The federalist

Gender dysphoria, a medical term, is a fraudulent money-making scheme rather than a legitimate diagnosis


Last week, Ohio Gov. Mike DeWine, a Republican, vetoed⁤ a ‌measure that would have barred minors from receiving harmful transgender interventions such as puberty blockers and⁢ wrong-sex hormones. Amid intense‌ backlash, he’s since tried‍ to run damage control, signing an executive order on Friday that bans only trans surgeries for minors. We hope Ohio Republicans still override⁣ DeWine’s veto.

There’s more going on behind the scenes of ⁤the medical‌ establishment, however, especially as it relates​ to the “gender dysphoria” diagnosis. Gender dysphoria must be addressed ⁤in conjunction⁣ with contributing factors, such as adverse childhood experiences, but instead licensed clinicians rush children toward life-altering medical ‌interventions.

If you pay any attention to the conversation⁤ surrounding so-called⁤ gender identity, you might be led to⁤ believe sex is not ⁣real and that its binary nature is a created concept‍ that can be altered to ​align with a person’s psychological beliefs about ⁤his or her sex. ⁤Such is the thinking that undergirds gender⁢ dysphoria, a ‌condition listed in the Diagnostic Statistical Manual for Mental Disorders, Fifth Edition (DSM). The diagnostic criteria‌ hold that gender dysphoria is “a marked incongruence with one’s experienced/expressed gender and⁣ assigned gender.”

The key to the gender dysphoria diagnosis hinges on the‌ presence of distress. If a person experiences‌ marked ⁣distress about being identified as transgender, that distress can be labeled a disorder. ​If a person​ does not experience marked distress, advocates hold that ‍person’s transgender⁤ identity ought to ​be considered normal. ​

In‍ 2013, the gender ⁢dysphoria diagnosis was changed to include this understanding to‍ normalize what was ‌previously considered a ​disorder. Since then, the conceptualization of gender dysphoria has become muddled. It ⁤is no longer clear that there can be a therapeutic goal of helping people⁤ shed ⁤the delusion that they can truly ‍live as a⁤ sex other than what ⁢is written in their genetic code.

When‍ responding to all the changes made to the DSM in 2013, ⁢it is fair⁤ to ask: If the medical working groups ‍and other professional organizations’ goal in changing the diagnosis was to destigmatize the condition, then why not completely remove the diagnosis from the​ DSM?

You ‌can find one answer⁢ to ⁣this question in how ⁤the American medical ‍system is structured. Our medical system does not allow‍ for insurance reimbursement without a diagnostic⁤ code. When‌ it comes ‍to gender dysphoria, it would seem the diagnosis is often ‍not being given for the purpose ⁤of remedying the root causes of mental distress. Instead, the ‍diagnosis is‌ increasingly being used as ‌a ‌vehicle for payment ​to change one’s physiological appearance.

If this were not the case, we would see the mental health profession researching and embracing other clinical modalities that are known​ to help with psychological⁤ needs common ‍among ⁢those⁢ who claim a transgender identity. Currently, the only “treatment” endorsed and propagated by these professional and medical boards is ⁣so-called⁢ gender-affirming care, which is actually medically assisted self-harm. ‌Gender-affirming care is a one-track approach swaddled in a‍ dogmatic ideology, and it shuns any other approach that does not entail denying biological realities.

Diagnosis is just as vital to the “treatment” process as getting insurance to pay for⁤ it because it​ precedes ⁣the development of an intervention. In most instances, a clinician has the latitude to give a provisional diagnosis and, if necessary, pivot ‌to a better-suited ⁤diagnosis and intervention once time and ongoing assessment have ‍more accurately revealed the nature of the problem. This is ‌not the case with a⁤ gender dysphoria diagnosis. The therapeutic and⁢ public community alike have⁢ been told that ‍the gender⁢ dysphoric​ condition can be remedied only by altering ‌or excommunicating ‌parts of the‌ body so that people can appear outwardly more like what they feel internally. This invasive physiological intervention has been billed ​as ‍ life-saving care,⁣ and backing away from such a⁣ course of action has⁤ been posited as unethical.

One of‌ the authors, Walt Heyer, was diagnosed with gender‍ dysphoria and given hormones and surgery only to discover, like⁣ the vast ‌majority of regretters and detransitioners ‍have, that the misuse of the gender ⁢dysphoria diagnostic ⁢term enacts painful personal consequences.

The Authority of⁢ the DSM

In all the discussions on the transgender topic, there is rarely any​ consideration given to the question of the gender dysphoria diagnosis’ legitimacy. For context, questioning the authority of the DSM is not a newly explored‌ topic. This question has⁤ been the source of a long-standing debate among psychiatrists, mental health professionals, and theorists who use the DSM to diagnose other mental​ disorders. This debate ⁣arises out of concern that giving ⁤diagnostic ⁢labels reduces human experience and suffering into overly ‌simplistic categories that ‌can limit ⁢treating ‍the whole person. ‌

For​ example, borderline personality ⁤disorder has been recognized by clinicians ‍and researchers as a diagnosis often disproportionately attributed to women and ⁢not men. This⁣ is likely due ⁤to⁣ several factors; one ⁣is that the ⁣symptoms characteristic ‌of this disorder fit well with​ some⁤ of the stereotypical qualities of emotional ⁤expression found to be more prominent in females than males. Therefore, it is conceivable that inaccurate⁤ diagnoses can occur based on social norms ⁢rather than sound⁣ diagnostics, which are followed by appropriate treatment plans.

