DSM-5: Transgender-A New Way to be Human?

Transgender  - A new way to be human

"...medical diseases are discovered and then given a name, such as acquired immune deficiency syndrome (AIDS). Mental diseases are invented and then given a name, such as attention deficit disorder. " Thomas Szasz. [1]

To paraphrase Canadian Science philosopher, Ian Hacking,  human 'kinds' are both identified and created by an interactive 'looping' process between the identifier and the identified. Whole new categories or 'kinds',  literally 'new ways of being human', come into existence as they are observed, calibrated and classified.  Finally the process of naming and categorising influences the way the new kinds of people subsequently think and behave.  [2]

Martti Olkinuora has described psycho-social contagion as a, "form of collective behaviour that consists of the dissemination of a set of symptoms for which no physical explanation can be found..." [3]

Accordingly  psycho-social contagions are spontaneous manifestations of an (often transitory) mental disorder that appears as if from nowhere and affects susceptible victims.  There are some well documented examples.

Traditionally, 'Koro'  takes several forms, including a fast spreading social belief in fatally retracting genitals, or a belief in genital theft.  This belief transcends cultural boundaries and  not uncommonly causes widespread panic once it becomes established. [4]

But psycho-social contagion and false epidemics can take many forms and are easily ignited, for example by false-positive medical diagnosis'.  The less traditional kinds can be difficult to distinguish from a genuine epidemic, be just as costly and are experienced as 'real' by anyone who develops the symptoms. [5]

The DSM-IV criteria for a diagnosis of ADHD include behaviours such as: "Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities, often has difficulty sustaining attention in tasks or play activities; often does not seem to listen when spoken to directly; often does not follow through on instructions and fails to finish schoolwork, chores...; often loses things necessary for tasks or activites at school or at home; is often easily distracted by extraneous stimuli..."

'Hyperactivity' is defined by behaviours like,  "fidgeting with hands or feet or squirming in seat; often leaving seat in classroom or in other situations in which remaining seated is expected; running about or climbing excessively in situations in which it is inappropriate; often has difficulty playing or engaging in leisure activities quietly; often talks excessively..." [6]

One 1997 survey of parents concluded that, using the DSM-IV criteria,  2.4 million American children would meet the standard for ADHD. [7]

The ICD-10 equivalent is Hyperkinetic disorder.  It states, "... Hyperkinetic disorders always arise early in development (usually in the first 5 years of life). Their chief characteristics are lack of persistence in activities that require cognitive involvement, and a tendency to move from one activity to another without completing any one, together with disorganized, ill-regulated, and excessive activity..." [8]

Both manuals have 'wooly' definitions, the 'diagnosis' are largely intuitive and require a values judgement from the individual attributing the disorder.  Nonetheless at least one study has shown significant disparities, in the order of 4% in ADHD attribution rates dependent on which of the two codes is being used. [9]

In 2000 the American Academy of Pediatrics declared Attention Deficit / Hyperactivity Disorder (ADHD) to be an epidemic. According to Daniel Goldin in the Huffingdon Post, "... 8% of school-aged children were reported to have an ADHD diagnosis by their parent in 2003. Diagnosis of ADHD increased an average of 3% per year from 1997 to 2006 [and] The production of stimulant medications [such as] Adderall and Dexedrine [had] increased by 4,516%, while the production of Ritalin also increased by 375% from 1993 -2003 (U.S.D.E.A., 2003)." [10]

If an average annual increase of 3% constitutes an ADHD epidemic it is tempting to declare that the increases in individuals seeking medical assistance for the purposes of changeing social gender role presentation  qualifies is a pandemic.  Globally, statistical data are sparse on the issue,  but some is available and the source is impeccable. In 2010 the British transgender advocate organisation, GIRES (Gender Information, Research and Education Society) published data  showing a growth trend of 11% per annum between the years 1998 to 2010. [11]

These numbers are likely to be reflected in other developed nations and the question that begs an answer is where did these people all come from?  In his 2000 article, A New Way to Be Mad, medically trained journalist, Carl Elliott writes:

Fifty years ago the suggestion that tens of thousands of people would someday want their genitals surgically altered so that they could change their sex would have been ludicrous. But it has happened. The question is why. One answer would have it that this is an ancient condition, that there have always been people who fall outside the traditional sex classifications, but that only during the past forty years or so have we developed the surgical and endocrinological tools to fix the problem.

But it is possible to imagine another story: that our cultural and historical conditions have not just revealed transsexuals but created them. That is, once "transsexual" and "gender-identity disorder" and "sex-reassignment surgery" became common linguistic currency, more people began conceptualizing and interpreting their experience in these terms. They began to make sense of their lives in a way that hadn't been available to them before, and to some degree they actually became the kinds of people described by these terms.  [12]

But Elliott has fallen for the smoke and mirrors of gender change. There are not 'tens of thousands' of the classical 'women or men trapped in the wrong body' kind of transsexuals.  'The kind of 'transsexual' Elliott is more likely referring to might be more properly described as people who feel 'trapped in the wrong social gender roles'. They are not, in fact Transsexuals at all.  Their goal is to alter aspects of their body in order to 'pass' themselves off as another sex. At the core of their behaviour lies a profound and unshakable belief in the primacy of identity over biological matter.

"Sometimes," (writes Ian Hacking) "our sciences create kinds of people that in a certain sense did not exist before. I call this ‘making up people’ ... We think of these kinds of people as definite classes defined by definite properties .. .But it’s not quite like that. They are moving targets because our investigations interact with them, and change them. And since they are changed, they are not quite the same kind of people as before. The target has moved. I call this the ‘looping effect’.   "[13]

 There exists no western history indicating a mass movement of gender role conversion in our past.  Other, different, cultures were mined to establish a legitimising 'trans' history. Sex had to be distinguished from gender. Evolutionary theory and cultural secularism had to establish themselves before 'identity' could replace the 'soul' as a metaphor for 'self'.
  
The next article in this series will examine the way 'transgender' came into being, both as  the product of a particular time and place and as a completely new way to be a person.