The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. DSM contains descriptions, symptoms and other criteria for diagnosing mental disorders…
determining an accurate diagnosis is the first step toward being able to appropriately treat any medical condition, and mental disorders are no exception.
As you read the following example you can use your gut reaction to test your own use of analytical thinking vs blind association with social trends to guide your beliefs. Do you find yourself stressed, distancing yourself from this argument therefore this presenter of the argument, or are you willing to consider all sides of an issue?
- 1952 – the American Psychiatric Association published its first edition of the Diagnostic and Statistical Manual (DSM-1), the definitive criteria for diagnosing behaviors as psychiatric illnesses. At that time it classifed “homosexuality” as a “sociopathic personality disturbance.”
- 1968 the second edition (DSM-2) reclassified homosexuality as a “sexual deviation.”
- 1973 – DSM-III created a new category called “Ego Dystonic Homosexuality”.
- 1987 – DSM-IV completely removed homosexuality.
In just 35 years the DSM changed from pronouncing adult homosexuality to be a sociopathic condition to being a normal variant of sexual behavior.
But that determination is not made on the basis of research-based statistical evidence, cause an effect, and most of all, the baseline criteria of mental health being rooted in reality and expressed in ways and means common with one’s culture.
Take the diagnosis of Schizotypal personality disorder, for just one example.
A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) ideas of reference (excluding delusions of reference)
(2) odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations)
(3) unusual perceptual experiences, including bodily illusions
(4) odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
(5) suspiciousness or paranoid ideation
(6) inappropriate or constricted affect
(7) behavior or appearance that is odd, eccentric, or peculiar
(8) lack of close friends or confidants other than first-degree relatives
(9) excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self
It only takes five criteria to make a diagnosis.
Let’s compare the self definition of LGBTQUIA.
Fundamentally, a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships.
Ultimately it is most important that each individual define themselves for themselves and therefore also define a term for themselves.
“If I didn’t define myself for myself, I would be crunched into other people’s fantasies for me and eaten alive.” Audre Lorde
- ideas of reference – the false belief that irrelevant occurrences or details in the world relate directly to oneself.
- a person with low self-esteem or who is suspicious of other people might often feel that people are laughing at him or her.
- Womxn: some womxn spell the word with an “x” as a form of empowerment to move away from the “men” in the “traditional” spelling of women.
- odd beliefs that influence behavior, bizarre fantasies or preoccupations
- Bondage and Discipline, Dominance and Submission, Sadism and Masochism not always overtly sexual in nature, the activities and relationships within a BDSM context are almost always eroticized by the participants in some fashion. Many of these practices fall outside of commonly held social norms.
- Neurodiversity refers to the natural and important variations in how human minds think. These differences can include autism, attention deficit hyperactivity disorder, dyspraxia, dyslexia, dyscalculia, Tourette Syndrome, and others. Like other variable human traits like race, gender, sexuality, or culture, there is no right or wrong form of diversity. The social dynamics that exert power over other forms of diversity also impact neurodivergent people. Neurodiversity is not something to be cured or corrected to fit some social norm – rather, we should celebrate different forms of communication and self-expression and promote support systems to allow neurodivergent people to thrive. (Neurocosmopolitanism, The National Symposium on Neurodiversity)
- unusual perceptual experiences, including bodily illusions
- Having two genders in one body
- Transition is the process of taking steps to live as one’s true gender identity…may involve making changes to one’s physical appearance, such as wearing certain clothing…or more complex changes such as medically transitioning through hormones or surgery. Transitioning can also involve changing legal documents to match one’s authentic sense of self.
- odd thinking and speech (e.g., vague, circumstantial, metaphorical, overelaborate, or stereotyped)
- Identifying as transgender, or trans, means that one’s internal knowledge of gender is different from conventional or cultural expectations based on the sex that person was assigned at birth. While transgender may refer to a woman who was assigned male at birth or a man who was assigned female at birth, transgender is an umbrella term that can also descrbe someone who identifies as a gender other than woman or man, such as non binary, genderqueer, genderfluid, no gender or multipe genders, or some other gender identity.
- This glossary is provided to help give others a more thorough but not entirely comprehensive understanding of the significance of these terms. You may even consider asking someone what they mean when they use a term.
