Hello- I wandered across your website in searching for
the address of the Psychiatric Association responsible for
editing and reissuing the DSM-V. I am quite sincerely requesting a revision on behalf of myself and my fellow
transsexuals and transgendered people. I am 50, natal male, I have an MS in Counseling Psychology and used to do both testing and some therapy until I realized I had a hard tome focusing on precisely what the pt. was saying to me. So, I wemt to Medical School in Chicago, graduated in 84, did a year of internal medicine, then completed a 4 year Radiology Residency. I did an additional specialized fellowship year at GTown in DC. I've been in the field since 1985.
I've always known I was a MtF transsexual, since kindergarten. I was into my sisters clothes by 8 and into my first psychiatrists office by age 12, for depression and cross-dressing(incidentally I was also an allstar
catcher in the little league and made my high school tennis team)...BUT, I had "the condition or syndrome"
Not a day went by when all I could think anout was becoming a girl, and I often prayed to God to change me.
Even if I slept in a frilly nightgown I woke up male.
OK..that is the setup for my writing to you.
What I am trying to accomplish is removal of transsexualism preferably from DSM-V, But if this is
not possible, to put it in a separate category, way far
away from the parphilias. If they still want to include autogynephilia, that entity constitues a true paraphilia
but should be distinguished as distinct from transsexualism, but can have some overlapping features.
This should be done, because publishing transsexualism as a serious psychiatric disorder, and I
believe placing it next to the paraphilias, automatically
condemns a group of people who are seeking professional help and are often met with hostility, prejudice, sarcasm, and derision...usually by the male psychiatrist.
In my lifetime, I have seen at least 8 or 9 shrinks,
6 of them white males. Two female shrinks who had no idea what to do with me. Two male PhDs, in clinical Psych, three female Therapists with PhDs in clinical Psych, 5 MSW'S, ONE MALE, FOUR FEMALE-i SPENT 4 YEARS WITH THE ONE WHO INSISTED SHE WAS GOING TO CURE ME, SEVERAL lpcs, art therapists, and OTHER, equally ineffective ancillary staff. I was married for 16 years-divorced this week, with two beautiful kids-Girl-15 and boy-13. I had a lucrative ten year partnership. The American Dream.
I denied, or suppressed, etc, my deep desire to change my sex-because I thought I could be normal if I had an important career and a a family. Well-to cut to the chase- I was misdiagnosed by clinician after clinician, many took me on and had no idea of what
gender dysphoria was. I was on virtually every possible combo. of med and mood stabilizer known to ma. I was an addict for 38 years- mostly cocaine, ritalin, ups, downs,
benzodiazepines, diet pills, pain killers, you name it, I was heavilt into LSD and the Dead(over 100 shows), BUT I
was still dressing and borrowing birth control pills form a girlfriend. I was diagnosed with the following- get this- anorexia, bulimia"early", NARCISSISTIC PERSONALITY
with hysterical features, bipolar typeii, severe OCD,
substance abuse, chronic, somatization of stress, mixed
personality disorder, and borderline personality disorder, MOS.....and oh yes, depression, anxiety and Gender Identity Disorder. I had to go to rehab twice. Then when I got real depressed I had a couple half-hearted suicide attempts. I even trried to hang myself.
My latest shrink started giving my Depo-prover shots to cut the obsessional nature of my central problem,,,,of
course that didn't work either.
For the most part, I was treated very disrespectfully and with underlying hostility by the white male shrinks. As a matter of fact I am about halfway through a 400pp document I entitled, The Arrogance of Psychiatry specifically about my mistreatment and the harm they did to me. I cannot tell you all here, but I have always taken meticulous journal notes-I have about 30 years worth. One shrink insulted me and my mother-you're very ugly...do u want to get your dick cut off and become one of those pathetic creatures...an ugly "it"?. Another guy asked me if I beat my dick raw> Another told me I reminded him of a character inSilence of the lambs....i said, "oh, Clarice
Starling...agent Foster" HE SAID NO, THAT WILD bILL, YOU KNOW THE GUY WHO SKINS THE GIRLS....I was told over and over that there was no such thing as a sex change...and I
wouldn't qualify...but not one even recignizrd the condition nor did they attempt to treat it or even refer me elsewhere. And I just got worse and worse until, My
mariage was falling apart, and I had a nervous breakdown. I was forced by the state medical society to join a program in Chicago-where I stayed for four months. One day I painted my nails...so the head shrink decided to humiliate me infront of the 40 other patients and then he punished me by denying priviliges. In four months he paid my GID lip service..and it was not addressed at all..instead I was forced to go to AA/ AND NA meetings everyday-Not for mr. I know I'm far afield here, but I wanted to give u some backround so you know where my motivation is coming from.
