Identify a past or current controversial DSM diagnosis, and discuss the reasons why it is controversial
Being a transsexual means having a desire of living as an opposite sex person. Transsexualism, also known as identity disorder (DIG), gender dysphoria or transgender, is the most common form of extreme of sexual identity disorder. It is characterized by a disagreement between an individual's anatomical sex and identity of gender. (Cohen-Kettenis & Gooren, 1999)
A person's gender identity describes how they publicly expressed in clothing, in the use of cosmetics, in appearance, body language and behavior. Normally, gender identity and anatomical sex are in agreement. However, in transsexuals there is an important disagreement between sex anatomical and gender identity, and persistent discomfort with genital sex, usually since childhood. The feeling of having inappropriate sex leads to an intense desire of living & being accepted as an opposite sex member through hormone treatment and surgical methods.
The first controversary related to transsexual was made in the medical literature in Hirschfeld's work in 1923. In this study, there was still no differentiation between transvestic, effeminate homosexuality or transsexualism. Only in the 1940s and 1940s did the term begin to be used in a more modern sense to designate people who wished to live permanently as the opposite gender. In 1966, many doctors recognize the potential benefits of surgery for sex exchange. (Wylie, 2004)
The diagnosis of transsexualism was introduced in the DSM-III (Manual Diagnosis and Statistics of Mental Disorders), in 1980, for individuals with gender dysphoria who demonstrated, at least for two years, the ongoing interest in transforming your anatomical and Social. (al. F. P., 2000)
The cause, whether psychogenic or biological, of identity disorders gender is still controversial and discussed for several years. Some authors believe that this disorder reflects mental & physical health of the mother at the time of pregnancy, or that results from an interaction disorder that occurs in parts of the brain with hormones during the fetus development phase, because in 6th week of gestation the brain & gender determination begins. Other theories describe developmental problems in early childhood. As per the past evidence, the etiology has bases neurobiological disorders during fetal development. Multiple sexual cores dysmorphic were found in the hypothalamus region. Zhou et al. found similarity in the brain structure of transsexual’s male to female with female standards (al., 1995). Kruijver et al. realized that the number of neurons in male transsexuals for females was similar to that of women and the number in transsexuals female to male was similar to that of men. (al. F. P., 2000)
According to DSM-IV 1994 of the American Psychiatric Association, criteria for the diagnosis of transsexualism as a gender identity are;
Strong persistence of cross-gender identification, that is, neurologically respond to sexual stimuli contrary to sex biological
Permanent and persistent evidence of discomfort with sex that biologically attributed to it, that is, a sense of impropriety the sexual role of that gender;
Diagnosis excluding physical intersexual condition, confirmed clinically;
Presence of anguish in significant impediments to social life, occupational, etc.
The diagnosis of DIG is based mainly on clinical criteria, such as intense desire to belong to the opposite sex, difficulty in early adaptation, dislike for the genital organ, low frequency of heterosexual relationships and low sex drive.
Discuss consumers' qualitative experience with receiving/having a mental health diagnosis.
Medical diagnosis is the process to determine which condition can explain the symptoms and the signals of a person. The information that a medical diagnosis requires is generally collected from the history and physical examination of the person seeking medical assistance. The psychiatric diagnosis is different: often there is no physical symptom nor are there specific biological tests that attest to mental suffering. Although in some cases biological tests may be important for unraveling underlying physical conditions, a healthcare professional making a psychiatric diagnosis should rely on the description of thoughts and emotions made by the person himself, together with the observation of his behaviors. In this sense it is often said that those who are in the best condition to make one diagnoses are the people themselves, with the support of adequate information and discussions with healthcare professionals. (Frances, 2003)
The main purpose of current psychiatric diagnoses is to help healthcare professionals in communicating with patients and to decide which form of medical treatment might be best to prescribe. Some people find that getting a diagnosis is helpful and reassuring, while others find it stigmatizing. A psychiatric diagnosis often leads to the prescription of medicines. Psychiatric medications can provide temporary relief, but they can also produce effects unpleasant and debilitating. If this happens it is very important to discuss it with a doctor. Every person with mental problems has the right to be, and must be, adequately involved in each phase of medical evaluation and potential treatment. (American Psychiatric Association (APA)., 2015)
Many people, including psychologists and doctors, question the value of the medical model. This does not it means minimizing the pain and upheaval in people's lives, but rather having a vision less restricted and one-sided of the causes of this pain. Instead of deciding on a medical diagnosis, the alternatives they could be discussed between people who experience suffering and their health workers. (American Psychiatric Association (APA)., 2015)
Many people who have received a diagnosis find it helpful to consult others with similar experiences. There are many organizations, led by people with lived experience of mental suffering, who offer support, advice and operating for a better relationship with the health and legal system.
The patient / citizen involvement process cannot be left to the initiative of hospital or service personnel. The staff who must collaborate with citizens and collecting their needs require adequate time, training and support to know all the possibilities for user involvement, must be accustomed to team work and multidisciplinary work. Many working groups, organized to oversee the participation process, do not know what it means to involve citizens, and do not have the necessary skills to develop questionnaires, interview patients or analyze data. These skills should be made available to operators who want to undertake a consultation experience.
al., F. P. (2000). Male-to-female transsexuals have female neuron. J Clin Endocrinol Metab,.
al., J. N. (1995). A sex difference in the human brain and its relation. Nature,.
American Psychiatric Association (APA). (2015). Diagnostic and statistical manual of mental disorders. Washington, DC.
Cohen-Kettenis, P. T., & Gooren, L. J. (1999). Transsexualism: a review of etiology, diagnosis and treatment. Journal of Psychosomatic Research, 315-320.
Frances, A. (2003). Essentials of Psychiatric Diagnosis, Revised Edition: Responding to the Challenge of DSM-5. Guilford Press.
Wylie, K. (2004). Gender related disorders. BMJ, 615-616.
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