Campaign against Pathologization
Stop Trans Pathologization 2012
20/10/2009
The campaign and its demands
This next October 17th, a manifestation Against Trans Pathologization will take place in different parts of the world. To this day, 167 groups from 37 countries have already confirmed their participation in the action with new groups adding every day.

The October 17th manifestation has its origin in an initiative for Trans Visibility that have been organised in Paris under the name Existrans for the last ten years. Some Spanish groups later added their voice adding the fight against transgender identity disorder in their manifesto. The first actions were organized in 2007 in Madrid and Barcelona simultaneously with the ones in Paris. Only a year later, some 11 cities joined in this “October
17th against Trans Pathologization” initiative.

These actions all share the same aim: eliminating the mention of gender identity as a disorder from the pages of the new version of the Statistical Diagnosis and Mental Disorders Manual of the American Psychiatry Association (DSM-V), to be published in 2012.

The American Psychiatry Association (APA) is currently putting under consideration the possible changes in the content of this manual. It has been spreading a survey in order to collect pertinent information. For this reason and because this topic is essential to all of us, it is urgent to make our points of view known and to increase our actions. We shall concentrate efforts in a coordinated action with an even greater number of cities this next
October 17th but also the following ones so that our claim demanding depathologization of trans identities is heard and known up every year until 2012.

The "Stop Trans Pathologization-2012" campaign is the result of this strategy. It aims at federating all initiatives against gender identity disorder. The manifestation can vary among cities, respecting the autonomy and the particularities of each group but we should all act under the motto "Stop Trans Patologización - 2012" and communicate around the campaign’s five basic goals:
-The elimination of Gender Identity Disorder (GID) from the
Statistical Diagnosis and Mental Disorder Manual of the American Psychiatry
Association (DSM-IV), and from the International Statistical Classification
of Diseases and Related Health Problems (ICD-10), that are common referents
for the World Health Organization.
- The elimination of the mention of sex from official documents.
- The abolition of binary normalization treatments for intersex
people.
-Free access to hormonal treatments and surgeries (without
psychiatric tutorship).
- The fight against transphobia and the promotion of education as well as the social and work inclusion of trans people.

Why this campaign?
The "Stop Trans Pathologization-2012" campaign reclaims a fundamental
right: gender identity is to be recognized as a right and does not entail any psychological disorder implication, which opens doors to citizen rights access.

This campaign is a reaction to the unfit stigma which gender identity suffers both in the
Diagnosis and Statistical Manual of Mental Disorders of the American
Psychiatry Association and in the International Classification of Diseases.

For the elaboration of both DSM IV and ICD 10, investigators were organized
in workgroups constituted by experts. In a second stage, their opinions were analyzed by a group of advisors. In spite of the number of people involved, the process did not prevent them from working with a slanted vision about sexual identity: all of them were trained in a environment that understands the binary gender as a model for health and normality.

The average individual in a given culture, including in the academic and scientific sectors, perceive and think according to the behavioural patterns that societies validate and that reach manifold dominions of psychological and behavioral functions, naturalizing what they feel. The determined criteria to guide their observations and systematize them, soon summarizing the average outcomes in behaviours according to which are later established the normality and reference, do not take into account the inventiveness and creativity that characterizes any person and the freedom to guide themselves by other map courses. These “off track” expressions are restricted by the rigorous process of socialization and are
described as abnormalities or disorders. The great discoveries of the
humanity came about from knowledge that in their day was fought against, because
it did not correspond to the average, habitual observation.

It is commonly accepted that the identities that man and woman assume within the
binary gender frame in which the human societies have been consolidated, are
valid and healthful expressions. Similarly, it is also accepted that those expressions are comparable processes with the ones followed by trans identities in their development processes and fixation though in alternative expressions to that duality. Nevertheless, in an attempt to refund the binary model, they are targeted by fundamentalist prejudice and are disqualified as disorder, disease, pathology, abnormality.

Those identities are stigmatized and forbidden because they break the gender limits: they have interiorized meanings since their personal intimate experience that leads to other learnings which escape the patriarcal and heteronormative control of power, and ultimately end up being through moral social sanction in terms of mental disorder and identity pathologies; giving way to State control over this iconoclast folks through health
institutions and their professionals assigned to deliver services. This political action managed from the very power structures that norm in a coactive way our sexuality, affects irremediably trans identities, whichever way they assume, and also impact the lives of intersexual people.

At this point, we must reaffirm firmly how the identity construction process be it for a man, a woman or a trans person is equally valid and has similar learning processes, even while imprinted differently by the exercise of cultural freedom; we must understand that serious conflicts are generated in social interaction because of discrimination and
social exclusion which have psychological consequences on the emotional balance of many.

These are conflicts between individual freedom and social norms crossed by gender, in which imbalance is created and affects an aspect and not the whole identity.

Contradictions
A false dilemma has emerged in this campaign: some affirm that eliminating sexual identity and personality disorder from diagnosis manuals will affect negatively a segment of the trans population as it could collide with the right and access to health, including reimbursement of hormone provision and genital reassignment surgeries services.

Some fear that their health rights could be neglected if the diagnosis that allows them to be attended is eliminated from the DSM Manual and ICD 10. Some think that a recognition of a right can remove another right, that of being medically attended. They forget that the right to sexual identity, as the respect to the freedom expressed through it, is consubstantial to trans people. It is not a right that can be mortgaged, because the dignity does not have price. All rights have an universal nature, therefore being deprived of one’s right through non social recognition is to violate one’s unicity and make one unintelligible for its social environment. This process which already leads to exclusion is reinforced by stigmatization of identity.

