[brightonlad89]

(Original post by lightburns)
To my understanding, a mental disorder can still have a biological cause. Look at schizophrenia - it is in the DSM, yet everyone is searching for genes and brain abnormalities.

So, to my understanding, GID is a mental disorder as it causes severe distress and requires medical treatment. Unlike homosexuality, it requires treatment. That is why homosexuality is not a disorder, and GID is. Homosexuality isn't maladaptive, but untreated GID is.

Personally, I think GID holds many similarities with BIID, and may be caused by a similar mechanism (BIID is thought to be a neurological failing of the brain's mapping function).

Yes, mental illnesses can have biological causes. However, there are many gaps in knowledge and although it is likely a safe assumption that Schizophrenia has a biological cause-- studies have never been able to replicate a standard way of identifying this. Leaving diagnostic criteria entirely subjective. That is the issue with most mental disorders. It's not that they don't exist, just that not enough is understood about them to prevent subjectivity in diagnostic and
treatment procedures.

The DSM is a collection of descriptions, diagnostic criteria and possible treatments for classified mental disorders. It neither discusses (nor can explain) cause nor cure. Criteria is agreed upon by a panel of 'experts', and not a result of objective evidence. This leaves the field of mental illness open to abuse.

G.I.D. does require treatment in most cases (Gorin-Lazrd et al, 2012) have shown positive correlation between physical treatment and quality of life. The argument and comparison between transsexuality's categorisation and homosexuality's former cateogorisation as a mental disorder is not on whether they are a condition or not, but whether they are a mental disorder or not.

Transsexuality is more likely to be a biological anomoly, yet is classified as a mental disorder for similar reasons as why homosexuality was classified-- social control. It has many negative affects on those diagnosed (justification of stigmatisation-- labelling theory etc., subjective diagnostic practices resulting in delayed or refused treatment). For example, in my research a transsexual man was referred for further psychiatric assessment and refused approval for a corrected birth certificate because he was gay. This wasn't referring to a new referral, but someone who had 'transitioned' early in his adult life and lived successfully as male for as long as he had unhappily lived as female.

Mental illness categorisation allows this to happen, hence why I'm skeptical of it. There is no doubt symptoms exist, but the implications of the current classification system is so flawed that it could (and does in some cases) cause more harm than good.

[lightburns]

(Original post by OU Student)
Is it in ICD-10? Not sure if I've got the title of that one quite right.

I think ICD has a similar sort of thing as DSM; 'dissocial personality disorder'.

[Dmon1Unlimited]

(Original post by PsychoHamster)
Suicide could potentially be a very rational thing for somebody who's life had very little joy or hope of there ever being any.

is that very rational? in terms of at that time and place, sure, but to think there is no way to get over this? that there are no solutions?

[memomemootoo]

mental illness is:

“a device to convince those who are sick and tired of society that it is they who are ill, impotent, and in need of technical repair”(Illich 1976)

i don't see why people are restating the fact that the notion of mental illness exists... i think it's more of a question of whether it is right to believe in it as a medicalising label for abnormal behaviour

[lightburns]

(Original post by brightonlad89)
Yes, mental illnesses can have biological causes. However, there are many gaps in knowledge and although it is likely a safe assumption that Schizophrenia has a biological cause-- studies have never been able to replicate a standard way of identifying this. Leaving diagnostic criteria entirely subjective. That is the issue with most mental disorders. It's not that they don't exist, just that not enough is understood about them to prevent subjectivity in diagnostic and
treatment procedures.

The DSM is a collection of descriptions, diagnostic criteria and possible treatments for classified mental disorders. It neither discusses (nor can explain) cause nor cure. Criteria is agreed upon by a panel of 'experts', and not a result of objective evidence. This leaves the field of mental illness open to abuse.

I agree that DSM is a rather rough way of getting to diagnoses, and will be full of errors. It does the job, but could be done better on the evidence rather than expert opinion, which is after all, opinion, even if it's knowledgeable opinion.

G.I.D. does require treatment in most cases (Gorin-Lazrd et al, 2012) have shown positive correlation between physical treatment and quality of life. The argument and comparison between transsexuality's categorisation and homosexuality's former cateogorisation as a mental disorder is not on whether they are a condition or not, but whether they are a mental disorder or not.

Surely if it's a condition, it is a mental condition? It's on how a person has distress and on their perception of themselves. If it's biological (as I suspect it is), surely it's brain-based.

Transsexuality is more likely to be a biological anomoly, yet is classified as a mental disorder for similar reasons as why homosexuality was classified-- social control. It has many negative affects on those diagnosed (justification of stigmatisation-- labelling theory etc., subjective diagnostic practices resulting in delayed or refused treatment). For example, in my research a transsexual man was referred for further psychiatric assessment and refused approval for a corrected birth certificate because he was gay. This wasn't referring to a new referral, but someone who had 'transitioned' early in his adult life and lived successfully as male for as long as he had unhappily lived as female.

Mental illness categorisation allows this to happen, hence why I'm skeptical of it. There is no doubt symptoms exist, but the implications of the current classification system is so flawed that it could (and does in some cases) cause more harm than good.

