Wednesday, May 21, 2008

A message to the linguistically challenged

I usually don't talk about my professional background. However, at times, when others who have degrees want to give advice, it is important that we who are intersex and/or trans, also speak with professional clarity and expect the same professional respect that non-trans/non-intersex professionals give to their peers. This is something that many of us have faced and those who are not intersex and/or trans often have no idea how they come across and they often have no idea how we often are devalued and deemed unworthy of any professional respect despite our own degrees and accomplishments. This is offensive and needs to stop.

I am a linguist with a degree in linguistics from the Université de Monptellier, France. As a linguist, I am concerned that Marshall Forstein, M.D., of Harvard Medical School pointed out in his e-mail that, contrary to claims made in petitions and frantic emails, "sexual orientation is NOT even an issue for the DSM committee to consider." What about the words "homosexuality" or "sexual orientation" does Dr. Forstein not understand? The people named to the board in question (Blanchard and Zucker) have used the word "homosexuality" repeatedly in referring to transsexuality. They are going to have input into the definitions concerning GID. Has Dr. Forstein taken the time to read what Blanchard and Zucker have written about homosexuality as part of the differential diagnosis for "GID"? If one reads their articles, it is plausible to conclude that Blanchard and Zucker would most likely try to introduce homosexuality into the DSM as part of the taxonomy for transsexuality because it is not based on GENDER at all, it is based on SEXUAL ORIENTATION.

This is what is disturbing to many people who read the rants of uninformed experts such as Dreger and it makes many of us very wary of their ability to discuss this topic with intelligence in order to make informed decisions considering the matter at hand: Zucker and Blanchard having control of the definitions of gender variance in the DSM, since they are on record as not really accepting gender as a valid construct for defining transsexuality.

Quotes from Blanchard:

"In my terminology, which follows the individual's chromosomal sex, these groups are homosexual and heterosexual transsexuals, respectively." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav

DOI 10.1007/s10508-008-9328-y)

We have the rudimentary terms used in this proposed taxonomy in the short sentence above: "chromosomal sex", "homosexual", and "heterosexual".

"There are two distinct types of cross-gender identity. The feminine gender identity that develops in homosexual males is different from the feminine gender identity that develops in heterosexual males. In other words, homosexual and heterosexual men cannot ''catch'' the same gender identity disorder in the way that homosexual and heterosexual men can both ''catch'' the identical strain of influenza virus. Each class of men is susceptible to its own type of gender identity disorder and only its own type of gender identity disorder." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav DOI 10.1007/s10508-008-9328-y)

"Homosexual and heterosexual men"? Very revealing use of the term "men" here. So there we see how Blanchard is referring to M to F transsexuals. In this case, he is referring to them as "men" and he uses the word "men" several times in that short paragraph.

If we read further in this same article, it is clear why Blanchard would refer to M to F transsexuals as "men":

"I have not seen any new research studies that present compelling evidence for a third, distinct type of male-to-female transsexualism. It is quite difficult, however, to achieve complete certainty in taxonomic work. I made this point in a lecture on the parallels between gender identity disorder (GID) and body integrity identity disorder (BIID), a condition characterized by the feeling that one's proper phenotype is that of an amputee, together with the desire for surgery to achieve this. Most, but not all, persons with BIID report some history of erotic arousal in association with thoughts of being an amputee (apotemnophilia). ." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav DOI 10.1007/s10508-008-9328-y)

What are the parallels between GID and BIID? As a linguist reading this rather short article, the semantic field that Blanchard has ascribed to the term GID is very problematic because he is using the term GID in a way which is inconsistent with the DSM itself.

The current edition of the Diagnostic and Statistical Manual of Mental Disorders has five criteria that must be met before a diagnosis of gender identity disorder (302.85) can be given:[2]
1. There must be evidence of a strong and persistent cross-gender identification.
2. This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
3. There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex.
4. The individual must not have a concurrent physical intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia).
5. There must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning.

There is no mention of sexual orientation as a factor for diagnosing GID.
There is no mention of body image problems and desire for castration, etc. That is covered in another part of the manual: GIDNOS.
The emphasis is on IDENTIFICATION and inappropriateness of GENDER ROLE. Blanchard is not talking about GID at all as it is currently defined in the DSM. He is talking about something unrelated to this diagnosis.

He is talking about homosexuality, sexual paraphilias, body integrity issues and that is clear if one takes the time to read his work. I would not say that his findings are all wrong. I would simply point out that he is not talking about GID and that is clear from all discursive analyses I have made of his texts.

So, I would hope that professionals in the field of psychiatry would take the time to examine how Blanchard is using language, how he is using the terms which would have a great impact on future revisions of the DSM.

Now, who is the one talking about homosexuality? Blanchard himself. And he calls the people he is talking about HOMOSEXUAL MEN.
As a linguist, I am not going to take Dr. Forstein's advice because it is based on ignorance. Dr. Forstein and Dreger would be better advised to scrutinize Blanchard's use of language and terms before giving advice to those of us in the intersex/trans community about speaking about "sexual orientation" and homosexuality.

Curtis E. Hinkle
Founder, OII