After four months, I still desperately wanted to be a woman, nothing had changed in my core at all since kindergarten. I lost my ten year partnership, and my disability insurance was revoked for pre-existing condition. My wife was at the end of her ropes as well.
But shortly thereafter, and in a completely desperate state, I was referred to Judy Van Masdem in Calif.- and SHE KNEW WITHIN TEN MINUTES THAT THIS WAS THE PROBLEM ALL ALONG- I was severly gender dysohoric. She referref me to a member of HIBGDA IN NYC AND she confirmed the diagnosis.
I saw her on an off in two hour sessions. I finally got linked up to a Gender friendly PhD therapist(female) NEAR MY
HOME, AND A gENDER EXPERT pSYCHIATRIST WHO TOLD ME IN NO
INDEFINITE TERMS THAT i WAS A ts- HE SAID, AS FAR AS gENDER dysphoria goes, on a scale of 1-10, you're an 11.
Time to make some choices. As soon as I was properly diagnosed and referred to an Endocrinologist for hormones..an amazing thing started to happen. ALL THOSE OTHER DIAGNOSES THAT I CARRIED AROUND WITH ME, BEGAN TO DISSOLVE..uNFORTUNATELY IT MEANT THE END OF MY MARIAGE..
BUT THIS WAS MY OPPORTUNITY TO SAVE MY LIFE-i'M BEING GIVEN A SECOND CHANCE TO LIVE THE WAY i SHOULD HAVE FROM THE START...I LOST 50 YEARS IN MISERY, SUICIDALITY, TEARS, ANGER, HOPELESSNESS AND SLEEPING..AND i SPENT THOUSANDS ON MEDS..ONE DOC HAD ME ON 6 MEDS. i ALSO HAD ect- prior to my beginning estrogen.
Now to my point, unfortunately, nobody I sought help from knew or cared to know anything about my real problem.
So it was given short shrift. And I suffred needlessly with a host of psychiatric disorders, that evolved as
a result of not treating the central issue properly.
I have been on hormones for two years, I had electrolysis and vocal lessons, I now have cheek bones and I have long dirty blonde hair...my kids have accepted me conditionally. I live as a woman, and I wear androgynous clothe sinc. eyemakeup to work. I start to work full time as a radiologist here next week. Its all so
anticlmactic to me. I have Facial Feminization in San Fran in 2 weeks...although I'ved been told I don't need iit- I could be Goldie Hawn's sister! mY BOTTOM SURGERY IS
SCHEDULED FOR JUNE 8TH, 2005-MY BIRTHDAY.
Here's the point...I no longer take the large doses of anti-dpressants and mood stabilizers I used to take, my blood pressure, is perfect, cholesterol-148, I'm within range for my planned weight loss so I can present on the beach next summer as a female in a bathing suit-2 piece. I'm starting to get asked out by guys...My whole life has turned around. All one has to do is look at the hard evidence...before, male, sad...always, never a smile,
EVERY SINGLE PIC OF ME AS A WOMAN SHOWS ME SMILING. I AM
FINALLY HAPPY AND ITS JUST BEGINNING. I'M EVEN STARTING TO LIKE MYSELF, AND I'M VERY COMFORTABLE BEING Natalie.
People like interacting with Natalie, she is focuse, ad
warm....and this was always my dream...but they, were the
naysayers, the theorists who quoted Stoller, and told me how hostile I am towards wome, etc. etc. Where did they get this bull****? i even had one shrink tell me that this happened because I live in a house with three srrong women and an absent father.....then I told him I had wanted to be a girl three years before my Daddy died.
So much for Freud.
I am a Diagnostic Radiologist and a published author. I was an Asst. Prof. at a Major University.
I belong to two large support groups. I am also a moderator of two large international internet forums designed primarily for Transsexual Physicians. I am a founder of Trnsgengendered Health Alliance, and a member of GLBT, and other orgs,. IFGE....and the whole, entire point of this
post...is that American Psychiatry's approach to transsexualis and transsexualism is archaic, based
on outdated psychiatric theories, when its probably AT LEAST PARTIALLY OR MOSTLY biological in nature. We are treated like third classs
citizens, we should be treated appropriately and respectfully and this includes financial help from the insurance companies for wj\hat is now to be considered corrective surgery for a congenital condition. How we are
defined in DSM-V HAS everything to do with being considered mentally ill, disturbed, denial of payment for hormones, denial of payment for everything.....
