June 2, 2009
Veronica Drantz, PhD
Professor – School of Anesthesia
NorthShore University HealthSystem
Evanston, Illinois
Alan F. Schatzberg
President
American Psychiatric Association
1000 Wilson Boulevard, Suite 1825
Arlington, VA 22209
Dear Dr. Schatzberg:
The upcoming fifth edition of the Diagnostic and Statistics Manual offers The American Psychiatric Association an opportunity to reclaim its compassion for human dignity and its mandate to do no harm. As a physiologist who has been following the research pertaining to the issue of sexual/gender identity, I am registering my dismay at the continued categorizing of transsexual and other gender variant people in the DSM as mentally disordered.
The scientific evidence that core sexual identity is biological and innate comes from multiple sources and is overwhelming. Moreover, transsexual persons have atypical brain structure and function that correspond to their felt identity. There is no scientific support for considering transsexuality “per se” as a psychiatric disorder. While transsexuality may not be common, transsexual people are natural and merely different. It is my ethical responsibility as a biologist to point out that diversity is the rule in nature and to insist that the psychiatric profession understand that differences are not necessarily disorders. Natural variations in sexuality are many and include the transsexuality that should be expected and celebrated in any population. The psychiatric profession needs to minimize the damage to its credibility in the eyes of the scientific community by doing its part to change the culture that persecutes transsexual people. The APA should learn from its past mistreatment of homosexual people and take the lead in educating the public about the natural variations in human sexuality rather than continuing its horrific complicity in societal discrimination against transsexual and other gender variant people.
1. I insist that the elected leadership and Board of Trustees of the American Psychiatric Association issue a position statement making clear that gender identity and expression which differ from assigned birth sex do not, in themselves, constitute mental disorder and imply no impairment in judgment or competence.
2. I urge the APA to issue a statement clarifying the medical necessity of hormonal and surgical transition treatments for those who suffer painful distress with their physical sex characteristics that are incongruent with their persistent gender identity. While it is a shame that the APA is not leading this cause, it can at least follow the American Medical Association and the American Psychological Association in this regard.
3. I advise the American Psychiatric Association to follow the example of the American Psychological Association in encouraging legal and social recognition of all people that is consistent with their gender identity and expression. The APA should affirm in a position statement the dignity and legitimacy of individuals who have transitioned their social gender roles, regardless of their physical anatomy or assigned birth sex. Surely, psychiatrists can help the public understand the important distinctions between the biological terms such as male or female and cultural terms such as man or woman.
4. In addition to the above three requests, I ask that the APA scrutinize the reasons for giving Dr. Kenneth Zucker and Dr. Raymond Blanchard such inordinate influence in the DSM revision process. The bizarre and mean-spirited theories of Zucker and Blanchard are refuted by the scientific evidence and do real harm to people who simply don’t conform. Their arrogance and unscientific attitude should not be tolerated in a profession that claims to be based on science and compassion.
It is my hope that the APA will revise the DSM in a fashion that is consistent with the evidence from all the sciences. It is time for the APA to officially take a stand that celebrates the natural sexual diversity of our species and promotes human dignity and freedom.
Sincerely,
Veronica Drantz, PhD
