DSM-V: Disordering Intersex Disobedience?

If this absurd example of illogic were carried to its inevitable conclusion David Reimer would have been given this diagnosis for rejecting Money's attempt to impose a female identity on him...
(TFF Commentary, below)

Peggy Cohen-Kettenis

Abstract:

Psychosocial and psychosexual aspects of disorders of sex development

Psychosocial aspects of the treatment of disorders of sex development (DSDs) concern gender assignment, information management and communication, timing of medical interventions, consequences of surgery, and sexuality. Although outcome is often satisfactory, a variety of medical and psychosocial factors may jeopardise the psychological development of children with DSDs. This sometimes results in the desire to change gender later in life. The clinical management of gender dysphoria in individuals with DSD may profit from methods and insights that have been developed for gender dysphoric individuals without DSD. In DSD care, clinical decisions are often made with long-lasting effects on quality of life and should be based on empirical evidence. Yet, such evidence (e.g., regarding gender assignment, information management and timing of surgery) is largely non-existent. DSD-specific protocols and educational materials need to be developed to standardise and evaluate interventions in order to facilitate decision making of professionals and individuals with DSD and enhance psychosocial care in this area.

TFF Comment:

Intersex biological diversity was subsumed into the world of psychological theory as a result of John Money's observations and beliefs, developed from the mid-1950's onward.  Psychologists, psychiatrists and other 'mental health professionals' have maintained an vice-like grip on Intersex issues and the personal lives of Intersex people since that time.

Following its public exposure in 1979,  Money's duplicity was swept aside by Psychological theorists such as Peggy Cohen-Kettenis and Heino Meyer Bahlburg (Recently implicated in the Fetal-Dex controversy as an advisor to Maria New) See: HERE

Heino Meyer Bahlburg

Both of these individuals are also members of the DSM-V review panel tasked with re-writing the section on gender identity disorders. (GID)  Meyer Bahlburg, in particular, was mentored by John Money and has arguably inherited Money's mantle as a leading proponent of upbringing (environmental determinism) as the most important if not the only influence on psychosexual formation.  Cohen-Kettenis is committee chair person and team leader.

The dominant role of psychology has resulted in an extraordinarily tunnel visioned and one dimensional understanding of Intersex issues.

That should not be surprising.  The profession brings to the subject a view predominately perceived through an ethnocentric prism of middle class European values and beliefs that has denied the very existence of Intersex bodies for centuries.  The desire to convert biological diversity into a psychosocial issue and deal with it on that basis is an almost inexorable by-product of that denial.

Cohen-Kettenis offers an almost perfect example of  ‘conversion’ when she claims  that...

“a variety of medical and psychosocial factors may jeopardise the psychological development of children with DSDs. This sometimes results in the desire to change gender later in life.”

Cohen-Kettenis is well aware of the difference between sex and gender.  The issue she side-steps is that gender change is often the easiest decision surgically miss-assigned Intersex individuals have to deal with.  More often it is loss of physical and genital integrity. The surgically reconstructed genitalia cannot be restored. And that, coupled with the theft of personal autonomy,  opportunity and lost genital sensation, all physiological ‘sex’ issues, can cause the greatest distress.

From its outset ‘gender’ theory has been the device employed by psychologists and  medical practitioners in their endeavour to tame and manage the wayward bodies and potentially unacceptable sexualities of Intersex lives.

“It was in psychological research at the Johns Hopkins University in Baltimore, USA, that the gender-concept was invented...experts construed “intersexuality” as a psychopathology in need of treatment during infancy, even though their samples demonstrated that...there was no problem before the researchers intervened.”

See: HERE

Now the signaled intention to doubly pathologise Intersex adolescents and adults who reject the pediatric gender assignment imposed on them as babies by including them in the DSM-V, under the new diagnosis of gender incongruence, moves the situation from the sublime to the ridiculous. HERE

If this absurd example of illogic were carried to its inevitable conclusion David Reimer could have been served up with this diagnosis for rejecting Money's attempt to impose a female identity on him. See: HERE

But in this an utterly one-sided discourse David Reimer would not have been considered guilty of possessing a disordered identity had he been malleable enough to accept the one Money attempted to impose!  This despite the fact that Reimer was as biologically male as it is humanly possible to be.

In the same vein the manipulated identities succesfully imposed on some Intersex babies are not perceived as disordered, despite their being predominately biologically male or female - all that is required for psychological legitimacy is total acceptance of the imposed identity.  Further pathologising and  'disordering' only comes into play when and if the identity acceptable to the psychological gender theorists is not realised.

Finally it should go without saying that Reimer's rejection of an imposed female identity would not have occurred were it not for the concerted attempt to impose it in the first place.
 
But that same argument applies every time an Intersex adolescent or adult rejects the attempt to impose a controlled identity - be it male, female or, for that matter, religious or political. In other words the failures are products of the attempted 'fix' and most likely due to post natal neurological organisation - activation overriding the environmental gender role conditioning.

The refusal by psychologists to recognise that their pet theories are not applicable across the board demonstrates both the disordered nature of psychological theory itself, and the lack of any willingness to accept responsibility, or to question the universality of the theories, even when they regularly fail to materialise the sought after result.

In this 'mental health professionals', along with other self-determined medical stake-holders, are reminiscent of the physicians of yesteryear.  Obsessively attempting to balance Humors in accord with the Hippocratic Corpus - whilst failing utterly to understand that their attempts at healing, in and of themselves, all too often cause the greater harm.


Cross Posted at: TS.Si.org