The American Psychiatric Association released a statement on Friday regarding some “inquiries about the DSM-V process.” I suspect many of those inquiries have focused on the disputes over treatment highlighted by the recent NPR broadcast on gender identity, often involving Dr. Ken Zucker. I asked Ken Zucker and Michael Bailey for their reactions to this press release from a transgender advocacy group. Dr. Zucker declined to comment, but sent the following APA statement. Dr. Bailey’s comment follows.
APA STATEMENT ON GID AND THE DSM
May 9, 2008
The American Psychiatric Association has received inquiries about the DSM-V process, particularly concerns raised about the Sexual and Gender Identity Disorders Work Group.
The APA has a long-standing mission to provide guidelines for the diagnosis and treatment of mental disorders, based on the most current clinical and scientific knowledge. Through advocacy and education of the public and policymakers, the APA also affirms it commitment to reducing stigma and discrimination.
The DSM addresses criteria for the diagnosis of mental disorders. The DSM does not provide treatment recommendations or guidelines. The APA is aware of the need for greater scientific and clinical consensus on the best treatments for individuals with Gender Identity Disorder (GID). Toward that end, the APA Board of Trustees voted to create a special APA Task Force to review the scientific and clinical literature on the treatment of GID. It is expected that members of the Task Force will be appointed shortly.
There are 13 DSM-V work groups. Collectively, the work group members will review all existing diagnostic categories in the current DSM. Each work group will be able to make proposals to revise existing diagnostic criteria, to consider new diagnostic categories, and to suggest deleting existing diagnostic categories.
All DSM-V work group proposals will be based on a careful, balanced review and analysis of the best clinical and scientific data. Evidence accumulated from work group members and hundreds of additional advisors to the DSM-V effort will be considered before final recommendations are made.The Sexual and Gender Identity Disorders Work Group, chaired by Kenneth J. Zucker, Ph.D., will have 13 members who will form three subcommittees:
– Gender Identity Disorders, chaired by Peggy T. Cohen-Kettenis, Ph.D.
– Paraphilias, chaired by Ray Blanchard, Ph.D.
– Sexual Dysfunctions, chaired by R. Taylor Segraves, M.D., Ph.D.
Each subcommittee will pursue its own charge, provide ongoing peer review, and consult with outside experts. The DSM-V is expected to be published in 2012.
Regarding the Transactive organization’s statement about the DSM-V, Dr. Bailey took strong exception to this statement:
“Zucker has stated that a secure gender identity possibly prevents the development of later homosexuality. This raised several red flags for those of us who work with gender non-conforming children, youth and their families. TransActive’s position is that “prevention of homosexuality” should not be the concern of childhood gender identity specialists.”
To which, Bailey said:
This is an utterly false characterization of Zucker’s position. He has no desire, stated or otherwise, to prevent homosexuality. Experience and logic suggest that when people have reasonable and sound positions, they do not need to mischaracterize the positions of others they disagree with.
I agree with Bailey, I have seen nothing which would suggest Zucker has a stake in the eventual sexual orientation of children. And I certainly agree with the last sentence which has some special significance to me in light of the cancellation of the APA symposium.
In my opinion, there are some advocates who implore various audiences to trust science but really do not want this unless the outcome suits their advocacy goals.