The essay Undiagnosing Gender appeared in a compilation of Butler’s work titled Undoing Gender, which examined the regulation of gender and sexuality by psychology, aesthetics and society, and the impact it has on transgender individuals
Undiagnosing Gender looks at the opposing views regarding the psychiatric and medical diagnosis of Gender Identity Disorder (GID), and how it pathologizes transsexuality
The term GID was created when transexualism was added to DSM-III in 1980
In each proceeding editions of DSM, the definitions related to transexualism and GID have been changed, illustrating the uncertainty that surrounds the diagnosis
E.g. In the most recent edition DSM-IV-TR (2000) transexualism has been replaced by the term “ Gender Identity Disorder in Adolescents and Adults,” while GID now falls into its own subcategory of Sexual Disorders
The diagnosis is now divided into 3 sub-categories: “ Gender Identity Disorder in Children ,” " Gender Identity Disorder in Adolescents or Adults ,” and " Gender Identity Disorder Not Otherwise Specified ”
Certain characteristics that DSM-IV associate with identifying GID are disconnected from both the diagnosis and psychiatry
E.g. DSM-IV claims that you can identify a girl experiencing cross-gender identification if she “prefers boys clothes, short hair, has mainly boy friends, expresses the desire to be a boy, and they are often misidentified by strangers as boys .” The initial behaviors and characteristics mentioned relate to cross-gender id. However a strangers perception of a child has no relevancy to this context, and in no way confirms cross-gender id.
While the intention of GID is to establish the criteria by which a transgender individual can be identified, through articulating the specifics of the diagnosis itself, the diagnosis creates another rigid version of gender norms
A butch lesbian who required a single mastectomy consulted her doctor about having both breasts removed to avoid the cancer’s reoccurrence. However, due to her appearance and sexuality her insurance company felt that the second mastectomy was an “elective” surgery and that paying for it would “set a precedent for covering elective transsexual surgery.”
Although she did not identify as transgender, the woman faced having to submit herself to psychological evaluation as being diagnosed with GID was the only way she would qualify for a double mastectomy covered by her insurance
= Demeaning her autonomy and right to self-determination
Could strengthen the diagnosis as a tool of self-expression and self-determination
Runs the risk of having unintended consequences e.g. those who are diagnosed may not be – or want to be – transgender
Jacob Hale recommends GID should be separated from psychiatry and psychology and aligned with the relationship between medical professional and patient
Psychological evaluation is not required for other reconstructive surgeries
Eliminating the requirement for a mental health evaluation would reinstate individuals’ rights of entitlement
As it is considered a mental health diagnosis there is a likelihood that medical professionals would still base decisions off the existing definitions
Removing it from psychology could discrediting or eliminate it altogether
Conclusion: Final Interpretation of Undiagnosing Gender
Butler clearly and successfully illustrates the value of both sides of the GID diagnosis debate:
On the other hand, transgender is not a disorder and the pathologizing affect that GID has only contradicts this fact. In addition there is the importance of self-determination, and the reality that gender identification should be chosen at will not dictated by society’s need for psychiatric and medical explanations like GID.
One the one hand, we should not underestimate the benefits that GID offers transgender individuals. Neither should we outlook the role that it plays in binding the norm that governs the way in which society perceives and accepts transgender.
The key point that Butler illustrates in the conclusion is that there is evidence the DSM and its definitions of GID and gender dysphoria: pathologizes transgender; empower insurance companies; influence societal perceptions; and restrict self-determination. However the reality is that until the empowered insurance companies adapt to offer fair and effective means for transgender individuals to access necessary procedures, GID will remain contrastingly vital and detrimental to the transgender community.