The fact of the matter is, that a new acceptable definition for transgendered and transsexual needs to
be inserted somewhere else...under Behavioral Adjustment Problem, Gender Identity Complex or Syndrome,.....Gender Dysphoria,
is perfect as is, the word transsexualism leaves something to be desire....even Congenital Gender
Misassignment Condition ...and Please....remove us from any mention of autOgynephilia or a paraphilia.
New suggested definition:
Idiopathic Congenital Gender Malassignment which often causes symptoms associated with Gender Dysphoria later
in life, is a congenital condition of as yet unknown
etiology. It can affect the weell-being of the person to such an extent as to cause secondary psychiatric symptoms. Severe, unrelenting depression is usually the
main secondary symptom, This condition affects every aspect of an indivdual's life whether it be educational, socio-economic,academic, professional, athletic, etc, most
often to its detriment. The range and spectrum of problems these people experience are Draconian and often
intense. IT MUST BE CONSIDERED POTENTIALLY LIFE THREATENING/. THREATENING Some deleterious and aditionally unhealthy and life threatening behaviours may
beset the life path of a young transsexual. These include
rejection by parents and family. Some wind up living on the street, having to resort to sex work to earn money
in order to eat, rejection by peers and trouble at school,
precipitated only by their being "different" AND this is often reinforced by an unknowing and unfeeling staff,..
Many turn to drugs and alcohol as a defense mechanism and to cover their internal pain, which in turn may contribute
to multiple admissions to a Rehab. facility or hospital.
With forced prostitution, a host of STDS surely awaits
them. Once out on the street they are at a significantly
increased risk for rape, assault, and loss of life(murder
with indifference). oBTAINING SATISFACTORY EMPLOYMENT, or gaing admissions to a school or program becomes much more
difficult because of their transgendered status. We are
stigmatized by society...and family relationships may
become strained...or dissolve. A Major portion of the
deleterious stigmatization comes directly from the classification in the DSM and by hostile psychiatrists
as a mental disease or aberration. Much of the person's
constant pain and suffering results directly from
being diagnosed with mental illness, made by the very person who we are seeking help from. Then of course, there's therapy and psychpharmacology. The transsexual
can be misdiagnosed as having delusional thinking, Obsessive Compulsive disorder(the obsession with changing
sex is part and parcel of this condition, or as was my case- called a borderline personality disorder, NOS.
Further, as witnessed by myself, it seems that most
white male psychiatrists deal with this problem subjectively...often with hostility, sarcasm, lack of empathy- Medical Schools are supposed to educate their
physicians appropriately, to provide knowledge and of course inculcate their students to provide kind and compassionate care. After all, isn't that one of the
key reasons for becoming a Physician in the first place.
My colleagues and I have found a severe deficit in the
kind and compassionate care you have been entrusted to provide? Please understand that this is NOT an indictment
of all such Psychiatrists. But we have found, when it comes to transgenderism and transsexualism lack of
appropriate and compassionate care.
What am I asking for? I AM asking you to plan on revising THE DSM V- by redefining transsexualism ,
Gender Identity Disorder and Transsgenderism. Gender Dysphoria describes what i went through perfectly.
I am asking the Psychiatric Community in general to
rethink their approach to the much more beneficial, cost effective, and humanistic treatment of those of us
who have been forced to live a portion of our lives, in secrecy, shame, embarrassment and fear. I ask the community to consider the significant loss of revenue
incurred by the wandering transsexual. Insurance companies can add the significant costs spent over the years on medications, therapy, hospitalizations,etc.
A cost-benefits ratio spent per patient per year may
demonstrate that it is not only their responsibility
as the Insurer to cover the costs of a large portion
of so-called sexual conversion(Now referred to as Corrective Surgery). lONG GONE ARE THE DAYS WHEN SUCH PROCEDURES CAN BE TERMED, EXPERIMENTAL, OR PURELY COSMETIC. THIS IS CORRECTIVE SURGERY OF A CONGENITAL PROBLEM OR CONDITION WHICH IF LEFT UNTREATED COULD RESULT
IN DEATH(POSSIBLY SUICIDE). Suicidal thoughts proliferate
when the transsexual truly believes that he/she is hopeless.
