GenderLife Forum: The Information Exchange

I'm suspecting that transfolk who are suffering from depression, anxiety, social disorders, ptsd due to growing up trans would be covered under those diagnostic codes.

Exactly

Let us assume that there is a person who is black and brown wants to see his doctor because he is suffering from depression. Is it correct to give him a diagnosis that he is black and brown instead of a depression?

His pigmentation can inflict discrimination on him but his skin color is not a disease. And the depression is not directly related with his pigmentation.

The feeling of being discriminated against is overwhelming. I know that feeling, I have been there. In that perspective I cannot accept that a victim is put in the role of a culprit.

Being individual who is transsexual is a personal quality as being black and brown. If there are side symptoms they should be diagnosed in accordance with their respective diagnostic criteria, not with a dump diagnosis of a GID

It is true that GID is a condition that needs an intervention of modern medicine. There are other conditions like that e.g. pregnancy. The treatment of GID is like the treatment of a pregnancy. The childbirth is widely accepted as a quality of the female sex and that is not a reason to discriminate against females in the work life. Actually that is illegal in many countries. If we take the surgeries as a part of the life of a transsexual individual, and we accept the fact that there are other variants of human beings than just Adam and Eve, we can have those treatments covered by the society/insurance companies, and we can have that discrimination against transsexual individuals declared illegal.

In the WHO ICD codes there are other series of diseases that are better in their task of describing GID than the psychiatric F series. I can accept a diagnosis that aims at the transition and assimilation as a female individual. But that diagnosis should be only a temporary one that allows the intervention of the modern medicine. After the GID is treated the diagnosis ceases to exist.

Being mentally ill is like being pregnant. You can't be just a little bit pregnant.

There are people out there that really need help from the mental health community. Those that get released from facilities, even though they still need continuing treatment. Most end up on the street, homeless, and hopeless.

They are wasting their time on us. They should be concentrating on those who really need help.

Worse yet they are wasting our time. And our money too.
And directly contributing to stigma.

Soon (January 2010), in the USA, with the Wellstone-Domenici Act. they will be wasting our employers' money also.
There is surely a lot of room for a (USA) bipartisan political win in acting to fix the last one.

As to psychological diagnosis, if 302.85 can't be used then how about 995.83?

There are some mental disorders that possess similar symptoms with the GID. That is why some psychiatric evaluation is still needed, to seize self-mutilation sex-fantasy people. In spite of the pshrink check list we should not be stigmatized as psychiatric cases.

Similar with bariatric surgery (for example anorexia nervosia can can people to want stomach stapling).

But there is all the difference in the world between ruling psychiatric problems out (as in bariatric surgery) and ruling psychiatric problems in (as in GID). For one thing is does not take a specialist to rule things out, just about any doctor can rule psychiatric problems out (and they do, routinely for non-trans people).

So we all (I think) have no objection to a GP performing a quick psychiatric exam at the first visit of a person presenting with GID and ruling out such things as depression, schizophrenia, self-mutilation sex-fantasy and so on; and then referring to an endocrinologist.

I'm not totally sure general practitioners have the training to handle a lot of psychiatric conditions. Heck, IMHO they tend to hand antidepressants out like candy and in many cases they don't ramp people up and down appropriately, resulting in severe side effects.

Also, they tend to not be so up to date on some of the issues with the various medications. For example, one antidepressant came out in generic. Turns out the medication itself was the same, but the delivery mechanism was different in the generic (it was still patented), which resulted in severe side effects from the generic but not the commercial brand.

In many cases, when a doctor suspects a mental condition, they simply refer to a specialist (psychiatrist or psychologist).

But Roxanne, the issue is not whether GPs can or cannot properly treat psychiatric conditions.

The issue is whether GPs can rule out psychiatric conditions when psychiatric conditions actually are absent.

Thus, for example, it is not whether they can prescribe the correct SRI drugs and CBT to treat depression. Rather it is whether they can correctly and properly say "Your problem is not depression, so it must be something else.".

I hold that GPs are competent to do the latter thing. That is really all that should be asked of them in terms of ruling out psychiatry as an effective treatment for transsexualism.

I think GP's do decide the problem is depression for patients far too often, at least in this country. That's why I suspect they hand out antidepressants like candy.

Honestly, I don't think a medical professional could make a determination of mental illness or rule it out in the 10-15 minutes they have to see you, which is the standard in the US medical system at least. They pretty much go with what you tell them.