DSM-5: some vague notes from a vaguely-researchy day

  • 5? Really? Why exactly are we leaving behind the Roman numerals? I like Roman numerals!
  • There were some lovely rumours, a while back, that asexuality was getting some mention. Some positive, not-a-disorder mention. This has, in fact, fallen through in a very dramatic way. (Dramatic to me, okay. Your mileage may vary.)

    The previous HSDD (Hypoactive Sexual Desire Disorder) has been split into two separate diagnoses: N 04 Sexual Interest/Arousal Disorder in Women and N 05 Hypoactive Sexual Desire Disorder in Men. Please note at this point the binaristic division; we’ll return to that in the next section. Let’s first wonder about the fact that they felt the need to split it at all – I can’t see how the disorder is spectacularly different for different sexes in ways that can’t be rectified by using gender-or-sex non-specific language. But whatever. That’s not really my area of expertise. It is fascinating to see that women must experience 3 of 6 identifiers, while men need only meet 1 of 1. The phrasing that lets them get away with saying asexuals aren’t automatically included is also different for each of the two diagnoses: “The disturbance causes marked distress or interpersonal difficulty” for men and “The problem causes clinically significant distress or impairment” for women.

    Now remember that binary view of gender when you look at the next thing, which came from the same task force:

  • P 01 Gender Dysphoria in Adolescents or Adults. A diagnosis must meet 2 of the 6 indicators, pasted below:

    1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics)

    2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)

    3. a strong desire for the primary and/or secondary sex characteristics of the other gender

    4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)

    5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)

    6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)

    or some alternative gender different from one’s assigned gender. or some alternative gender, you guys. DSM-5 is breaking out of a gender binary. DSM-5 is calling it Gender Dysphoria rather than Gender Identity Disorder. DSM-5 made me cry at what a big step forward this is.

    Would it be better if we didn’t have to have a formal diagnosis in order to seek treatment? Yes. Medical gatekeeping to transition is a little extreme. But look at what they’ve done. It’s not called a disorder anymore. It’s still regulated by the DSM, the APA is still the boss of who is or isn’t, legally speaking, but it’s not called a disorder anymore. We’re acknowledged as healthy human beings. More than that – room has been made for the nonbinary transpeople. I am not kidding when I say I cried at that. It is about time.

  • Hypersexual Disorder is also fascinating me and I am eager to see what happens with it.

Oh, DSM-5, why you make me infuriated and overjoyed at the same time.

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