Trans identities as disorders

The decision to remove “gender identity disorder” from the DSM has been controversial. Many saw this as a positive step, but others such as Chase Strangio have pointed out that this could prove detrimental for trans people, usually women of colour within incarceration or controlled living circumstances, in accessing medical services. As a trans person with mental illnesses, I feel ambivalent.

I have a variety of disabilities and some of them are things that I don’t know if I would “cure” if given the option. Disabled people have a wide variety of feelings and opinions on how they process their disabilities and stigmas that it’s impossible to simplify it all. In many cases, my mental illnesses fall under the disorders that I would “cure” if given the chance.

While some of the disabilities I have make up part of who I am and aren’t things I would “cure” for the sake of being “normal”, I will admit that even the ones I won’t “cure” create obstacles in my life. My mental illness is not something that I feel, as some others do, brings many positives to my life. My mental illness holds me back and prevents me from really doing the things I want to do. I would “cure” my paralysing anxiety if given the chance, my OCD, all of it, because it seriously impairs me.

“Transgender” being a mental illness

My agender identity doesn’t impair me. I don’t see being non-binary as a “disordered” way of thinking or existing. My lack of gender doesn’t prevent me from doing anything. People prevent me from existing in the same ways they do as who I am by their inability to accept anything beyond a binary. I don’t believe I am disordered about my gender. Society is disordered about gender. But, I do face ableism when it comes to my mental illness.

People often don’t understand anxiety or OCD and that can create problems, but I feel as though I would have problems in my life regardless of the way people treat me. For things I do consider “disorders”, things I would “cure”, the problems they create in my life would continue regardless of stigma. My anxiety does stem from treatment I have had in the past, but at this point it is so well engrained that it exists on it’s own. Sure, the treatment of others can exacerbate my anxiety, but positive treatment won’t cure it.

I don’t feel I want to “cure” how I view my gender. To put it simply, my mental illnesses are about the disordered way in which I relate and interpret society, whereas my status as trans is more about the way a disordered society misinterprets and doesn’t relate to me.

This is one of my favourite quotes and episodes of all time in Doctor Who. They could have easily made it so that Vincent Van Gogh had a “happier” ending, and I loved that instead they chose to illustrate a very good point about mental illness.

Trans experiences are too varied for us to really be able to draw lines and decide whether or not is or isn’t a disorder of our own minds or a disorder of society. The most crucial issue that hangs within the balance of this classification is the access to resources and the ways in which a cis- centric medical establishment has control over trans people and they way they experience their bodies. I don’t necessarily feel that gender identity disorder diagnosis always prevents or helps that case.

In my experience of disability, I’ve found that control over my body has always been an issue. Having nurses take my blood as I physically fought them when I was younger, I learned pretty quickly that body autonomy was a privilege I didn’t have. My disorder created circumstances that made it impossible for me to do certain things from sleeping over last minute at a friend’s house to running away from home. Still, despite the obstacles my disabilities cause me, despite feeling that I would “cure” some of them if given the chance, I do not feel ashamed to be disabled.

Mental illness stigma

The thing that concerns me about the celebration of “gender identity disorder” from the DSM is the continuation of the mental health stigma, the continuation of the idea that a “disorder” is not only something negative but something to feel shame over and it makes me feel a bit lax to celebrate. In general, I feel that what should be focused on more than just removing or adding a disorder from the DSM, is a joining of perhaps trans and disabled (or indeed trans disabled) individuals to argue for more bodily autonomy for trans people and people with disabilities.

I am told twice over that I’m not the boss of my own body. I’ve been given medications and treatments all of my life for disorders without doctors explaining to me what these do, now forced to continue oestrogen replacement therapy because there is no alternative other than osteoporoses. Doctors have always, whether on trans or disability issues, assumed that my say in my own body, in my own treatments, is the least important or not worthy any at all of consideration. Focus has never been put on prioritising my comfort and my ability to understand my conditions or even inhabit my own body over the doctor’s ability to treat me and, in my own experience, doctor’s ability to examine me.

I think Erik’s relationship with Shaw illustrates is the ways in which your difference can be exploited for someone else’s gain and thusly shaped by it.

Because I grew up working class, I had to go to a hospital that treated me without charging. But the cost of that was that I’d be inspected by medical students like a lab rat. It’s an experience I look back on with disdain and frustration when I wonder how my treatment and my experience of my own disorder would have been different if I were wealthier. My mother, being only 18 with a very sick child and coming from a broken home herself, had little preparation for navigating the medical establishment and quite often felt ill equipped to contradict men in white coats.

I’m grateful for the times when she put her foot down, when she said no when they wanted to do exploratory brain surgery on me. When she was adamant that I was blind in one eye because of the way I played Peek-a-boo, despite several, probably condescending white men in coats telling her that I just had a lazy eye. But there was only so much that a poor woman working at McDonalds to feed four kids could do. And it doesn’t surprise me that something like the removal of GID from the DSM will affect the poorest and most vulnerable of trans people. I’ve already seen the wreckage when disability and poverty or disability and trans status can collide. I can’t imagine what happens under multiple intersections.

Disabled and trans people both need more bodily autonomy within medical systems. Whether trans gender identities are considered “disordered” or not, medical professionals and establishments need to make more room for the people they’re treating and understand them not as just “patients” but as fellow human beings with a right to their own bodies.

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