Classification of transsexual people
   HOME

TheInfoList



OR:

The classification of
transsexual Transsexual people experience a gender identity that is inconsistent with their assigned sex, and desire to permanently transition to the sex or gender with which they identify, usually seeking medical assistance (including sex reassignmen ...
and
gender non-conforming Gender variance or gender nonconformity is behavior or gender expression by an individual that does not match masculine or feminine gender norms. A gender-nonconforming person may be variant in their gender identity, being transgender or non-bi ...
people into distinct groups has been attempted since the mid-1960s.


History

During the 20th century, the Western medical community endorsed a binary concept of gender in which males and females were seen as naturally distinct in terms of
gender expression Gender expression, or gender presentation, is a person's behavior, mannerisms, interests, and appearance that are associated with gender, specifically with the categories of femininity or masculinity. This also includes gender roles. These cate ...
. During this time, people who were assigned male at birth (AMAB) and expressed
gender nonconformity Gender variance or gender nonconformity is behavior or gender expression by an individual that does not match masculine or feminine gender norms. A gender-nonconforming person may be variant in their gender identity, being transgender or non-bina ...
were often classified into one of two subgroups. One group comprised males expressing feminine traits from early childhood, along with attraction to men and the desire to become a woman; this group has been referred to as ''classical'', ''type 1'', or '' homosexual transexuals''. The second group comprised males who often did not have strong cross-gendered childhoods, were often sexually attracted to women, and sought sex reassignment later in life; this group has been referred to as ''non-classical'' or ''heterosexual transexuals'', and often described as ''
transvestite Transvestism is the practice of dressing in a manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional, or ceremonial reasons. The term is considered outdated in Western ...
s''. More recently, the these two subgroups have been referred to as ''androphilic'' and ''gynephilic'', respectively. Other classifications are used relative to one's
gender identity Gender identity is the personal sense of one's own gender. Gender identity can correlate with a person's assigned sex or can differ from it. In most individuals, the various biological determinants of sex are congruent, and consistent with the ...
rather than assigned sex. The United States has seen increasing social trends since the early 21st century that allow for less rigid expression of one's own gender identity, and gender-nonconforming people may express a range of masculine and feminine traits. The term ''
transgender A transgender (often abbreviated as trans) person is someone whose gender identity or gender expression does not correspond with their sex assigned at birth. Many transgender people experience dysphoria, which they seek to alleviate through ...
'' has become more common in part to reflect such diversity of gender expression.


Sex Orientation Scale (1966)

Harry Benjamin Harry Benjamin (January 12, 1885 – August 24, 1986) was a German-American endocrinologist and sexologist, widely known for his clinical work with transgender people. Early life and career Benjamin was born in Berlin, and raised in a German ...
created the
Sex Orientation Scale The Sex Orientation Scale (SOS) was Harry Benjamin's attempt to classify and understand various forms and subtypes of transvestism and transsexualism in biological males, published in 1966.Benjamin, Harry (1966). ''The Transsexual Phenomenon.'' The ...
(SOS) to classify and understand various forms and subtypes of
transvestism Transvestism is the practice of dressing in a manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional, or ceremonial reasons. The term is considered outdated in Western ...
and
transsexualism Transsexual people experience a gender identity that is inconsistent with their assigned sex, and desire to permanently transition to the sex or gender with which they identify, usually seeking medical assistance (including sex reassignmen ...
in biological males.Benjamin, H. (1966). ''The Transsexual Phenomenon.'' New York: The Julian Press, page 22. It was a seven-point scale with three types of transvestism, three types of transsexualism, and one category for typical males. Benjamin's scale references and uses the Kinsey scale in distinguishing between "true transsexualism" and "transvestism". Benjamin noted, "It must be emphasized again that the remaining six types are not and never can be sharply separated." Benjamin added a caveat: "It has been the intention here to point out the possibility of several conceptions and classifications of the transvestitic and the transsexual phenomenon. Future studies and observations may decide which one is likely to come closest to the truth and in this way a possible understanding of the etiology may be gained."


''Diagnostic and Statistical Manual'' (1980)


DSM-III

''Transsexualism'' was included for the first time in the
DSM-III The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...
in 1980. "Gender Identity Disorder" was a term created in the DSM-III in regard to transsexuals, and the categories were "GID/Children Transsexualism"; "GID/Adolescent and Adult, Non-transsexual type" and "GID/Not Otherwise Specified". Interestingly, in the major revision of the DSM,
DSM-III-R The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
, they were placed in the category "Disorders Usually First Evident in Infancy, Childhood or Adolescence". The problem was that it got lost here, as well as the issue of adult onset explained above. In the DSM-III, the terms "Homosexual", "Heterosexual", and "Asexual" were used - with quite a bit of confusion.Pauly, I. B. (1993). Terminology and classification of gender identity disorders. ''Journal of Psychology & Human Sexuality, 5,'' 1-12. (These terms were replaced in the DSM-IV by "Attracted to males", "Attracted to Females", "Attracted to Both" and "Attracted to neither.")