Certainly this subject is more sensible in developed countries in which exists a health system that gives cover to their population, a situation that contrasts with developing countries which do not have have resources to take care of their citizens, where the private health currents make impossible to benefit from this right not only for trans people but for the whole population, and where that services occur outside all control, with the exception of a few countries.

The recognized Judith Butler has gathered this dilemma in her book To undo the Gender and she has been emphatic when affirming that although gender identity pathogization is an instrument for access to certain medical services, it’s also an instrument for the transphobic people, that they’re in true. For that reason, the principle that is due to demand is autonomy. Nevertheless, she has been also cautious when showing that “it would be a mistake to ask for its eradication without having previously established one series of structures that allow to pay the transition and to obtain legal estatus”. Most countries in which health system gives services to trans people is just because there is a legislative apparatus that recognizes them like as such, in this sense, the task would be rather to separate one thing from the other, or that its entailment leave to be protected in a medical justification.

The right to health like the enjoyment of a physical, mental and social well-being, is a right in which trans community must also withstand taking care of its particularities. A trans people sector for whom it’s significant to accede to hormones and sexual reassignment surgeries that the current medicine offers, have in these procedures an opportunity to wear their bodies in the forms socially expected for, standardizing upon the supervising glance of the heteronormative society, to elude the confrontation and the violence cause by the gender dissidence, as well as the discrimination that undermines their capacities. Therefore the emotional misalignments that are observed in all persons of any assumed identity are motivated by the violence and transphobia, that this confrontation outcomes incapacitating.


Arguing that when being suppressed the consideration of sexual identity disorder, trans community demands would be taken like a sumptuary subject, is not true, cause health mental spoil is not the result of superfluous variable situations, but deep roots that are settled down in the fundamentalist idea that standardizes the relation sex-gender determining that only to feminine sex undoubting belongs the ideal woman and unquestionably to masculine sex the ideal man. That standing diagnosis must be suppressed, not as it’s erroneously nowadays established in a obtusely way rising a stigmatization to the hole identity. Could somebody say that in relation to demands raised by a man or a woman in order to modify a significant defect that jeopardizes their sexuality, that the disorder is in the ground of sexual identity? Knowing that only one aspect is affected, ought to the conflict generated by not fitting in the social norm that prevails over the bodies. Then the own society must assume the consequences caused by the thought that it promotes and that expects be interiorized by a sector of trans people and not to exempt from its pathological upon sexual and gender identity per se.

In this sense is a fact that diagnosed within the category of pathologization, as it up today gender identity, takes place a very serious disorder in people without no health problem “the own diagnosis can cause emotional damage when hurting the self-esteem of a boy who does not suffer any mental disorder” (Butler 123). If that effect has in people in develop, it is not little damage caused in adults, because introduces a paternalist structure that undermines the implicit autonomy to right identity. The concrete effect to maintain gender identity in the psychiatric and medical manuals is to confuse autonomy with pathology (Butler). For Butler like for those who support this campaign there is no doubt on the necessity that the right to liberty must be free and without coactions by false truths and that if access to medical service is conditioned, contradicts the freedom that it proclaims; therefore freedom cannot be chained.

The campaign against trans pathologization vindicates our dignity, freedom, integrity and autonomy. The few groups that do not agree with the campaign have expressed that they discord with pathologization of trans identity. We tell them then, doing ours the questions of Butler, that must ask themselves if they are ready to adapt to the psychological speech that stipulates the gender norms, before to the gender norms themselves; and that they must also face that although diagnosis will alleviate his suffering (when allowing access to the health services they demand, therefore where it is possible), at the same time also intensifies that suffering because it continues justifying it in the disease, the peculiarity, the abnormality.

As Cornelia says from Support Transgenre Strasbourg, the transgenderism is not a medical problem, but it is political. The undertaken vindication at October 17th is one of the grounds that are going to have implications in the total enjoyment of our human rights. Let us understand that there is no dilemma, because the rights in play do not collide, on the contrary they are reinforced. The fight that we undertake must watch out for the eradicating of all discriminations, stigma and transphobia in our societies from one pole to the other, but we must undertake this struggle without any crack in a common front.

Final words
We wanted to take this route of the campaign “Stop Trans Patologization - 2012” to give account of his historical coming, but also to try to convince those who still are doubtful souls. We do not have to be ashamed to demand our rights, nor to fall inside the comfortable attitude of the “smaller badness”, it is possible to dream the impossible, it is possible to have a different world, trans people are alive test of it. Perhaps the way already crossed has been difficult enough and hard as to reject greater confrontations. But those confrontations are those that have done who we are and we cannot deny them nor underestimate them in its transformation possibilities.

We trust that if there isn’t total conviction, at least these words invite to the reflection, to the continuity of the dialogue, the debate and the positive interchange of points of view on this issue.


Belissa Andía Pérez
ILGA - Secretariado Trans
Asociación Internacional de Lesbianas,
Gays, Bisexuales, Trans e Intersexuales
Instituto Runa de Desarrollo
Y Estudios sobre Género
http://www.ilga.org
http://trans.ilga.org
http://www.runa.org.pe


Latin America and Caribbean