Is There Harm in Diagnosing Gender Dysphoria?

Is There Harm in Diagnosing Gender Dysphoria? October 17, 2018

There was great debate over how to approach Gender Identity Disorder when the latest edition of the Diagnostic Statistical Manual was being developed. The DSM-5 task force settled on Gender Dysphoria. Some people believe that it is harmful to diagnose a transgendered individual. If that is the case, then it is harmful to identify anything as mental illness. It is difficult and painful to be diagnosed with a mental illness. No one wants to be diagnosed with Schizophrenia, Borderline Personality Disorder, or any other diagnosis. At the same time,  many individuals express that their diagnosis comes with a mix of emotions. Some experience denial. Some experience relief (“Glad to know I am not going crazy…there is something wrong in my brain and I can receive help for this.”) Some experience sadness or anger. Regardless of the response, the diagnosis can be a helpful part of the process.

Truly, the intent is never to harm, but to shed light on a real problem. Ultimately, a treatment plan is developed with the intention of helping the person find relief from their suffering. Peace, Hope, Wholeness. People who have addictive or eating disorders struggle with the desire and drive to engage in harmful behaviors. They find some momentary relief from their actions, but it’s temporary. The conflict that leads to the addiction, binge eating, etc. always returns. Until the underlying problems are dealt with. Mental health professionals accept them as people who are worthy of dignity and respect, while at the same time caring enough about them to help them see how their behaviors are harmful.  We meet them where they are with the sole goal of helping them get better.

The same should be true for those with gender dysphoria.

Society says that it is perfectly fine for those who are born as females to believe in their minds that they are males (and vice versa). As a result, there is this belief that we should accept them as their preferred gender – the gender they believe they were intended to be. They thought goes that this will solve the issue; that the inner turmoil will disappear as long we allow people to live “authentically.” But is it really authentic? This is not a joke – I cannot be a different age, race, or ethnicity just because I believe I was born in the wrong year, skin color, or culture. Likewise,  I cannot be a male just because I believe I was born with the wrong genitalia. Changing the external will never change the DNA. Diagnosing the problem and compassionately attempting to help a hurting person is not what is harmful. Engaging and furthering culture’s lie is what is harmful.

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  • Paperboy_73

    When it comes to something as all-encompassing as dysphoria, it strikes me that you either have to change the CPU or the plumbing. One of those seems much easier to alter than the other.

  • Kate Phillips

    Exactly. Especially since the cause of the transgender condition is thought to be biological rather than mental or emotional. The only lie being told is that being transgender is a mental illness, that can somehow be controlled by medication or therapy. It’s amazing how so many supposedly intelligent people can either discount, or just simply ignore, the decades of research that have been spent on this, and have come to a conclusion different than what they want to hear.

  • Lennie

    This article is factual and truly makes sense. I wonder why people can recognize it’s not healthy for someone to believe they are fat when objectively and scientifically they are not and that this is a mental disorder. And the same people know it’s unhealthy when someone with four perfectly healthy limbs believes they are really an amputee “inside” and seeks to fulfill that externally via risky and unnecessary surgery. Yet some of these same educated people can NOT comprehend that it’s also unhealthy when a person is objectively and scientifically a man yet believes “inside” he really is a woman; and so much so that he seeks to fulfill that externally by risky and unnecessary surgery. Sometimes we see people who are actually Caucasian and yet feel “inside” that they are African-American and want others to join in their delusion. As the article states: “Diagnosing the problem and compassionately attempting to help a hurting person is not what is harmful.” Engaging and furthering the lie is what is harmful!

  • Illithid

    “Changing the external will never change the DNA.”

    I’ll gently suggest that the reduction of sex and gender to a male/female dichotomy strictly determined by possession of XX or XY chromosomes is overly simplistic. There are sexually dimorphic brain structures thst develop indepently of, and sometimes in contrast to, overt sexual characteristics. A transgender person is not simply a man who thinks he’s a woman, or vice versa.

  • Katrina Williams

    Dr. Shaler, you pointed out, at the end, “compassion.” This is the largest part of any treatment plan, even when helping those diagnosed with Gender Dysphoria. As someone who is diagnosed with mental illness, I know all too well the mixed emotions each diagnosis can bring. I believe, wholeheartedly that Gender Dysphoria is a real thing and can be treated when taken seriously. I completely agree with this blog!