The Psychology of Gender 4th Edition

8 Chapter 1

SIDEBAR 1.1:Should Gender Identity Disorder Be Classified as a Mental Illness?

According to theDiagnostic and Statistical Manual of Mental Disorders(DSM-IV-TR), Gender

Identity Disorder involves the following four characteristics:

a. Identification with the other sex (as indicated by four of the following five):

1. Desire to be the other sex


2. Preference to dress as the other sex


3. Preference to behave as the other sex


4. Desire to play games and activities associated with the other sex


5. Preference for other-sex playmates
   b. Discomfort with own sex
   c. Disturbance causes significant distress and impairs functioning
   d. Doesnothaveanintersexcondition

Gender Identity Disorder is one of the most controversial disorders in theDSM-IV-TR

(Manners, 2009). Some people have called for the removal of Gender Identity Disorder from the

DSM-Vthat is due to be published in 2013 (Ault & Brzuzy, 2009). Some liken the debate over

whether it should be included in the future edition of theDSM-IVto the debate that occurred

several decades ago over homosexuality, which ultimately led to its removal in 1980. Gender

Identity Disorder is especially controversial as a diagnosis in childhood for several reasons.

First, characteristic a (listed above) requires only four of the five features, which means that

the most critical feature (desire to be the other sex) need not be present. Second, the other four

features revolve around gender stereotypical behavior, and what is deemed gender stereotypical

today may change with time and does change with culture. This diagnosis suggests that gen-

der nonconformity is evidence of a disorder and justifies the treatment of children who do not

conform to stereotypical gender roles. Some have questioned whether the diagnosis in children

comes from a discomfort with the behavior among parents rather than the children themselves

(Hill et al., 2007). Interestingly, boys are more likely to be referred for Gender Identity Disorder

than girls, which may reflect society’s greater intolerance of other-sex behavior in boys than

girls (Zucker & Cohen-Kettenis, 2008). Furthermore, follow-up studies of children with Gender

Identity Disorder show that only a minority persist into adolescence and adulthood (Zucker,

2010). By contrast, there is a higher rate of persistence among adolescents. Even among adults,

however, there is debate as to whether the desire to be the other sex should be labeled as a

disorder. This diagnosis pathologizes transgendered people and transsexuals, despite the fact

that many of these individuals are well functioning. The inclusion of Gender Identity Disorder

as a mental illness increases the stigma and subsequent discrimination associated with gender

noncomformity.

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