonesque in its absurdity.
We - and the psychiatric establishment - have been treading on thin ice for decades now. The patient has to be diagnosed with the "mental illness" GID (Gender Identity Disorder) in order to qualify for surgery, but anyone with a severe "mental illness" cannot possibly give informed consent. There is a basic contradiction here, one that everyone has ignored because "the system works". Well, it's only a matter of time before someone notices, and legislation is passed to prevent surgery.
Hopefully the French move is not just a cost-cutting exercise to stop the French health system from having to pay for treatment. Hopefully this spurious "mental disorder" that isn't actually mental will be replaced by the congenital (we think) physiological neurological cross-gendering condition that masses of evidence suggest it is.
We need *a* diagnosis - just not a fictitious one. Just the way people born with cleft palates need one too. They're not considered "mentally ill" because of the distress their somatic condition causes.
I'll quote from the situation here in Australia, and the Re Kevin case.
At paragraph : 'But I am satisfied that the evidence now is inconsistent with the distinction formerly drawn between biological factors, meaning genitals, chromosomes and gonads, and merely "psychological factors", and on this basis distinguishing between cases of inter-sex (incongruities among biological factors) and transsexualism (incongruities between biology and psychology)'.In short, unshackle the science from the politics. Let those who are transgendered (rather than transsexual) not be pathologised for "mental health thought crime", for the heinous sin of being diverse. Much as being gay was de-pathologised, because there's no sign of them being "mentally ill".
At paragraph : 'In my view the evidence demonstrates (at least on the balance of probabilities) that the characteristics of transsexuals are as much "biological" as those of people thought of as inter-sex'.
At paragraph : 'I agree with Ms Wallbank that in the present context the word "man" should be given its ordinary contemporary meaning. In determining that meaning, it is relevant to have regard to many things that were the subject of evidence and submissions. They include the context of the legislation, the body of case law on the meaning of "man" and similar words, the purpose of the legislation, and the current legal, social and medical environment. These matters are considered in the course of the judgment. I believe that this approach is in accordance with common sense, principles of statutory interpretation, and with all or virtually all of the authorities in which the issue of sexual identity has arisen. As Professor Gooren and a colleague put it:-
"There should be no escape for medical and legal authorities that these definitions ought to be corrected and updated when new information becomes available, particularly when our outdated definitions bring suffering to some of our fellow human beings".'
And let those whose congenitally cross-gendered neurology is such that they need a body to match be able to obtain that treatment on the basis of a physiological, rather than a psychological, condition, the same way other cases of congenital physiological anomalies can.
And most of all - let those people who were surgically mutilated as infants to conform to societal expectations not be considered "mentally ill" if they object as adults to their past (mis)treatment.
In summary - to act on the basis of our current best guess as to the facts. This also happens to be in accordance with basic humanity, but I confess that that to me is a secondary consideration. I prefer unpleasant truths to pleasant lies. Right now, we have unpleasant lies.
There is a significant danger: that "transgender" will be seen as a "normal human variation" requiring no treatment, and that transsexuality will be "morally mandated out of existence", with surgery and hormonal treatment being seen as purely voluntary cosmesis, or worse, denied altogether.
Transsexuality as we know it should be pathologised - at least until it's treated - as not having the right shaped body - even if social role is corrected - causes significant distress. Much as having a hare lip - even in a society where such things are not mocked - should be pathologised. One causes difficulty with eating, the other with being eaten, so to speak.
Once that's sorted, we can deal with the other legal problems. Such as the one faced by Professor Jennifer Finney Boylan in the New York Times (and incidentally, myself too).
Gender involves a lot of gray area. And efforts to legislate a binary truth upon the wide spectrum of gender have proven only how elusive sexual identity can be. The case of J’noel Gardiner, in Kansas, provides a telling example. Ms. Gardiner, a postoperative transsexual woman, married her husband, Marshall Gardiner, in 1998. When he died in 1999, she was denied her half of his $2.5 million estate by the Kansas Supreme Court on the ground that her marriage was invalid. Thus in Kansas, any transgendered person who is anatomically female is now allowed to marry only another woman.Does anyone else think that the way people like myself are treated is best described as Stark Staring Bonkers? Because my sex, my gender, my marriage, and my sanity all depend on where I happen to be at the time.
Similar rulings have left couples in similar situations in Florida, Ohio and Texas. A 1999 ruling in San Antonio, in Littleton v. Prange, determined that marriage could be only between people with different chromosomes. The result, of course, was that lesbian couples in that jurisdiction were then allowed to wed as long as one member of the couple had a Y chromosome, which is the case with both transgendered male-to-females and people born with conditions like androgen insensitivity syndrome. This ruling made Texas, paradoxically, one of the first states in which gay marriage was legal.
A lawyer for the transgendered plaintiff in the Littleton case noted the absurdity of the country’s gender laws as they pertain to marriage: “Taking this situation to its logical conclusion, Mrs. Littleton, while in San Antonio, Tex., is a male and has a void marriage; as she travels to Houston, Tex., and enters federal property, she is female and a widow; upon traveling to Kentucky she is female and a widow; but, upon entering Ohio, she is once again male and prohibited from marriage; entering Connecticut, she is again female and may marry; if her travel takes her north to Vermont, she is male and may marry a female; if instead she travels south to New Jersey, she may marry a male.”
Legal scholars can (and have) devoted themselves to the ultimately frustrating task of defining “male” and “female” as entities fixed and unmoving. A better use of their time, however, might be to focus on accepting the elusiveness of gender — and to celebrate it. Whether a marriage like mine is a same-sex marriage or some other kind is hardly the point. What matters is that my spouse and I love each other, and that our legal union has been a good thing — for us, for our children and for our community.