- always evolving and changing and often mean different things to different people
- suspiciousness or paranoid ideation
- Transphobia: See Cissexsim above. *As a staff, we’ve been intentionally moving away from using words like “transphobic,” “homophobic,” and “biphobic” because (1) they inaccurately describe systems of oppression as irrational fears, and (2) for some people, phobias are a very distressing part of their lived experience and co-opting this language is disrespectful to their experiences and perpetuates ableism.
- terms, such as ableism and disability, that may not be considered directly related to identities of sexuality or gender… are important to acknowledge as part of our mission to challenge all forms of oppression that affect the multiple, intersectional identities held by members of our community.
- inappropriate or constricted affect
- expressing dysphoria at society’s oppression even when accepted and adored by one’s own social group.
- behavior or appearance that is odd, eccentric, or peculiar
- groomed and dress contrary to genetics or social norms
- lack of close friends or confidants other than first-degree relatives
- This definition assumes conventional family ties. LGBT persons defined themselves by their relationships with other LGBTs, not their family of origin, but the essence of the criteria remains the same. The importance of this criteria can be seen by LGBTs demand that straight people abandon their Millenia’s long paradigm on social order.
- Cisgender: a gender identity, or performance in a gender role, that society deems to match the person’s assigned sex at birth. A term used to highlight the privilege of people who are not transgender.
- Cissexism/Genderism: The pervasive system of discrimination that oppresses people whose gender and/or gender expression falls outside of cis-normative constructs…cisgender people are the dominant group and trans/ gender non-conforming people are the oppressed group.
- excessive social anxiety that does not diminish with familiarity and tends to be associated with paranoid fears rather than negative judgments about self
- Socialization: The process by which societal norms influence a number of aspects that frame how members of a community live – including how they might think, behave, and hold certain values. Socialization can reinforce assumptions or expectations that give power to systems of oppression
Note, the very definition of LGBTQUIA is updated constantly so current definition has to be learned via an online glossary collectively built by the LGBTQUIA Resource Center since the early 2000’s: “always evolving and changing and often mean different things to different people.”
Instability in relationships is the underlying definition of DSM-defined Borderline Personality Disorder,,
and once again we find that every other criteria matches the signs – objective observations of dysfunction vs reported symptoms of distress – of LGBTQUIA.
- unstable or changing relationships
- unstable self-image, including struggles with sense of self and identity
- stress-related paranoia
- anger regulation problems, including frequent loss of temper or physical fights
- consistent and constant feelings of sadness or worthlessness
- self-injury, suicidal ideation, or suicidal behavior
- frequent mood swings
- impulsive behaviors such as unsafe sex and substance abuse
- fear of abandonment
There is absolutely no doubt about the fact that the decision to remove homosexuality from the DSM was not based on standard diagnostic criteria but made for political reasons.
Out of DSM: Depathologizing HomosexualityBehav Sci (Basel). 2015 Dec; 5(4): 565–575.Published online 2015 Dec 4. doi: 10.3390/bs5040565PMCID: PMC4695779PMID: 26690228
In 1973, the American Psychiatric Association (APA) removed the diagnosis of “homosexuality” from the second edition of its Diagnostic and Statistical Manual (DSM)…
the most significant catalyst for diagnostic change was gay activism.
Gay activist protests succeeded in getting APA’s attention and led to unprecedented educational panels at the group’s next two annual meetings…the stigma caused by the “homosexuality” diagnosis [53,54,55]…
APA’s scientific body addressing this issue also wrestled with the question of what constitutes a mental disorder…and concluded that, with the exception of homosexuality and perhaps some of the other ‘sexual deviations’, they all regularly caused subjective distress or were associated with generalized impairment in social effectiveness of functioning” , (p. 211). Having arrived at this novel definition of mental disorder, the Nomenclature Committee agreed that homosexuality per se was not one…As a result, in December 1973, APA’s Board of Trustees (BOT) voted to remove homosexuality from the DSM.
Psychiatrists from the psychoanalytic community, however, objected to the decision. They petitioned APA to hold a referendum asking the entire membership to vote either in support of or against the BOT decision. The decision to remove was upheld by a 58% majority of 10,000 voting members.
