I wanted to write you to give some feedback on your article published in today’s 24 newspaper here in Vancouver.
I am a transgender person living with mental health challenges and it always excites me to see the mainstream public advancing their knowledge about both mental health and transgender issues. Seeing your article in this morning’s paper gave me hope of this being a very “mainstream” outlet from which to continue to advance these conversations. I was however upset to read your article and see how much it continued to muddle issues around gender identity and presentation with that of sexual orientation and mental health. Many trans people are queer, or read as such, but not all are, and discrimination based on gender presentation may be linked to the perception of someone’s orientation, it is actually something else altogether, most commonly referred to as transphobia. (http://en.wikipedia.org/wiki/Transphobia) . Please allow me to make a few points of critique to your article. I am excited that you have such a broad based audience to engage in education and dialogue around mental health, I’d like to provide this feedback to further this dialogue.
Last week, a ladyboy was my waitress as I dined in the small city of Pattani, also a few days later at a Burger King in the seaside town of Hua Hin. Last month, fledgling Thai airline PC Air hired six transsexuals as flight attendants, all of which will be given special uniforms that identify them as the “third sex.”
Understanding that biological “sex” can be determined by genitals, hormones or chromosomal make-up and that gender is the correct term that refers to someone’s presentation or identity. This can be most simply broken down by understanding that sex is what’s between the legs, gender is what’s between the ears. For some folks that is the same (cis-gendered or non-trans people) and for others it is not (trans as umbrella, or transgender meaning that the gender is different than the sex assigned at birth) while for others that is something that they wish medical intervention with (transsexual- using surgery, hormones, electrolysis etc to change the sex characteristics of a persons body). It is also important to note that within Thai culture, according to my understanding and echoed by your statements here, “lady-boys” are not accepted into society as the gender they feel or present, but are given the option of “other”. This is great for some people, myself included, who do feel other from the options of male or female, but in the larger context of transgender and transsexual acceptance and understanding it’s important to note that some trans people do not want to exist merely as “other”, but would like to be accepted as the gender that they feel and present and respected within that. This would mean transwomen (MTF or male to female transgender or transsexual individuals) would be hired, uniformed and treated as women. Creating a separate category, as exists within Thai “ladyboy” culture or India’s hijra class where trans people are “accepted” but still treated as “less than” is not equality or true acceptance.
In Canada, attitudes are slowly changing, but unfortunately homophobia is still rampant. Last year, a teacher at a Catholic high school for girls in Vancouver was told to work from home after parents complained about having a lesbian teach their kids, and sadly a year hardly goes by with out some rednecks “gay bashing” an unfortunate gentleman in the West End. Yet, we are far away from accepting “ladyboys” in our workforce.
These are examples of violence and discrimination on the basis of sexual orientation, not gender identity or presentation. There is no shortage of examples that can actually refer to what you seem to be attempting to communicate here, transphobic violence or discrimination. One place to find such reports is here: http://www.transgenderdor.org/ the online home of the Transgender Day of Remembrance, a day set aside to acknowledge and remember the violence perpetrated against members of trans communities. Also relevant to this would be information about the bill C-389 which recently died on its way through government due to the call of election, this was a private members bill sponsored by Burnaby MP Bill Siksay which would add gender identity and gender expression to list of discriminations protected under the Human Rights Act.
The Diagnostic and Statistical Manual of Mental Disorders is the authoritative source doctors use to classify mental illnesses. Presently, the field of psychiatric medicine is using the fourth version, DSM-IV. But as cultural attitudes continue to change and psychiatric knowledge continues to grow, there will undoubtedly be a fifth edition and then later a sixth.
A person can freely express himself in one culture and be mentally healthy, and yet in another time and place they would be deemed disturbed. In Canada, people who don’t fit into the dominant heterosexual orientation mold, the stress of either hiding or expressing their sexual orientation can be very severe. To be mentally healthy, a person needs to feel like they belong.
It’s important to remember that although homosexuality was removed from the DSM-II in 1973, gender identity disorder remains on the DSM-IV, which means that people whose gender identity doesn’t match their body must access mental health services and be diagnosed with a mental health condition (GID) to access hormones, surgery and other physical remedies to this physical health and societal condition, which for some reason remains a classifiable mental illness. We can hope that GID will be removed from DSM-V, but the debate remains amongst cisgendered health care professionals about how best to treat conditions of gender diversity in the medical system. Being a “mentally well” trans person is greatly dependant on societal attitudes, matters of acceptance and freedom from fear of discrimination and violence; but as the matter stands, any trans person who wishes to access medical assistance or intervention must be diagnosed as mentally ill according to the DSM-IV.
Isn't it interesting to think of the prevalence and variations of mental illness diagnoses within the context of cultural differences? Let us not forget that a cultural shift in attitude can bring about positive changes in mental health.
You do pose a good question in asking the public how a reframing of mental illness according to how cultural understandings of “normalcy” shift. I think that this cultural shift is dependent on a clear understanding of the issues at hand, including the distinction of sex and gender, the differences between transphobia and homophobia and the ways that the mental health systems holds the reins on transition services for people outside the gender binary. Thank you for bringing discussion of mental health into such a mainstream publication, hopefully this dialogue and discourse can continue to develop a better understanding of mental health issues. This development of understanding and public dialogue is needed to end the stigma surrounding mental health; I look forward to where you may take it next.