Transsexuality: gender identity or psychological disorder?
Formerly, society considered that most of behaviors, orientations and sexual identities away from heteronormativity they were due to the existence of psychological problems. Over the years, minority groups have achieved greater social acceptance, while the different studies showed that these groups did not suffer from any type of pathology.
It is what has been happening little by little with aspects with sexual orientations such as homosexuality and bisexuality. However, in the case of sexual identity, the debate has been a bit longer over time, with the transsexuality reflected until recently in the main diagnostic classifications.
Let's talk about transsexuality: A matter of gender identity or a psychological disorder?
The concept of transsexuality
It is understood by transsexual that person who feels the existence of a continuous incongruence in the time between his biological sex and his gender identity. This incongruity usually provokes in the person the desire to initiate a process of transformation in order to live according to the gender felt as their own, using for it elements such as hormonation and surgery.
Gender identity, as a sexual self-concept that each one has of himself and the valuation that we give to that identity, is something that is largely socially mediated. Being male or female implies different things according to the society or culture in which we live, implications that may seem more or less close to our own identity.
The definition of transsexuality cited above indicates the existence of an inadequacy between the physical and the psychological . The basic question is whether this sensation of inadequacy is given as a normal reaction to a difference between the mental and the physical or, on the contrary, constitutes a disorder.
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Why do some people still consider it a psychological disorder?
Regardless of issues linked to the tradition and beliefs of a part of the population in this regard, the main reason why transsexuality has been considered as a disorder up to now. is based on the concept of gender dysphoria .
Gender dysphoria is understood as the deep frustration and discomfort that many people have in relation to their own body when considering that it is not what they should have, considering that it does not correspond to their own gender identity.
This psychological phenomenon It can cause great stress and anxiety , in addition to problems of self-esteem, depressive and anxious disorders and the deployment of isolation and self-concealment behaviors.
That is why, in diagnostic manuals such as the DSM, gender dysphoria continues to be a trigger for discomfort related to transsexuality.
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Transsexuality does not necessarily imply dysphoria
However, gender dysphoria with transsexuality should not be identified. It is not necessary to want to transform or live as the opposite sex to feel discomfort with the assigned gender role, in the same way that you do not need to feel bad about yourself to want to make this transition.
And it is that, although it can happen, Not all transsexuals feel a deep dislike for their body , or this is not a bigger problem than the desire to change. For example, there are transsexuals who do not see the need to make a total physical change, opting to hormone and change their clothes and way of acting in pursuit of which they feel more proper.
In this way, not every transsexual person will have a marked gender dysphoria that produces suffering. In fact, it is even possible that more than suffering, the fact of realizing the true gender identity can be experienced as a liberation for those who have seen their identity repressed.
Other arguments against its consideration as a disorder
The conclusions drawn from various investigations reflect that transsexuality is not a disorder, using different arguments for it.
First of all you have to keep in mind that the existence of an identity is not in itself pathological , so that when dealing with transsexuality the existence of a divergent identity with the biological one could not be considered a disorder.
Second, it is important to take into account the fact that, as a general rule, people who want to change sex and do so with due psychological, hormonal and, in some cases, surgical treatment present an improvement in their quality of life with respect to when they had not externalized their sexual identity.In addition, the very consideration that it is a disorder causes manifest damage and high stigmatization to the transsexual population, favoring transphobia and inequality.
Finally, we must bear in mind that the desire to make body modifications such as cosmetic surgery is not considered pathological as long as it does not threaten gender stereotypes. Modifying our weight with a liposuction, changing the shape of the nose by rhinoplasty or injecting botulinum toxin implies that we do not like what we had before and we want to change it, without necessarily being cases of Body Dysmorphic Disorder. The same goes for sexual characteristics and identity .
The situation today
Although until now transsexuality has been collected as a mental disorder in the predominant diagnostic classifications worldwide, such as the DSM-IV, which includes it as a disorder under the name of Sexual Identity Disorder or the ICD-10 (here the term transsexualism as a mental disorder appears), this fact is about to change.
The World Health Organization, which publishes the International Classification of Diseases or CIE, which includes mental disorders (being in this sense another of the world reference manuals together with the DSM), will publish throughout the year 2018 the next edition of the CIE, the ICD-11.
As happened in its previous version (published in 1990) with homosexuality, WHO will no longer consider transsexuality a mental disorder. Instead, transsexuality will be considered a condition related to sexual health, under the name of gender incongruence.