When something isn't

Yup, it's another conumdrum. And it's in the transgender community, like that's new or news, but really more in the medical community. I watched the recent eposide of "In the Life" about "Revising Gender" with Linda Hinton. It's an excellent nutshell description of the conumdrum minus one element, the health insurance companies.

The American Psychological Association (APA and not to be confused with the American Psychiatric Association, also APA) writes the Diagnostic and Statistics Manual, DSM and often called the Diagnostic Standards Manual. It define all the mental health conditiions, disorders and diseases mental health experts can diagnose, and everything outside the DSM is consider normal or a nonpathological condition.

According to the medical community, anything described in the DSM is considered worthy of medical intervention and help and is usually covered by some type of health insurance or by a state or federal program. In short, you're considered mentally abnormal (their words not mine, just google "abnormal psychology") and should be treated, and that treatment should be partly, mostly or wholly paid by someone other than yourself.

In the DSM-IVTR (latest revision), Gender Identity Disorder (GID) is described along with treatment. But since GID was inlcuded in the DSM in 1980, shortly after homosexuality was removed, the APA has not pushed for insurance coverage, until this year (as short as it is so far), except they only "recommend" insurance coverage. And most health insurers have explicity exclusivity clauses in their coverage for GID treatment, specifically identify sex-change transistions.

Ok, but that's not the issue here. GID didn't exist before 1980 and to and for many people doesn't belong in the DSM in any form, manner or description. Yet the APA is currently revising the DSM for DSM-V to be released in 2012 to not only be more inclusive of GID but to expand and almost make it a pathology, meaning if you are diagnosed, you're one sick person.

Yet, while the APA lists treatment which "cures" GID, and along with the WPATH, has the complete procedures a patient goes through to become "normal", aka "cured", they still don't identity it sufficiently to require insurance coverage. Meaning you're sick but not sick enough.

Many in the transgender community argue that GID is a bogus condition which shouldn't be in the DSM, but is simply another expression of human being and covered under WPATH (formerly HBIGDA). The reality is that we're all transgender to some degree, just that most have characteristics of their birth sex so it's not an mental issue. Some, however, have more characteristics of the opposite sex to the point of wanting to be and live as one of the opposite sex.

That's not a crime, or a mental health condition, it's a problem with the body. The scienfitic evidence is starting to show GID is a neurobiological condition introduced in the fetus and reinforced in early life. But the APA fails or doesn't want to recognize those facts, and most important one which hits them in the face.

The APA is exercising their morality over the definition of "normal". GID isn't real but a group of white men imposing their opinions and morality on the rest of society and the few who want to be who they know they are. And imposing the DSM only excerbates their anxiety, fear and stress about themselves. The APA is creating a problem than solving one with their morality.

Because GID isn't. It isn't anything beyond being human. But that's only half the story.

If GID were removed from the DSM, as many want, then people lose the right for health insurance coverage, if it were covered. Since the APA doesn't require coverage, then everyone wanting to transistion faces the $25-50,000+ cost for it. So the person is left writing checks for something that will stigmatize them for life, having a mental health condition.

So the transgender community is stuck, and the APA knows this and does nothing, or very little (not to ignore the efforts of some in the APA to get change) to help beyond stigmatizing a class of people because of the APA's morality of "normal". If it's removed, as it should, then all bets (coverage) are off and the medical communtiy can simply forget it, like homosexuality.

Except people need help to get the therapy, drugs, and sugery to change from what they are to who they are, It's that simply. A simple solution to a personal issue. It's not rocket science but the APA refuses to see the light and the people for their own morality. In the end GID isn't but not being is worse than being, and being is worse having to live with the DSM which doesn't do much except tag them as abnormal.

And almost nowhere is GID covered by insurance. This is changing but only slowly and with employers than health insurance companies. The latter is like the APA, we don't like you and therefore won't help you, but don't forget those premiums to cover any sickness you have, except GID. One might get the idea there's a collusion between the APA and health insurance industry to impose their morality?

Ok, I've rambled around the issue, kinda like the In the Life show did because the issue is broad and deep, and historic and current. And the new DSM only looks to make matter worse for those with GID. What happened to the ethic, "First do no harm"? This seems to me that the APA should be doing. Looking a helping people (sorry to use their classification) GID. If you define them, shouldn't you be helping them?

So, to the APA where is your help? I don't want to hear your morality, I want to hear your help. That's the least you can do. The next is demand health insurance coverage. It's good science, good medicine and good humanity. Or did you forget that?