Wednesday, December 2, 2015

Gender Dysphoria - Homosexuality and Transgender

In the past, there was an amazing amount of stigma against homosexuality. King Henry the VIII of England declared "the detestable and abominable vice of buggery" a felony punishable by death. It was not until 1861 that the maximum penalty in England was reduced to 10 years in prison. Similarly, in 1885, when lesbianism was about to be criminalized, Queen Victoria declared lesbianism to be impossible, and therefore there was no point in making a law against it. In the US, the last law prohibiting homosexuality was struck down by the Supreme Court in 2003. As recently as 1973, homosexuality was a diagnosable disorder in the DSM. 

However, homosexuality was accepted in non-Western cultures. For instance, in Melanesia, which is a group of islands in the South Pacific, a society called the Sambia believe that semen is important for physical growth, strength, and spirituality. They also believe that the body is only capable of creating a small amount of semen, so they must get the semen from elsewhere. In order to maintain adequate semen levels, boys exchange semen through oral sex. After puberty, the teens can penetrate the younger boys, thus providing them with semen. As the teen ages, he "transforms" into a heterosexual, and ends sexual intercourse with boys after the birth of his first child. Melanesian children who refuse such practices are considered abnormal and are therefore very rare. 

Thankfully, Western culture is beginning to accept homosexuality. In the 1960's gay and lesbian people began to be more active for their rights. Such activist action led to increased brutality of police and homophobic citizens against homosexuals. Most recently, homosexual activity, although still highly stigmatized by some groups, is more widely accepted as within moral boundaries. Same sex marriages have become legal in all 50 states. 

Despite the removal of much of the stigma against homosexual people, there is still a shocking amount of stigma against transgender / transsexual people. In fact, trans people are the minority most likely to be killed in the US. As of October 2015, 22 transgender women have been killed in the US. Considering how rare trans people are in the US, these are shocking murder rates. 

Again, the stigma against trans people is most pronounced in Western culture. For instance, before being colonized by the British in the 18th century, transsexuals were revered as holy people who could remove the Evil Eye and bless homes and other places. But with the British also came stigma. Now, transsexual women resort mainly to begging and prostitution. (I will review a documentary on this subject on Saturday.)

In the US, transsexuals must jump through many hoops and red tape in order be approved for surgery. It is a several year-long process. The first step is to be diagnosed with "gender dysphoria" - persistent discomfort about one's biological sex, or the belief that one should be another sex. Gender dysphoria can be diagnosed in children if six of the following characteristics are met: strong desire to be of another gender; a strong preference for cross-dressing in boys; a strong preference for cross-gender rolls; a strong preference for toys, games, and activities associated with the opposite sex; a strong preference for playmates of another gender; in boys, a strong rejection of typically masculine toys and activities; a strong dislike of one's sexual anatomy; a strong desire for the sex characteristics of the opposite gender. 

Generally, boys with gender dysphoria more often turn out to be homosexual than transexual; however, the large majority of adults with gender dysphoria develop this characteristic as a child. Given that most children with gender dysphoria grow into emotionally healthy adults, there is some controversy about the inclusion of child gender dysphoria in the DSM-5. In fact, when children with gender dysphoria are brought in for counselling, it is often the parents who receive the most counseling. 

In adults, gender dysphoria can be diagnosed if two of the following traits are present: an incongruence between the person's sexual gender and his perceived gender; a strong desire to be rid of one's sex characteristics; a strong desire for the sex characteristics of the opposite sex; a strong desire to be of the other gender; a strong desire to be treated as the other gender; a strong conviction that one has feelings of the other gender. 

After an adult is diagnosed with gender dysphoria, he must undergo years of therapy, including a year of living as the other sex. Only after all these years of hard work can the transsexual be approved by insurance for gender reassignment surgery. 

Disclaimer: I apologize for the male (or male->female) leaning of this post. I'm making these posts to help me study for my Abnormal Psychology class, and the book was mainly about men on this subject. 

This is a series of posts summarizing what I'm learning in my Abnormal Psychology course. Much of the information provided comes from reading my James N. Butcher's textbook Abnormal Psychology. To read the other posts, follow these links: 

The Definition of Abnormal
A History of Abnormal Psychology
Abnormal Psychology in Contemporary Society
Contemporary Viewpoints on Treating Mental Illness - Biology
Contemporary Viewpoints on Treating Mental Illness - Psychology
Frontline: New Asylums
Brave New Films: This is Crazy
Clinical Mental Health Diagnosis: Biological Assessment
Clinical Mental Health Diagnosis: Psychological Assessment
Does the DSM Encourage Overmedication?
Post Traumatic Stress Syndrome - The Basics
Panic Disorder
Obsessive Compulsive Disorder
Hoarding and Body Dysmorphic Disorders
Depression - an Overview
Personality Disorders - Clusters and Dimensions
Personality Disorders - Cluster A
Personality Disorders - Cluster B
Personality Disorders - Cluster C
Biological Effects of Stress on Your Body
Somatic Symptom and Related Disorders
Dissociative Disorders
Borderline Personality Disorder
Dialectical Behavioral Therapy
Paraphilic Disorders
Gender Dysphoria - Homosexuality and Transgender
Anxiety Disorders
Bipolar Disorder - The Basics
Suicide - An Overview


Butcher, James N. Hooley, Jill M. Mineka, Susan. (2014) Chapter 12: Sexual Variance, Abuse, and Dysfunctions. Abnormal Psychology, sixteenth edition (pp. 405-442). Pearson Education Inc.


  1. This is such a timely subject.

    I am 48 years old. I have seen society change so much items of tolerance towards gay people. This is one of the reasons that I keep insisting that society is getting better. With all that, there is still outrageous discrimination going on.

    The discrimination and violence directed against Transgender folks is terrible. Thankfully on that front I think that change is starting to happen fast.

    1. Yeah, tolerance for many groups is getting much better. But tolerance for emigrants, and especially of Muslims, is still pretty bad as well. I also wish they would cut out the mass shootings!

      Anyway, I agree, our society is improving if we use our own society's standards as the bar. :) Who knows what sort of horrible things we'll be perceived to have said and done 100 years down the road, though.