DSM ON THE BOOKSHELF:
An open letter to WPATH Members From Tracie O'Keefe
Copyright © 2008, Tracie O'Keefe
On May 30, 2008, WPATH member Tracie O'Keefe sent an eloquent letter to the membership concerning the ongoing debate about the upcoming revision of the DSM. Her letter resonated with readers concerned about the DSM's pathologization of gender variance as "mental illness". Some urged her to make the letter public, for the benefit of the larger trans-community. Tracie has now done that, and has graciously given permission for its publication in this site. - L.C., June 3, 2008. [PDF]
---------------------------- Original Message 
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Subject: Re: [WPATH-MEMBERSHIP] DSM Debate open response
From:    Tracie O'Keefe
Date:    Fri, May 30, 2008 10:09 am
To:      WPATH-MEMBERSHIP
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DSM ON THE BOOKSHELF
There are 
	always such wars driven by the interpretation of words. People are so 
	invested in their descriptions of themselves, the descriptions bestowed upon 
	them by others. The less conducive the description the more ‘other’ the 
	other becomes. Many are so offended by what this association and its members 
	have referred to them as over the years.
I disagree 
	that the sole purpose of HBIGDA was to help TSs and TGs, because I have 
	always viewed it as a trade association as much as a vehicle of 
	philanthropy. I had a hotel in my portfolio once so I was a member of the 
	small hoteliers association, which, as an aside, were far less 
	argumentative. As for the acronym WPATH I have always seen it as being more 
	about PATH (pathology), if you will excuse the Freudian slip. I have sat 
	across the table from friends who are psychiatrists and smiled wryly about 
	many of their interpretations of the human condition just as they have about 
	my own pontifications. My own DSM IV has spent most of its life propping up 
	one end of a bookshelf where the pegs have fallen out from the shelf above. 
	But I do understand the legal people suffer from the OCD of doing 
	categorisation by numbers just like insurance companies and 
	government-funded agencies. And of course some clinicians also prefer to 
	practise by numbers too.
Let us 
	remember what Einstein said, “It is the discipline that determines what can 
	be observed”, which dear old R. D. Laing would remind us with a whiskey in 
	one hand and the means of attaining an altered state of awareness in the 
	other.
 
On my 12th birthday in 1967 I was surrounded by a clutch of psychiatrists who fed me LSD to rid me of my desire to be female. It did not work but I think Timothy Leary may have thought it the right move for a whole host of other reasons.
I remember 
	April Ashley telling me they had given her ECT, which did not work either; 
	maybe it was not the right kind of electricity or perhaps supplied by an 
	inauspicious company. I also remember Peggy Cohen-Kettenis saying that she 
	had given psychological tests to young teenagers to determine which ones 
	were suitable for GID treatment and some of the ones they had rejected 
	turned up years later for treatment very angry. So exactly which one of us 
	is qualified to play God…not I? 
We as an 
	association are not qualified to determine the etiology of the whole world’s 
	population of sex and gender diverse people and we have no business 
	pretending that we do, because it would be fraud. The mere appearance of 
	information about different sex and gender diverse identities in the DSM 
	suggests that something is a mental illness or psychological disturbance and 
	WPATH, preferably without the PATH, should be fervently against any such 
	suggestion without incontrovertible evidence, of which there is absolutely 
	none.
We should 
	as an association be responsibly spending our time taking  transexed, 
	transsexual, transgender, androgynous, neuter, and fluid gender queer 
	identities out of the DSM. Shame…shame…shame if this does not happen in the 
	next DSM!
I find 
	this discourse an axiomatic power struggle but very little to do with 
	cultural interpretations of sex and gender identity. If HBIGDA or WPATH must 
	contribute to the future of the furniture in my office, please make it 
	brief.
Sex 
	Dysphoria – unhappiness with physical sex characteristics.
Gender 
	Dysphoria – unhappy with gender performance.
Sexuality 
	Dysphoria – unhappiness with one’s sexuality
One should 
	always bear in mind it is the duty of the present generation not to embrace 
	or saddle our descendants with our own bizarre ideas and theories, no matter 
	how earnest. How daft does the word transsexual sound now linguistically and 
	what would Chomsky have to say about that? And how utterly rude of the board 
	to call us all transgender when many of us are no such thing. CBT for 
	children who are sex and gender diverse? Whatever next? Anklets and 
	electrodes planted into our brains? 
Tracie 
	O’Keefe
PS. DSM 
	Committee – think diplomacy because if you believe you have suffered an 
	onslaught up to this point, just imagine the bite you will receive if you 
	step on the tiger’s  tail…and absolutely no amount of academic accolades 
	will save you… think Napoleon’s end. Perhaps your motto could be keep it 
	simple…very simple. Good luck with that – you have an unenviable task and 
	may you execute it with grace. 
Dr Tracie O'Keefe DCH (Doctor of Clinical Hypnotherapy)
Clinical Hypnotherapist, Psychotherapist, Counsellor, Sex Therapist
Director, Australian Health & Education Centre, Sydney
Ph +61 (0) 2 9562 6802
Fax +61 (0) 2 9562 6801
Email: Tracie O'Keefe
Web http://www.tracieokeefe.com/
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