Diagnosing Difference

The Diagnostic and Statistical Manual of Mental Disorders is referred to as “the Bible” by the psychologists and psychiatrists who utilize it to diagnosis and treat patients. A project of the American Psychiatric Association, the DSM was first published in 1952 and subsequently revised in 1968, 1980, 1987, 1994, and 2000; the forthcoming 2012 edition is currently in formation. If you’re feeling bored, dear reader, let me cut to the chase and tell you why this all matters.

As feminists well know—hello, hysteria!—a diagnosis of mental disability may simply be an accusation of difference or a punishment for refusing to comply with political, economic, aesthetic, or social demands. Diagnosis is not always, if ever, a neutral process. It is, instead, a process of translating behaviors (such as homosexuality or sexual fetishism) into identities (“deviants” or “perverts”). Paying attention to the historic and political context within which the DSM operates reveals not simply the prevalence of bias, but the fallacy of objectivity in social scientific inquiry.

Diagnosing Difference, directed by queer, clinical psychologist Annalise Ophelian, tackles the politics of diagnosis and the impact of Gender Identity Disorder (GID) on transgender and gender non-conforming individuals. The full-length documentary features interviews with trans-identified mental health professionals, activists, and scholars who speak to the burden of GID. Dylan Scholinski, for example, recounts being forcibly locked up in a mental hospital at age 15 for being “an inappropriate female.”

Public health advocates Willy Wilkinson, Cecilia Chung, and Renata J. Razza discuss the importance of re-educating health care providers with culturally competent and trans-positive information. The GID diagnosis, which is often required before doctors will administer hormones or provide gender reassignment surgery and government agencies will legally change a person’s name or sex on a driver’s license or birth certificate, does not represent the experience of many trans people. The GID criteria demands an individual unambiguously live and present as their “opposite” gender and deny any affiliation with their gender assigned at birth.

However, even the varied identities of transgender, transexual, gender queer, gender variant, and so on testify to the multiplicity of gender expressions beyond simply man or woman. The GID diagnosis reifies gender norms, privatizing gender variance as a “problem” for individuals. As Pauline Park, trans activist and founder of the New York Association for Gender Rights Advocacy, often remarks, “I don’t have a Gender Identity Disorder; society does.”

Diagnosing Difference builds an important bridge between mental health professionals and community advocates, and participates in the growing GID-reform movement. The documentary is a vital project for educators, public health advocates, social workers, and doctors, and anyone interested in the gender politics.

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