DSM-III-R

The DSM-III-R, published in 1987, retained the term ''transsexualism''. It was located under "Disorders Usually First Evident in Infancy, Childhood or Adolescence".


DSM-IV and DSM-IV-TR

''Gender Identity Disorder in Adolescents and Adults'' replaced the term transsexualism. In the
DSM-IV-TR The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langua ...
, GID is placed in the category of Sexual Disorders, with the subcategory of Gender Identity Disorders. The names were changed in
DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...
to "Gender Identity Disorder in Children", "Gender Identity Disorder in Adolescents or Adults", and "Gender Identity Disorder Not Otherwise Specified". The
DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...
was published in 1994 and revised (DSMIV-TR), in a minor way, in 2000. The French translation is edited by Masson.


DSM-5

In the
DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatri ...
, gender identity disorder was replaced with gender dysphoria; the focus is no longer on identity, but on the distress that trans people may experience when their biological sexes do not line up with said identities. Persons with gender dysphoria are also no longer classified by sexuality.The
DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the '' Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatri ...
was published in 2013 in United States and in 2015 in France.


International Statistical Classification of Diseases and Related Health Problems

The '' International Statistical Classification of Diseases and Related Health Problems'' (most commonly known by the abbreviation ICD) is according to its publisher, the
United Nations The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and security, develop friendly relations among nations, achieve international cooperation, and be a centre for harmoniz ...
-sponsored
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
"the standard diagnostic tool for epidemiology, health management and clinical purposes." It is known as a health care classification system that provides codes to classify
disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...
s and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease. Under this system, every health condition can be assigned to a unique category and given a code, up to six characters long. Such categories can include a set of similar diseases. The International Classification of Diseases is published by the
World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of ...
(WHO) and used worldwide for morbidity and mortality statistics,
reimbursement Reimbursement is the act of compensating someone for an out-of-pocket expense by giving them an amount of money equal to what was spent. Companies, governments and nonprofit organizations may compensate their employees or officers for necessary ...
systems, and automated decision support in health care. This system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics. The ICD is a core classification of the
WHO Family of International Classifications A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, which are used to track diseas ...
(WHO-FIC).World Health Organization
Family of International Classifications.
Accessed July 12, 2011.
The ICD is revised periodically and is currently in its eleventh revision. Annual minor updates and
triennial An anniversary is the date on which an event took place or an institution was founded in a previous year, and may also refer to the commemoration or celebration of that event. The word was first used for Catholic feasts to commemorate saints. ...
major updates of the ICD are published by the WHO.


ICD-10

The ICD-10, as it is therefore known, was developed in 1992 to track health statistics. The ICD is part of a "family" of guides that can be used to complement each other, including also the
International Classification of Functioning, Disability and Health The International Classification of Functioning, Disability and Health (ICF) is a classification of the health components of functioning and disability. The ICF received approval from all 191 World Health Organization (WHO) member states on May 22 ...
which focuses on the domains of functioning (disability) associated with health conditions, from both medical and social perspectives. In the ICD-10, transsexualism is located within
Gender identity disorder Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identitytheir personal sense of their own genderand their sex assigned at birth. The diagnostic label gender identity disorder (GID) was used unti ...
s, F64 in ICD-10 Chapter V: Mental and behavioural disorders under the heading "Disorders of adult personality and behaviour".


ICD-11 for Mortality and Morbidity Statistics (2018)

The eleventh revision of ICD,
ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...
was published in June 2018 by WHO and was revised using
Web 2.0 Web 2.0 (also known as participative (or participatory) web and social web) refers to websites that emphasize user-generated content, ease of use, participatory culture and interoperability (i.e., compatibility with other products, systems, and ...
principles. In this new major revision, ICD-11 has abolished codes F64 Gender identity disorders and F65.1
Fetishistic Transvestism Transvestic fetishism is a psychiatric diagnosis applied to men who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for enter ...
, among other sexual practices, that used to be referred to as
paraphilia Paraphilia (previously known as sexual perversion and sexual deviation) is the experience of intense sexual arousal to atypical objects, situations, fantasies, behaviors, or individuals. It has also been defined as sexual interest in anything ot ...
s. The above codes have been replaced in part by cod
HA60 Gender incongruence of adolescence or adulthood
ref name=":0">
, which refers to the three conditions that classify the condition of gender dysphoria. The major paradigm shift is reflected in the last sentence from code HA60: "Gender variant behavior and preferences alone are not a basis for assigning the diagnosis." This has profoundly changed the way Science and Psychology views transgender people and transexuals, as it has removed the stigma related to being referred to as people who suffer from paraphilias, 132 years after
Richard von Krafft-Ebing Richard Freiherr von Krafft-Ebing (full name Richard Fridolin Joseph Freiherr Krafft von Festenberg auf Frohnberg, genannt von Ebing; 14 August 1840 – 22 December 1902) was a German psychiatrist and author of the foundational work '' Psychopath ...
first published ''Psychopathia Sexualis''.


