Updated DSM Draft Expands Harmful “Transvestic Disorder” Diagnosis

NCTE is concerned by the American Psychiatric Association’s recent proposal to expand the diagnosis of Transvestic Disorder (currently known as Transvestic Fetishism) to pathologize an even larger number of transgender people. We continue to call for complete removal of this diagnosis from the Diagnostic and Statistical Manual of Mental Disorders.

In April, NCTE joined many other LGBT organizations in submitting comments to the American Psychiatric Association that raised concerns about the proposed retention of this diagnosis with only minor modifications in the forthcoming 5th edition of the DSM. We stated:

NCTE believes there is no place in the twenty-first century for a diagnosis of Transvestic Fetishism/Tranvestic Disorder. While there are certainly some individuals who experience psychological distress in relation to their desire to cross-dress – often due to the pervasive social stigma and discrimination against transgender people – this experience no more justifies a psychiatric diagnosis than does “ego-dystonic homosexuality.”  We urge the APA to eliminate this unnecessary and harmful diagnosis in the DSM 5.

On May 17, the APA added to its website an update to the proposed DSM 5 criteria for Transvestic Disorder. Rather than eliminate or narrow the diagnostic criteria, the updated draft expands the diagnosis substantially by providing that anyone can be labeled with this supposed disorder, regardless of their birth-assigned or self-identified gender. While the fact that the DSM has previously restricted the diagnosis of Transvestic Fetishism only to “males” served to underscore a preoccupation with gender stereotypes, expanding the diagnosis only makes matters worse.  This change is unresponsive to, and actually exacerbates, the fundamental concerns of transgender advocates: that pathologizing gender non-conforming behaviors or desires is inappropriate and wrong.

Serious questions have been raised about the scientific basis for such a diagnosis. On May 26, the World Professional Association for Transgender Health (WPATH) released a statement calling for the de-psychopathologization of gender variance worldwide, stating: “The expression of gender characteristics, including identities, that are not stereotypically associated with one’s assigned sex at birth is a common and culturally-diverse human phenomenon which should not be judged as inherently pathological or negative.” A psychiatric diagnosis for cross-dressing has yielded no benefits for transgender people and has contributed to the perpetuation of official and unofficial discrimination. NCTE urges the complete removal of this diagnosis in the DSM 5.