Those are flaws in the system, not a reason to chuck out the system. It is like how transwomen were, only a decade or so ago in the UK, forced to wear a skirt or dress if they wanted treatment. Incredible sexism. That's a problem that needed to be fixed.
It doesn't change whether or not it is a condition.

It also comes with benefits. To get treatment on NHS, you have to have something wrong with you; i.e. you need a diagnosis. If there's nothing wrong, then surgery for GID would be on a par with getting a boob job.
It also enables transpeople to have something to point to for why they are in such distress. It's the similar distinction between someone getting told to pull themselves together over their mood, then being able to say "it's a medical thing; I'm bipolar".

I just really don't see the parallels between GID and homosexuality in diagnosis. Homosexuality as a sexuality is not chosen, but acting on it is - someone can make the choice to be celibate and have a perfectly good life. This is not possible for someone with GID. Both the inclination AND the lifestyle becomes completely determined, as it is impossible for someone with GID to live as the sex they had been living as.

[turkishdisco]

(Original post by Tilly87)
Of course mental illness exists? It is not something you 'believe' in, it has a neurological basis!

It does, but it's often not clear-cut at all. One of the reasons that people are disillusioned with psychiatrists is that they can't treat mental conditions as easily or efficiently as physical ones, where you can look for very specific, objective criteria.

I agree with you, and with the idea that mental illness does exist.. i'm just playing devil's advocate here.

[Like a BAWS]

(Original post by OU Student)
Well, yes. Why would anyone who is of sound mind commit suicide?

They might have come to the conclusion life is meaningless, or that to live is no better than to not. Perhaps they might have even come to the conclusion that it is better to be dead than to live in this life when so much suffering takes place.

I don't share that viewpoint myself, I'm reasonably positive But if someone had that outlook, whilst I think it would be a shame, I wouldn't consider them to have a mental illness

[Mister Dead]

I worked in a psychiatric institution for a long time and can confirm the existence of mental illness.

It has a face and I have seen it, literally.

[lightburns]

(Original post by memomemootoo)
mental illness is:

“a device to convince those who are sick and tired of society that it is they who are ill, impotent, and in need of technical repair”(Illich 1976)

i don't see why people are restating the fact that the notion of mental illness exists... i think it's more of a question of whether it is right to believe in it as a medicalising label for abnormal behaviour

Labelling is like democracy. You can argue against it and poke holes in it until it's almost all air for all the problems it's got. But it's the best option we've got, and we couldn't do without it.

Labelling allows for research and treatment of mental disorders. If you don't label people, and see everyone as having their own unique individual symptom-set, then you cannot treat them. You cannot do research to find out what helps. Put a label of them of a group that they roughly fall under with similar symptom-sets, and you can do research to find out a cause that groups them all together, and which treatments work and do not work.

[OU Student]

(Original post by Like a BAWS)
They might have come to the conclusion life is meaningless, or that to live is no better than to not. Perhaps they might have even come to the conclusion that it is better to be dead than to live in this life when so much suffering takes place.

I don't share that viewpoint myself, I'm reasonably positive But if someone had that outlook, whilst I think it would be a shame, I wouldn't consider them to have a mental illness

Whereas I would consider them to be mentally ill.

[7589200]

(Original post by BabyGirl92)
Yes it does exist, all mental illnesses have a physical basis. For example anxiety can be caused by a deficiency of Serotonin neurotransmitter.

Anything can have a physical basis doesn't mean its necessarily 'an illness'.

[Sovr'gnChancellor£]

I believe 'Mania' is classed as a 'mental illness'. However, this essentially says that there is something ;wrong' about 'Mania' etc.

But this is dubious as some of the so-called 'symptoms' of mania are grandiose thoughts and ambitions and brief periods of euphoria and so on and so forth. I cannot at all see what's 'wrong' with that.

Personally, I can identify with some of those 'symptoms' and I really don't think that any person would class me as having a 'mental illness'.

On the other hand, I cannot at all dispute schizophrenia, for example, as being a mental illness. If somebody is hearing clear voices in their head, something is neurologically wrong and there would indeed be a brain malfunction and cerebral incohesion.

[turkishdisco]

(Original post by marky--mark)
Umm... Yeah. That's like saying 'Do you believe in the postman?'. He exists. They exist. What's the confusion?

Of course it isn't. That's just nonsensical. We're talking about a subjective thing here - patterns of behaviour, chemical imbalances, neurological anatomy, life experiences that combine to dictate how a person is, how they interact with others, how they view life. Tomas Szasz is the biggest proponent of the idea that mental illness is a made-up concept because we're 'medicalising normality' - what one person may see as 'normal' may be 'abnormal' for another (culture comes into it too). Whether or not someone is diagnosed with a mental illness/disorder is often down to the interpretation of symptoms by the psychiatrist.

You see a postman, I see a man who likes to wear a red coat and walk around with a satchel.

[brightonlad89]

(Original post by lightburns)
I agree that DSM is a rather rough way of getting to diagnoses, and will be full of errors. It does the job, but could be done better on the evidence rather than expert opinion, which is after all, opinion, even if it's knowledgeable opinion.


