Monetizing Madness

Incremental change means you have to stop sometimes and step back to appreciate just how insane things are. Ironically the one place you don't want to look is in the psychiatric profession.

The American Psychiatric Association's DSM still effectively lists transsexualism as a mental disorder--only now it's "transgenderism" and it's classified as "dysphoria". The distinction is politically motivated and narrative-crucial: as far as I can tell, if you have a disorder you're ill, nuts in old-speak, if you have dysphoria you're just unhappy. In fact, you're unhappy because society is ill, with its traditional gender roles. That's implied in the DSM and shouted through the Megaphone.

But there remains a contradiction here for an opposition to exploit, should one develop.

Nantional Review interviewed a Canadian academic and trans heretic who worked on the DSM and was temporarily booted from Twitter for giving a clinically correct, politically incorrect opinion

Madeleine Kearns: You believe transsexualism and gender dysphoria to be a mental disorder. Am I correct in saying that’s how it appears in the DSM-5 [the current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, which is the bible of psychiatry]?

Ray Blanchard: Yes. The diagnostic entity is called gender dysphoria in DSM-5. It was first introduced in DSM-III under the name transsexualism, and it was still called transsexualism or gender-identity disorder, I forget which, in DSM-IV, but in DSM-5 the name of the entity got changed to gender dysphoria. But the diagnostic criteria are fairly similar.

Kearns: Why was there a name change then? Was that to avoid the word “disorder”?

Blanchard: Yes, it was primarily to make patients and also trans activists and transsexual-activist groups feel happy or that they had been listened to, but I would say that the name change probably owed more to — or owed as much to politics as it did to any change in the science.

There's more than keeping trannies happy here. As if pacifying the emotions of our growing class of drama queens on hormones isn't one impossible task too many already. The APA's adjustment means trans folk can have their cake and eat it too--specifically they can have their normal status and insurance coverage too

Kearns: Is it anything do with the fact that, obviously for insurance and medical providers, there would need to be a medical problem in order for it to justify treatment?

Blanchard: Absolutely. There has to be a diagnosis in order for third-party payment. Whether we are talking public or private insurance, there has to be a diagnosis of some disorder to pay for sex-reassignment surgeries or for people who have drug plans in order to pay for testosterone injections or estrogenic medications for biological males. So this is something that for the trans activists is a stumbling block. If there isn’t a disorder of some sort, then all individuals who wanted to have sex-reassignment surgery or exogenous hormones would be paying the whole cost themselves. 

Kearns: It seems to me that many activists hold two contradictory positions simultaneously. One is that transgenderism is not a mental disorder and the other is that gender dysphoria is a mental disorder. How does one make sense of that? 

Blanchard: I think it’s this kind of Talmudic reading of the DSM. It’s like, well, gender dysphoria is a mental disorder because that’s now listed in the DSM. But transsexualism isn’t a mental disorder because that’s no longer a word used in the DSM. It’s just this kind of weird, naïve outsiders’ literalist interpretation of how the DSM is written.

The battle next be over the extent to which we will be compelled to pay for the transsexual revolution. If we foot the bill we not only pay to perpetuate the problem we probably increase the ranks of the transsexual, already trending upward, encouraged by political propaganda romanticizing the individual transsexual as heroic and, of course, good old American commerce joining in.

If we could force everyone who wants such as gender reassignment surgery to pay for it, we'd probably get a lot less of it. If we can be forced to pay for it, we'll get a lot more of it. Disturbingly, a lot of people stand to profit from this market.