Zucker's GID therapy - DSM implications and deflections
by Prof. M. Italiano, OII advisor on Variations of Sex Development
Here we find an odd article by Zucker and Spitzer. It should be noted, that the great majority of those presenting with extreme boyhood femininity in childhood do NOT grow up to be transsexual. This has been noted by Richard Green, Collette Chiland and suggested earlier by Ethel Person & Lionel Ovesey, Irving Bieber, Charles Socarides and Susan Coates. In the great majority of cases, these children when not treated, still do not become transsexual, but instead become gay. Thus, Zucker's therapy is not preventing transsexuality based upon their clinical presentation, since most of these types of boys would not develop into transsexuals, but are instead prototypical pre-homosexuals. If Zucker is not averting adult transsexualism as an outcome in the vast majority of these boys, since they are not pre-transsexual boys, but instead are pre-homosexual boys, what is Zucker's therapy doing? If these boys still become gay without therapy, can we also state that they would be gay even with Zucker's therapy? Again, what is Zucker actually achieving here, and where are the data which support his claims of the effectiveness of his therapy? If the great majority of boys who get diagnosed as having gender identity disorder of childhood and adolescence are pre-homosexual, then stating as do Zucker and Spitzer, that the clinical researchers had merit, in placing this diagnosis in the 1980 edition of the DSM (DSM III), is a "sin of omission". Why haven't subsequent "experts" included a disclaimer, in recent DSM editions, which states that this disorder is a misnomer, as gender identity is likely not what is affected?
Even though gender identity of disorder of childhood and adolescence usually does not become (with or without therapy) adult GID, is it left in there, as a mis-appropriated smokescreen, to pathologize transsexuals and transsexualism? After all, since most children diagnosed as having a GID of childhood are pre-homosexual, when they grow up to be adults, they will be "cured", since homosexuality has been long out of the DSM (since 1973). Thus, gay men who had a GID of childhood (labelling them as mentally disordered) will not have a mental disorder when they reach adulthood. But transsexuals have no such option, as they will receive a GID of adulthood diagnosis. So, the question is not so much if it is a "back door" maneuver for childhood GID to be in the DSM as a "substitute for adult homosexuality" (because when these boys grow up, they will be out of there anyways).
But, again, the question should be, is GID of childhood, which usually consists of "pre-homosexual men", actually remaining there, to misuse/diagnose gender identity (despite that some like Bailey claim not to know what it is in his "Queen"), as a smokescreen to pathologize adult transsexuals who DO fit the adult GID category and thus who DO get pathologically labelled well into adulthood? Perhaps, the pre-homosexuals making up the majority of those in the category of GID of childhood can't be claimed to have a sexual ORIENTATION disorder of childhood, since sexual orientation (homosexuality) has been taken out. But this problem, which is criticized as the "backdoor approach" to re-introducing homosexuality into the DSM as a pathology, is only secondary, to the "coincidence", that transsexuals (those whose gender identity IS affected) are the ones targeted as pathological, and that pre-homosexuals (whose gender identity is not affected, but get a GID of childhood), set up the smokescreen as a 'deflection". If feminine pre-homosexual boys, who don't have a female gender identity, nonetheless behave in a feminine type way, why not call this gender ROLE disorder of childhood?
The literature is becoming packed with cases where gender role, but not gender identity, is supposedly affected. This is commonly applied to intersexed persons, who express dissatisfaction with their gender assignment. If it is claimed as for intersexed children with gender dysphoria who reject their assignment, they are "spared" from being diagnosed with GID of childhood/adolescence, or adult GID. They receive a diagnosis of GIDNOS-gender identity disorder not otherwise specified. But here again, they do not say these people have a gender ROLE disorder not otherwise specified, but a gender IDENTITY disorder not otherwise specified. Thus it suits these clinicians to pathologize their gender identity over and over again, by using the term gender IDENTITY instead of gender ROLE, when it suits their purpose, as persons like Zucker, try devising scales which supposedly "discriminate" gender identity for gender role. One can ask if the purpose of this, is diminish the voices of intersexed individuals and augment that of "professionals" treating them. But, still, for intersexed persons who end up being diagnosed as having GIDNOS, the problem here, is that they are in a category with those who are "preoccupied" with castration or penectomy and with those who transiently cross-dress due to stress.
Curtis Hinkle's response to Bailey's article on Warren Throckmorton's blog with several quotes from Bailey's own "Queen" book
Bailey wrote:
“This is an utterly false characterization of Zucker’s position. He has no desire, stated or otherwise, to prevent homosexuality. Experience and logic suggest that when people have reasonable and sound positions, they do not need to mischaracterize the positions of others they disagree with.”
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I don’t really think that the issue is explained by Zucker as a means to prevent homosexuality but to prevent transsexuality but there is no proof that feminine boys will be transsexuals at any significant rate, so it would appear that what is being treated in fact is pre-homosexuality in childhood and to no effect because most still grow up to be homosexual men. There is no proof that transsexuality was prevented by the treatment because there are no studies which prove that feminines boys grow up to be transsexuals at any rate that is statistically significant. There are also many masculine boys that grow up to be transsexuals.
So technically, Zucker can state that it is not homosexuality per se that is being “treated” but since most of these boys grow up to be homosexual men, all they have proved is that they have done nothing except try to enforce gender role conformity which has no statistical link to transsexuality that is significantly higher than homosexuality (actually there is a much higher link with homosexuality). So why call it gender identity disorder in childhood?
Some quotes from the Bailey’s “Queen” book:
“I do not ask Edwin about his childhood because I do not need to. I already know that Edwin played with dolls and loathed football, that his best friends were girls. I know that he was often teased by other boys, who called him “sissy”". (Page x in book) (See also page xi, where Bailey describes whom he knows Edwin would like to have sex with, being the feminine adult man, with which Bailey describes Edwin as being.)
“Zucker thinks that an important goal of treatment is to help the children accept their birth sex and to avoid becoming transsexual. His experience has convinced him that if a boy with GID becomes an adolescent with GID, the chances that he will become an adult with GID and seek a sex change are much higher. And he thinks the kind of therapy he practices helps reduce this risk” (Page 30 in book)
“….Zucker believes that most boys who play with girls’ things often enough to earn a diagnosis of GID would become girls if they could. Failure to intervene increases the chances of transsexualism in adulthood, which Zucker considers a bad outcome.” (Page 31 in book)
“Still most boys who want to be girls become men who don’t want to be women.” (Page 32 in book)
“…Zucker’s therapy seems kinder and more consistent, and thus more likely to be effective. Zucker believes that it is, although he is the first to ackowledge that no scientific studies currently support the effectiveness of what he does.” (Page 34 in book).
Controlling the definitions. Controlling the right to be.
by Curtis E. Hinkle
17 May 2008
Summary: Zucker, Blanchard and Cohen-Kettenis, influential members of this committee, will control the definitions, i.e. diagnoses. GID could be redefined as a SEX disorder which could make it problematic for therpaists to recommend any reassignment treatments for individuals under their care.
This essay is available at: http://www.intersexualite.org/Controlling.html
Language and Identity
This essay is available at: http://www.intersexualite.org/Language.html
Curtis Hinkle's response (Click here) to Bailey's article on Warren Throckmorton's blog with several quotes from Bailey's own "Queen" book
CALL TO ACTION FROM KRISTEN WORLEY: CLICK HERE
