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Medical Abuse of GLBT Youth
From the PFLAG-Talk/TGS-PFLAG Virtual Library
Medical Abuse of GLBT Youth
(this handout is on the web at
http://www.critpath.org/pflag-talk/gid.htm)
by Nancy Sharp, Co-chair PFLAG Transgender Special Outreach
Network
In recent years, the medical abuse of youths has become more
prevalent, and is, for the most part, being conducted without the
awareness of individuals and organizations concerned about the
treatment of gay, lesbian, bisexual and transgendered youths.
Clearly, transgendered youth are at great risk for abuse; however,
advocates for gay and lesbian youths should be equally concerned,
and should not assume that gay and lesbian youths are not at equal
risk. Many gay and lesbian advocates fail to realize that abuses
which occurred prior to 1973 to correct the "mental disorder" of
homosexuality are now being carried out under the "mental disorder"
of Gender Identity Disorder. Adults can argue about the "labels" used
to justify the abuse but that does not alter the fact that youths are
being abused.
In 1973, the American Psychiatric Association eliminated
homosexuality from it's list of mental disorders. However, this
elimination did not result in the elimination of homophobia within
segments of the psychiatric community. It is still possible for
influential "homophobic" psychiatrists to serve on sub-committees
which develop criteria for psychiatric diagnoses within the
Diagnostic and Statistical Manual (DSM) of the APA.
The publication of DSM-III in 1980, was hailed by gay advocates as
a significant breakthrough; however, what received little attention
is that a new "mental illness" appeared in the DSM-III in 1980:
"Gender Identity Disorder of Childhood (GIDC)." Receiving even less
attention is the fact that the criteria for receiving a diagnosis
of GIDC are being broadened with each revision of the DSM and that
substantial numbers of gay and lesbians are being diagnosed with
GIDC. While there are legitimate arguments that children with
"true" gender identity disorders benefit from receiving appropriate
medical care, recent evidence would indicate that significant
portions of children with Gender Identity Disorder are receiving
inappropriate and abusive, but approved, psychiatric therapy.
Dr. Susan Coates, a clinical psychologist who runs the Childhood
Gender Identity Project at Roosevelt Hospital in New York, the
largest gender treatment center for children in the U.S., when asked
what can happen in the offices of psychiatrists and psychologists all
over the world to children who refuse to behave "like a girl" or
"like a boy" replied, " You'd be shocked, you would be very shocked,
at what goes on even at this age level." The evidence indicates Dr.
Coates is not exaggerating. She fears that these children will be
referred to therapists who use "intense behavior modification" and
drug therapy. A recently published book, "Gender Shock", exposes
these abuses.
In 1980, with the publication of DSM-III, Gender Identity Disorder
of Childhood is described as "apparently rare," and it was estimated
that approximately one percent of children were affected. In 1994,
with the publication of DSM-IV, the condition is stated to occur in
two to five percent of children. Further research reveals that the
criteria for being classified for Gender Identity Disorder are
being broadened with each subsequent revision of the DSM and that
more and more children are meeting the less stringent diagnostic
criteria and are subject to abuse.
Transsexuality is not becoming more prevalent, although
more transsexuals are seeking treatment as they become aware that
medical treatment is available. Certainly they do not comprise
from two to five percent of children! Most common estimates for the
occurrence of transsexuality range from 1 out of 23,000 individuals
to 1 out of 40,000 individuals. Transvestitism or cross- dressing is
much more common, but even then, estimates are about 1or 2 percent of
the population and most of them do not show obvious cross- gender
behaviors as adolescents. Most hide their activities, confine
cross-dressing behaviors to private settings, and would not be
exposed and referred to psychiatrists for treatment. Evidence and
logic indicates that substantial numbers of gay, lesbian, and
heterosexuals youths who demonstrate behaviors which are considered
to be "gender variant" are receiving abusive therapy to correct their
gender deviant behavior.
There are few legal protections for these children and youths. The
parents are granted broad rights and, if a psychiatrist convinces a
homophobic parent that he can cure a child of his or her gender
disorder by confining the child to an institution for long term
corrective therapy, there is no legal remedy for the child. Children
who resist treatment simply meet the criteria for an additional
diagnosis of Oppositional Defiant Disorder. If they have actually
engaged in sex, they qualify for the diagnosis of sex offender, since
it is illegal for underage youths to have sex with each other in most
states. In cases of consensual heterosexual sex between adolescents,
it is rare for them to be declared sex offenders and placed in
programs with convicted rapists. Richard Green, a psychiatrist with
extensive experience with treating GID, a member of the GID DSM
sub-committee, and an attorney, states in "Gender Shock", " parents
have the legal right to seek treatment to modify their child's cross-
gender behavior to standard boy or girl behavior, even if their
only motivation is to prevent homosexuality." In 1987, Green
recommended direct behavior modification activities, discouraging in
every way the free expression of cross gender role behavior through
negative reinforcement, extinction, and positive role modeling.
In 1995, George A. Rekers, a UCLA and Harvard- trained clinical
psychologist with extensive experience with GID, published the
"Handbook of Child and Adolescent Sexual Problems" which is designed
to assist the general practitioner and pediatrician when he or she is
presented with a gender non- conforming child. Reker's behavior
modification therapies, rather that being an aberration, are now
being presented as a diagnostic and treatment model. Rekers has
recently published an article highlighting the success of his
therapies with children and has asked the APA to revisit their 1973
decision which eliminated homosexuality from the DSM. In view of
recent information offered by Rekers, homosexuality is a mental
disorder and is treatable. The motivations of these prominent and
well educated psychiatrists and psychologists is not fully
understood. It is known, however, that Green and Rekers have received
substantial funds through National Institute of Mental Health Grants.
At least 1.5 million dollars were awarded by NIMH to study gender
deviant behavior since the early 1970's. Reker's himself claims
that the NIMH has funded him over a half a million dollars. The
biased goals of the research is revealed in the language of the grant
applications where references to atypical sex roles, atypical gender
identity, modification of deviant behavior, and pre-transsexual
behavior are included in the grant proposals. Other agencies funding
gender corrective therapies are the Foundation Fund for Research in
Psychiatry, the Research Scientist Development Award fund, the Public
Health Service's clinical research grants, and the National Institute
of Health's Biomedical Research Support grants.
It is extremely difficult to differentiate between a gay,
lesbian, transgendered, or heterosexual youth! Usually, later,
the youth can determine their true identity. A youth who initially
identifies as gay, or lesbian, or transgendered may be mistaken in
their original assessment and may later learn that they fall into
another category. Significant numbers of individuals who are
female-to-male transsexuals identify as lesbians for many years
before they recognize their identity. Indeed, some PFLAG leaders in
other areas of the U.S. have children who demonstrate this fact.
There are many understanding and supportive therapists who are not
abusive. Morton Shane, M.D. and Estelle Shane, Ph.D, in their article
"Clinical Perspectives on Gender Role/Identity Disorder" state, " The
fear evoked now concerning the intractable course and outcome of
gender disorders in childhood can lead to anxiety and despair, and
may not create the optimal atmosphere for learning about and treating
such conditions. Our safest stance is one of uncertainty, humility,
and empathy."
Your webmaster encourages you to support Youth
Guardian Services and Critical Path AIDS Project.
Visit their websites at www.Youth-Guard.org
and www.CritPath.org.
YGS hosts the PFLAG-Talk, PFLAG-Announce, PFLAG-Discuss, TGS-PFLAG,
Youth and Schools e-mail lists, and the PFLAG T-SON.
The Critical Path hosts the PFLAG-Talk/TGS-PFLAG
website.
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