The transgender relevant terms used by the DSM-5-TR, the revised version of the American psychiatric manual

The DSM-5 is published by the Americal Psychiatric Association and includes all kinds of diagnoses relevant to mental health. 

Being transgender is no longer considered a mental illness, but the manual does contain a chapter of gender dysphoria, which is a possible effect of gender incongruence (a mismatch between someone's assigned gender and their experienced gender.) 

The manual also have an interesting introductory chapter, which presents the gender relevant language of American psychiatry right now.

I am taking the liberty of republishing the revised 2022 introduction to the chapter on gender dysphoria here, as it can serve as useful reminder in a time where all kinds of transphobic activists claim that "science" is on their side.

I have reformatted the text to increase legibility. The headlines are mine.

Note that I do not necessarily agree with the use of all of these terms ("disorders of sex development" should have been binned in the same way as "gender identity disorder"), but all in all I think the APA has managed to develop a terminology that encompasses gender variance in both a scientific and socially respectful manner.

Note also that:

• The term “desired gender” is now “experienced gender." 
• The term “cross-sex medical procedure” is now “gender-affirming medical procedure." 
• The term “natal male”/“natal female” is now “individual assigned male/female at birth.”

Finally: The American Psychiatric Association should publish the whole volume for free online, in the spirit of open science and open access. Asking for 170 US$ for a text that has so many ramifications for so many people represents a serious democratic problem.

Here's the introduction to the DSM-5-TR chapter on gender dysphoria.

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Gender dysphoria

In this chapter, there is one overarching diagnosis of gender dysphoria, with separate developmentally appropriate criteria sets for children and for adolescents and adults. 

Biological sex

The area of sex and gender is highly controversial and has led to a proliferation of terms whose meanings vary over time and within and between disciplines. An additional source of confusion is that in English “sex” connotes both male/female and sexuality.

The word "paraphilia" does indeed mean "sexual perversion". Don't let the transphobes whitewash their transphobia.

In some of the online "autogynephilia" debates I come across Blanchard-supporters who tell me that "paraphilia" is a benign term that simply means "unusual". The implicit message is that calling a trans woman "paraphilic" cannot be stigmatizing, as it is an innocent descriptive term. They are wrong.

For those who are unfamiliar with these terms: "autogynephilia" is a term made up by Ray Blanchard, a transphobilc psychologist, who have spent much of his time helping anti-trans activists, arguing that trans women who are attracted to women are suffering from a "paraphilia".

Many of his supporters, some of whom are trans folks who have internalized the transphobia of their society, try desperately to picture him in a more positive view, to the point where they even try to turn into a friend of trans people.

He is not, as I have documented in the article Science and Transphobia: Ray Blanchard is Now Assisting White Supremacists. Why?

Blanchard has never presented "autogynephilia" as anything else but a sexual perversion. And given that his "autogynephilia" is a "paraphilia", his message is, and has always been that gynephilic and bisexual trans women are sexual perverts. It cannot get much more stigmatizing than that.

Here's what he said in an interview with the conservative site National Review:

Kearns: I’m really interested in your work on “paraphilia.” What is the difference between “paraphilia” and, say, a “disorder” or an even older term perhaps, a “perversion”?

Blanchard: Yeah sure, “perversion” was an older label for what’s now called paraphilia. Correct.

Kearns: And is the only difference a linguistic one where the morally loaded connotations of the word are removed? Or is there a substantive difference?

Blanchard: I don’t think there is any substantive difference. I mean the word “pervert” had become part of the lay vocabulary and was routinely used as an insult or as a derogatory comment whether seriously or in jest. Everybody knew the word pervert, had a vague idea of what it meant, and knew that it was something bad. So, the word paraphilia was substituted because it had a nice medical sound to it, and it had not and still has not entered the popular vocabulary as an insult.

The DSM-5 and ICD-11 on Transgender, Gender Dysphoria and Transsexualism

The fact that the DSM-5 text on transgender and transsexual is not available online has become a democratic problem. Transsexual separatist are now misrepresenting the chapter on gender dysphoria for political purposes. I have therefore decided to make parts of the text available to my readers.

In a recent debate on tumblr the DSM-5 chapter on gender dysphoria has been used in support of a new myth created by so-called "truscum" transsexual separatists.

DSM-5

The myth says that the word "transgender" refers to people with gender dysphoria only, and that other gender variant people who use the term transgender are offending "true" transgender men and women.

It seems the main motive for this attempted hijacking of the term is that many of them find the word "transsexual" embarrassing.  I also suspect that many of them would rather not be seen in company with crossdressers, drag queens and other gender-nonconforming people, and that this is another reason for this cleansing of the transgender concept.

I have seen many instances of truscum claiming that the American psychiatric manual, the DSM-5, requires gender dysphoria for a transgender diagnosis. Basically these online activists are trying to mobilize the medical establishment in their support.

The DSM distinguishes between transgender and transsexual

The problem is that none of them have actually read the DSM-5. If they had they would have known that the DSM does not require gender dysphoria for someone to call themselves transgender. Indeed, the word the DSM uses to describe the class of trans people the truscum want to protect is "transsexual".