It should be noted that psychiatrists did not vote, as is often reported in the popular press, on whether homosexuality should remain a diagnosis. What APA members voted on was to either “favor” or “oppose” the APA Board of Trustees…process they had set up to make the determination , (p. 148). Further, opponents of the 1973 removal have repeatedly tried to discredit the referendum’s outcome by declaring, “science cannot be decided by a vote” …
[So] the DSM-II contained a new diagnosis: Sexual Orientation Disturbance (SOD). SOD regarded homosexuality as an illness if an individual with same-sex attractions found them distressing and wanted to change [56,57]…
SOD was later replaced in DSM-III  by a new category called “Ego Dystonic Homosexuality” (EDH) . However, it was obvious to psychiatrists more than a decade later that the inclusion first of SOD, and later EDH, was the result of earlier political compromises and that neither diagnosis met the definition of a disorder in the new nosology. Otherwise, all kinds of identity disturbances could be considered psychiatric disorders. “Should people of color unhappy about their race be considered mentally ill?” critics asked. What about short people unhappy about their height? Why not ego-dystonic masturbation ? As a result, ego-dystonic homosexuality was removed from the next revision, DSM-III-R, in 1987 . In so doing, the APA implicitly accepted a normal variant view of homosexuality in a way that had not been possible fourteen years earlier…
Similar shifts gradually took place in the international mental health community as well. In 1990, the World Health Organization removed homosexuality per se from the International Classification of Diseases (ICD-10) …
As a result, cultural attitudes about homosexuality changed in the US and other countries as those who accepted scientific authority on such matters gradually came to accept the normalizing view. For if homosexuality was no longer considered an illness, and if one did not literally accept biblical prohibitions against it, and if gay people are able and prepared to function as productive citizens, then what is wrong with being gay? Additionally…what moral and legal principles should the larger society endorse in helping gay people openly live their lives?
The result, in many countries, eventually led, among other things, to (1) the repeal of sodomy laws that criminalized homosexuality; (2) the enactment of laws protecting the human rights of lesbian, gay, bisexual and transgender (LGBT) people in society and the workplace; (3) the ability of LGBT personnel to serve openly in the military; (4) marriage equality and civil unions in an ever growing number of countries; (5) the facilitation of gay parents’ adoption rights; (6) the easing of gay spouses’ rights of inheritance; and (7) an ever increasing number of religious denominations that would allow openly gay people to serve as clergy.
Now that’s a massive paradigm shift from
- being abhorred by society as a pathological influence
- to being accepted by social leaders as a normal variant
- be being advocated by social leaders as victims of social oppression
- to being actively promoted as the new norm by social leaders
- to attacking non LBGT institutions and members of society as the enemy to be eliminated from society.
Including parents rights in concert with their responsibilities for raising their children.
- 2000 – the revised DSM-IV (TR) included children for the first time in homosexuality with a diagnosis of Gender Identity Disorder in Children. As a disorder this was considered a illness to be treated by changing the patient’s thinking, behavior and emotions.
- 2013 – the DSM-5 removed the GIDC diagnosis and replaced it with Gender Dysphoria. The difference is that dysphoria = unhappiness to be resolved by social support of the individual’s sense of self.
- “There is some controversy around the inclusion of gender dysphoria within the diagnostic manuals, as it may inadvertently pathologize gender variance through its inclusion in this manual.
- Minority stress is seen systemically through the chronic violence toward transgender and gender nonconforming individuals, high rates of homelessness, underemployment, and poor medical care for these individuals.
- the dysphoria is not the result of the individual’s gender identity itself.
And that opened the door to a flood of newly acceptable sexual variants that effectively removes these behaviors from consideration as being, a baseline, “at risk for danger to self or others.”
Most of all,
- this eliminated the individual’s responsibility to change his/her behavior
- through individualized treatment
- for the individual’s restoration of emotional, cognitive, physical and social health and well-being,
- and made them victims of society’s antagonism towards these behaviors.
If we are objective on this issue, we see that a massive social paradigm shift on sexuality has come about by accepting a minority social activists group’s self-benefiting demands after a couple of decades while rejecting millennia’s-long social leaders’ prohibitions with the interests of larger society in mind.
If we consider this situation objectively, we can see how LGBT advocates, having achieved political change from the extreme of suppressing to moderate acceptance have rather inexplicably accelerated to the polar extreme of imposing.
On what basis do we trust that this new sexual paradigm will result in a positive outcome for our children’s, and our society’s, future? Remember, there is only an association between severe depression and social disapproved of certain socio-sexual behaviors.
What if it is these behaviors that cause not only individual depression, but an avalanche effect wiping out families and society, and it is ancient knowledge of well established principles underlying the millennia’s-long prohibition of these behaviors within a culture?