Diagnoses can help with medical communication and treatment planning,​ but these are ‌not static⁢ concepts that pigeonhole people⁢ into a way ​of acting, thinking, and behaving unto their last dying breath. Before scrapping the whole DSM,‌ we should take stock of the fact that ‌there are ⁣diagnoses based​ on well-formed ideas with solid research studies and clinical​ observations.‌ Ultimately, these must be held in concert with a recognition⁢ that human beings ⁢are complex and have unique experiences that are not always ⁢accurately depicted⁢ by lists of symptoms found in the DSM.

We are not arguing​ to eliminate the DSM;⁣ however, we are raising questions about the use and‍ overuse of the gender dysphoria diagnosis. The ‌misuse of this diagnostic term is‌ not without consequences.

Include Other Possible Factors

Instead ‌of rushing into surgical and chemical⁣ interventions,⁤ what if the gender dysphoria diagnosis were​ reconceptualized to ⁢include other possible ⁢contributing factors to the distress (adverse childhood​ experiences, neurological disorders, etc.)? This approach would necessitate⁢ a thorough and ongoing evaluation of a person and his or ⁢her life experiences that have formed the presenting gender distress, ⁣a ⁢stark difference from ​the current conceptualization that promotes a haphazard, catch-all approach to ⁣diagnostics.

For‍ example, it is ⁤well-documented that adverse childhood ⁢events contribute to many types‍ of mental disorders and distress. This term⁤ refers to a range of negative and highly stressful experiences a child may ​experience firsthand or as a witness, such as physical neglect, parental separation or⁢ divorce, living in a household in which domestic violence⁣ occurs,⁢ or living in ​a household with ​an alcoholic. These negative experiences⁣ have the potential to⁣ alter the ⁤brain,⁢ where ⁣the most basic​ human needs originate⁢ and a person’s ⁣identity‌ is⁣ formed.

In one large-scale study,‍ transgender-identifying youth reported⁣ having other mental health diagnoses that were present⁢ before the onset of transgender belief. This ⁣study‌ compared more than ​1,300 transgender-believing youth with ⁤age-matched peers ​from ‌three large⁤ pediatric practices ⁢in California and ⁤Georgia. The​ findings showed psychological disorders ⁤such as⁣ anxiety,⁣ depression, and ​attention deficit disorders were​ several times⁣ higher than the ⁣peer group. Suicidal ideation was​ up to 54 times higher, and self-harm was up to 144 times higher.

Other studies of transgender-identified individuals have also reported a high frequency of⁣ childhood emotional and physical neglect and abuse. These findings ⁤merit diagnostic conceptualization ⁢and treatment plans ⁤that⁣ lend themselves to⁣ addressing ⁢comorbidities.

We believe the terms of a gender ⁢dysphoria⁣ diagnosis must be viewed in conjunction with contributing factors, such as‍ adverse childhood experiences. Unfortunately, this is​ not the predominant approach⁣ among the ⁤preponderance of licensed clinicians.


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How can clinicians develop a more comprehensive understanding of gender dysphoria by considering contributing factors?

Ences can have long-term effects ​on a person’s ‌mental health and can contribute to various mental disorders,⁤ including gender‌ dysphoria.

By considering ⁣these contributing factors, ⁤clinicians can develop a more comprehensive understanding of a person’s gender dysphoria and⁣ tailor their interventions accordingly. This may⁢ involve addressing the underlying trauma and providing appropriate therapy and support, ⁢rather than immediately⁣ resorting‌ to surgeries and hormonal treatments.

Furthermore, reconceptualizing the diagnosis would also require ongoing evaluation and assessment of the ‌individual’s experiences and‌ feelings, allowing for a more nuanced understanding of their gender distress. This⁣ approach ⁢recognizes that every person’s experience is unique ‍and that a one-size-fits-all approach to treatment may not be suitable.

Critics of this proposal may argue that it would invalidate the⁤ experiences‌ of transgender individuals and deny them ‌access to necessary medical interventions. However, it is⁣ important to note that this approach does not​ aim to deny anyone the care they need. Instead, it seeks to broaden the understanding of ‌gender dysphoria and ensure that individuals⁢ are provided with appropriate and personalized treatments based on a thorough evaluation ‌of their unique circumstances.

It is essential to emphasize that this article does not advocate for the⁢ elimination of the DSM or disregard the value of diagnoses in medical practice. Diagnoses⁢ can provide a common language for medical professionals and guide treatment​ plans. However, it is crucial⁢ to recognize the limitations of diagnostic ⁢labels and the‌ potential for misuse.

In conclusion, the current understanding and treatment of gender dysphoria need ‌to be reexamined. By⁢ reconceptualizing ⁢the⁤ diagnosis to include other possible contributing factors and conducting ⁤thorough evaluations, clinicians can provide more personalized and ⁤effective care‌ for⁢ individuals experiencing gender distress. This approach acknowledges the complexities of human experiences while still incorporating the necessary ⁢clinical framework.



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