The place of transgender and gender variant people in American society is rapidly changing. Another marker of this change was issued this summer by the American Psychiatric Association (APA). The APA formed a task force on the treatment of gender identity disorder (GID) – the psychiatric label the APA assigned to transgender people in 1980 – to “perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA.”
The report of this task force (including the literature review) is available at http://ajp.psychiatryonline.org/data/Journals/AJP/24709/appi.ajp.2012.169.8.875.ds001.pdf
What is more interesting, however, is that the Task Force concluded, “While the existence of the [GID] diagnosis contributes to the stigma of affected individuals, the unintended result of the APA’s silence [referring to a dearth of any other official statements about care of transgender people] is a failure to facilitate full access to care for those diagnosed with GID.” Accordingly, the Task Force recommended, among other things, that the APA issue a position statement opposing discrimination against trans and gender non-conforming people. That position statement was approved this summer and reads:
“Issue: Being transgender gender or variant [sic] implies no impairment in judgment, stability, reliability, or general social or vocational capabilities; however, these individuals often experience discrimination due to a lack of civil rights protections for their gender identity or expression. As a result, transgender and gender variant persons face challenges in their marriage, adoption and parenting rights, are regularly discharged from uniformed services or are rejected from enlisting due to their gender identity, and have difficulty revising government identity documents. Incarcerated transgender and gender variant person suffer risks to their personal safety and lack of access to comprehensive healthcare. Further, transgender and gender variant individuals may be inappropriately assigned space in gender-segregated facilities such as inpatient psychiatric units and residential treatment programs. Transgender and gender variant people are frequently harassed and discriminated against when seeking housing or applying to jobs or schools and are often victims of violent hate crimes.
“The APA declares in its vision statement that it is, “the voice and conscience of modern psychiatry.” Thus, this position statement is relevant to the APA because discrimination and lack of equal civil rights is damaging to the mental health of transgender and gender variant individuals. In addition, APA’s values include “advocacy for patients.” Speaking out firmly and professionally against discrimination and lack of equal civil rights is a critical advocacy role that the APA is uniquely positioned to take.
“Therefore, the American Psychiatric Association:
- Supports laws that protect the civil rights of transgender and gender variant individuals.
- Urges the repeal of laws and policies that discrimination against transgender and gender variant individuals.
- Opposes all public and private discrimination against transgender and gender variant individuals in such areas a health care, employment, housing, public accommodation, education, and licensing.
- Declares that no burden of proof of such judgment, capacity, or reliability shall be placed upon these individuals greater than that imposed on any other persons.”