There is a lot of confusion regarding basic trans terms on tumblr. This especially applies to the term “transgender”. There is a meme saying that you have to suffer from gender dysphoria to call yourself transgender.

I have argued elsewhere why this is incorrect. Still, given that several so-called truscum activists have written that this is the definition of the American Psychiatric Association, I think it is necessary to make the relevant text of their manual, the DSM-5, more widely available.

I am definitely not agreeing with everything that manual says. The DSM has been one of the major instruments used in the stigmatization of transgender people.

That being said: The gender dysphoria chapter in the latest edition is a huge improvement and it gives a good overview over where both psychiatry and psychology stand today as regards trans lives.

Anyone who is interested in trans issues should read it, which is why I have included a link to the text itself in this blog post.

Here are some important points, relevant to the recent debate:

1. The DSM-5 defines “transgender” as a wider umbrella term that encompasses a wide variety of gender variance. Gender dysphoria is not needed to be classified as transgender. Transsexual is a sub-category of transgender. The terms are not synonymous.

2. The diagnosis “gender dysphoria” does not require a complete identification with one of the two genders as traditionally defined. Non-binary identities are accepted.

3. “A strong conviction that one has the typical feelings and reactions of the other gender” is only one of many possible criteria. It is not a required criteria. In fact, you need to fulfill only to of the six criteria for gender dysphoria listed to be diagnosed as having gender dysphoria.

4. The manual stresses that “In adults with gender dysphoria, the discrepancy between experienced gender and physical sex characteristics is often, but not always, accompanied by a desire to be rid of primary and/or secondary sex characteristics and/or a strong desire to acquire some primary and/or secondary sex characteristics of the other gender.” (My emphasis) This is important as it is often argued that an anatomic dysphoria is needed for someone to be classified as gender dysphoric.

5. Crossdressers and crossdreamers can be diagnosed with having gender dysphoria. The chapter underlines that “An individual with transvestic disorder who also has clinically significant gender dysphoria can be given both diagnoses. In many cases of late-onset gender dysphoria in gynephilic natal males, transvestic behavior with sexual excitement is a precursor.”

6. One of the reasons the DSM-5 distinguishes between gender dysphoria and transsexualism, is that people with gender dysphoria do not always end up transitioning. In the DSM the word transsexual is limited to those who plan to transition to their target sex, or who have done so.

7. The DSM-5 does not require “bottom surgery” for someone to be considered transsexual.

You can read the text yourself here!

Note that there is also an international manual, the WHO ICD. I have looked at documents preparing the 2017 edition of that manual, and find the same to be true here. The people writing it is clearly distinguishing between transsexual and transgender. More about this here!

I would like to thank Brenda Lana Smith for helping me transcribe large parts of the gender dysphoria chapter of the DSM-5.