Blanchard's transsexualism typology

Blanchard's transsexualism typology (also Blanchard autogynephilia theory (BAT) and Blanchard's taxonomy) is a psychological typology of male-to-female
transsexualism Transsexual people experience a gender identity that is inconsistent with their assigned sex, and desire to permanently transition to the sex or gender with which they identify, usually seeking medical assistance (including sex reassignmen ...
created by
Ray Blanchard Ray Milton Blanchard ( ; born October 9, 1945) is an American-Canadian sexologist, best known for his research studies on transsexualism, pedophilia and sexual orientation. He found that men with more older brothers are more likely to be gay th ...
through the 1980s and 1990s, building on the work of his colleague,
Kurt Freund Kurt Freund (17 January 1914 – 23 October 1996) was a Czech-Canadian physician and sexologist best known for developing the penile plethysmograph (a measurement of sexual arousal in males), research studies in pedophilia, and for the "courts ...
. Blanchard divides male-to-female (MtF or M2F) transsexuals into two different groups: "
homosexual transsexual ''Homosexual transsexual'' is a taxonomic category used in sexology, psychology, and psychiatry, to classify transgender or transsexual people who are attracted to members of the same biological sex. It classifies trans women attracted to men (a ...
s", who are attracted to men, and "non-homosexual transsexuals", who are "autogynephilic" (sexually aroused by the thought or image of themselves as a woman). The typology does not purport to identify the cause of transsexualism in natal males, but it has some implications for the cause—specifically, that the cause of transsexualism may not be the same for both groups. Scientific criticism of the research and theory has come from John Bancroft, Jaimie Veale, Larry Nuttbrock,
Charles Allen Moser Charles Allen Moser (born 1952) is an American physician specializing in transgender health, a clinical sexologist, sex therapist, and sex educator practicing in San Francisco, California. He is the author of numerous academic publications and b ...
, and others who argue that the theory is poorly representative of MtF transsexuals, reduces
gender identity Gender identity is the personal sense of one's own gender. Gender identity can correlate with a person's assigned sex or can differ from it. In most individuals, the various biological determinants of sex are congruent, and consistent with the ...
to a matter of attraction, is non-instructive, and that the research cited in support of the theory has inadequate control groups or is contradicted by other data. Supporters of the theory include Anne Lawrence, J. Michael Bailey,
James Cantor James M. Cantor is an American-Canadian clinical psychologist and sexologist specializing in hypersexuality and paraphilias. A former senior scientist with the Centre for Addiction and Mental Health (CAMH) in Toronto,The Man Who Would Be Queen ''The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism'' is a 2003 book by the American psychologist J. Michael Bailey, published by Joseph Henry Press.Bailey, J. Michael (2003). ''The Man Who Would Be Queen: The Science ...
'' in 2003. In 2005, Blanchard distanced himself from Bailey's affirmation of the scientific certainty of the cause, expressing that further research was needed before said certainty could be sufficiently justified. A 2016 review found support for the predictions of Blanchard's typology that androphilic and gynephilic trans women have different brain
phenotype In genetics, the phenotype () is the set of observable characteristics or traits of an organism. The term covers the organism's morphology or physical form and structure, its developmental processes, its biochemical and physiological pr ...
s. It stated that although
James Cantor James M. Cantor is an American-Canadian clinical psychologist and sexologist specializing in hypersexuality and paraphilias. A former senior scientist with the Centre for Addiction and Mental Health (CAMH) in Toronto,neuroimaging Neuroimaging is the use of quantitative (computational) techniques to study the structure and function of the central nervous system, developed as an objective way of scientifically studying the healthy human brain in a non-invasive manner. Incr ...
studies, there is "still only one study on nonhomosexual MtFs; to fully confirm the hypothesis, more independent studies on nonhomosexual MtFs are needed. A much better verification of the hypothesis could be supplied by a specifically designed study including homosexual and nonhomosexual MtFs." The review stated that "confirming Blanchard's prediction still needs a specifically designed comparison of homosexual MtF, homosexual male, and heterosexual male and female people."


References


External links

{{DEFAULTSORT:Classification Of Transsexuals Transgender studies Classification of people