Kenneth Zucker, Ph.D.
Irving Binik, Ph.D.
Ray Blanchard, Ph.D.
Lori Brotto, Ph.D.
Peggy Cohen-Kettenis, Ph.D.
Jack Drescher, M.D.
Cynthia Graham, Ph.D.
Martin Kafka, M.D.
Richard Krueger, M.D.
Niklas Långström, M.D., Ph.D.
Heino Meyer-Bahlburg, Dr. rer. nat.
Friedemann Pfäfflin, M.D.
Robert Segraves, M.D., Ph.D.
Ladies and Gentlemen,
While I appreciate the rhetorical logic of your diagnostic approach with respect to transvestic fetishism, this approach suggests the larger question, which you, as clinicians and researchers, have failed to adequately and honestly address. Is the locus of “impairment” in social functioning internal to the individual or is it indeed just as appropriate to see, in the manifest distress of the individual, the reflection of an often ignorant and bigoted social consensus which centers on perceptions of "deviance from the norm".
As mental health care professionals, certainly you must acknowledge that you are in a dynamic and indeed subjective relationship with those whom you categorize. In creating taxonomies of impairment, you fail to neither recognize nor assign responsibility to the significant role society plays in stigmatizing these individuals. Yours has been the history of assigning degrees of “social impairment” without critically examining the role society plays in setting the very ground rules for gender-normative behaviors in the first place. You indeed establish, often it seems arbitrarily, the bounds of that which society regards as normal. yet you fail to explore, much less address, the obvious question - itself bound in a larger sociology. That question being; absent society’s often shortsighted prejudice and opprobrium, who indeed is being injured by these objectively innocuous behaviors?
Is it not just as logical to suggest that the so-called “social impairment” experienced by the individual is the direct result of society’s relentless policing of the boundaries of gender? Is not the lived experience of gender itself a social construct? Moreover, if indeed it is merely a social construct, who shall be held responsible for it being used as a means to socially marginalize the individual? Could you, in the face of a theoretically altered social paradigm which allowed for various degrees of fluidity in gender expression, point with authority to the objective harm that would justify the necessity for a psychiatric diagnosis?
Your responsibilities as mental health professionals in addressing the question of what is normative behavior must be thoughtfully weighed against the backdrop of the more significant question:
How am I, as an individual member of a larger society, objectively harmed by the behavior of another? Moreover, how am I causing demonstrable harm to others?
I would offer, not at all on both counts, excepting where informed by the ignorance and prejudice to which society may subjectively cling. Thus, if no objective harm can be shown, does there remain any logical justification for a stigmatizing diagnosis of psychopathology?
Remove transvestic fetishism from any further additions of the DSM as this innocuous behavior harms no one.
R.M. Thomas
Renee Thomas ©2010 All Rights Reserved
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