Transsexualism, for the most part has little do
with either autogynephilia, or the paraphilias. We have
many theories for etiology.....none of them proven. You
can't see God in front of you..you can only have faith.
You can no longer treat the myriad of gender patiens who
are in great pain, and coming to you for help in such an unfeeling and rsistant manner.
It is time to bring American Psychiatry out of the dark ages. You've already started the ball rolling by establishing
the precedent and finally realizing that homosexuals
by being gay in and of itself does not conform to an appro
iate example of mental illness. It is past due, that
people born with the condition called transsexualism
are no longer considered mentally ill. Because we ARE
NOT MENTALLY ILL. Remove us from that classifcation scheme..it's based on negative heresay, absolutely
not based on science. Wasn't it two pharmacists who called
gender correction surgery experimental? We are great in numbers, more than you have imagined. We are appealing to your sense of logic and PROGRESSIVE THINKING....which
is not based on religious belief, morals, politics. The
truly insigtful, and caring professional dealing with
a newly presenting transsexual(i'm not even goona touch
the legal issues in vases of the younger transsexual-I am
well aware of them)WILL MOST OFTEN FIND TRANSITION TO BE
EGO-SYNTONIC...THUS PROVING MY POINT.
I was a miserable, suicidal, hopeless mess of a guy
who was ready to die,,,because I was not leading the
genuine life I was suppose to...as a woman.....I was made into a pill popping walking DSM-IV....by those who chose to ignore the facts. As soon as I received multple confirmations from experts I hhad sought out-for something I was sure of all of my life, and started injecting Estrogen and undergoing electrolysis, and communicating with my brothers and sisters over the net.
and dropping 44 lbs, with a consequent normalization of
my Elevated BP....I dyed my hair blonde and let it grow
and started voice lessons..and began living my life as a woman....all of those psychiatric diagnoses laid on me,
which I knew were incorrect...and started socializing as female...the bad stuff which had plagued me for years
was goig up in smoke. I am smiling in every micture of me as a woman. I haven't been this happy in years. I finally
feel normal....and free. The depression is gone. I no longer need to take 4-6 hour naps every day, I don't drink
or smoke- I was also misdiagnosed as an alcoholic and forced to attend AA meetings which I got absolutely nothing out of for FIVE YEARS. If I could only have the money and the time back....in retrospect, I was treated like a ping pong ball by a bunch of mean spirited, hostile and totally inappropriate Psychiatrist. This should not happen to anyone. In spite of the cruelty(which I have documented fully in some 30 years of journalling)I am on the cusp of living as I always imaguned I would...I enter the surgical phase in two weeks
out in SF...although lately I've been looking alot like Goldie Hawn!!!!!!
Depathologize Transsexualism, remove it from the anals of mental illness, the DSM, call it whatever you want.The fact is, its a congenital condition of unknown
etiology. Make an accurate diagnosis.....and proceed to
treat. Get that patient in therapy, make an expeditious
decision about hormones, get that person to a support group,....and down the line , refer the patient for voice therapy, and a reputable surgeon. That's how to save
a life. And Insurance companies have a moral obligation
to help pay for the correction of a congenital condition,
like a club foot or or a cleft palate. I didn't imply that
Insurance covers lazer skin resurfacing, but Implants and SRS , maybe partial help with face-certainly hormones and electrolysis, and therapy and with FtM- Mastectomy, hysterectomy, ethormones, etc....In the long run we will be saving money, and saving lives, and avoiding all the aggravation that is totally unnecessary. Its ashame that
the science of medicine ie stem cell research and an issue as simple as this have fallen behind our more forward thinking European Physicians and Scientists.
I believe I've stated my case accurately, although redundantly and a tad too long.
Sincerely, Natalie Ilana Freed MS MD
nORTHERN vIRGINIA
rEPRESENTING BOTH TRANS HEALTH ALLIANCE AND TRANS HEALTH PROFESSIONALS, MEMEBER National Coalition for GLBT HEALTH, former ASST Professor-Georgetown U Hospital
PS I ANTICIPATE AN APPROPRIATE RESONSE FROM THE BOARD THAT IS IN CHARGE OF ORGANIZING THE NEW DSM...........NOTE- If absolutely necessary, I will try to mobilize my colleagues and associates who agree with the tenor of this letter. I am prepared to publisize this issue......it is that important to me. Besides, I'm already tired of being a third class citizen.