Surely if it's a condition, it is a mental condition? It's on how a person has distress and on their perception of themselves. If it's biological (as I suspect it is), surely it's brain-based.


Those are flaws in the system, not a reason to chuck out the system. It is like how transwomen were, only a decade or so ago in the UK, forced to wear a skirt or dress if they wanted treatment. Incredible sexism. That's a problem that needed to be fixed.
It doesn't change whether or not it is a condition.

It also comes with benefits. To get treatment on NHS, you have to have something wrong with you; i.e. you need a diagnosis. If there's nothing wrong, then surgery for GID would be on a par with getting a boob job.
It also enables transpeople to have something to point to for why they are in such distress. It's the similar distinction between someone getting told to pull themselves together over their mood, then being able to say "it's a medical thing; I'm bipolar".

I just really don't see the parallels between GID and homosexuality in diagnosis. Homosexuality as a sexuality is not chosen, but acting on it is - someone can make the choice to be celibate and have a perfectly good life. This is not possible for someone with GID. Both the inclination AND the lifestyle becomes completely determined, as it is impossible for someone with GID to live as the sex they had been living as.

Homosexuality and transsexuality are completely different, yes. The comparison comes in the reasons behind their mental illness classifications as their level of perceived deviance, in their respective times, were seen as quite similar. Homosexuality was viewed as a threat to gender binary (gay men as having something wrong with their masculinity), and although we have today gotten beyond that, transsexuality is viewed as a similar line of deviance to what homosexuality used to be. They are polars apart of course in objective terms, but in societal deviance their 'offence' to society's norms are comparable (medicalisation has replaced criminalisation in many cases to control perceived deviance).

There are many reasons why the mental illness classification for transsexuality/G.I.D. is not in the service users' best interests and I'll name a few:

- The name itself Gender Identity Disorder, implies the issue is psychological disturbance of one's gender identity (a problem in the mind) and justifies layman's misconceptions such as the old chestnut of 'a transsexual woman is really a man who thinks she's a woman'. 87% of transsexual people in my study felt that the name of the disorder, and its mental illness categorisation, negatively affected how laymen viewed the condition and also contradicted their basis for argument against transphobia.

- Mental illness classification relies upon criteria that is agreed upon by a panel of experts rather than the referral to biological data. This means in reality that people sit down and decide what gender dysphoric people should be allowed treatment. i.e. will allowing X to transition, will X then become a more socially acceptable person?'. If the answer is no, they will have to jump through a heck of a lot of hoops and suffer disrespect from people (doctors) who they have turned to, often in distress.

For example, a post-transition trans man on a morning TV show a year or so ago was also a cross-dresser (transvestite) and did drag shows in caberet bars. So, here we had this man who was assigned a female sex role at birth, who happily lives as a gay man but also likes to, on weekends, dress as a drag queen and perform in gay bars. This exists in non-transsexual men, so of course can exist in transsexual men also. But, had he disclosed this during consultation, he would almost certainly have been denied treatment despite his hobby and sexuality having nothing to do with whether or not his brain sex is male.

I believe personally that it would benefit more from being listed as physical condition as, unlike 'other' mental disorders, successful treatment does not focus on altering thought patterns and behaviours, but to correct the secondary sexual characteristics of say, a female infant who was born with a penis and subsequently raised as male.

The mental illness system is useful of course in a lot of circumstances, but our current knowledge just means that it can be more detrimental in some cases than good due to its lack of objectivity.

[Nuffles]

(Original post by ednut)
so everyone who commits suicide is mentally ill?

At what point in my post did I say that people who commit suicide = mentally ill? People who commit suicide may by mentally ill, and in a lot of cases they actually are, but committing suicide does not mean that you are mentally ill - they are not mutually exclusive. Not everybody that commits suicide is mentally ill, much in the same way that not everybody that is mentally ill, commits suicide.

[lightburns]

(Original post by Sovr'gnChancellor£)
I believe 'Mania' is classed as a 'mental illness'. However, this essentially says that there is something ;wrong' about 'Mania' etc.

But this is dubious as some of the so-called 'symptoms' of mania are grandiose thoughts and ambitions and brief periods of euphoria and so on and so forth. I cannot at all see what's 'wrong' with that.

Manic individuals can make their families think they are on drugs. The mania high is similar to drug highs.
Grandiose thoughts and ambitions would be, for example, to believe that they have £10,000 in the bank when in fact they are very poor. To believe that they will get a top job, when they have no qualifications. Everyone is a little deluded about themselves, but whilst going through mania, the self-delusions are incredibly extreme.

[lightburns]

(Original post by brightonlad89)
Homosexuality and transsexuality are completely different, yes. The comparison comes in the reasons behind their mental illness classifications as their level of perceived deviance, in their respective times, were seen as quite similar. Homosexuality was viewed as a threat to gender binary (gay men as having something wrong with their masculinity), and although we have today gotten beyond that, transsexuality is viewed as a similar line of deviance to what homosexuality used to be. They are polars apart of course in objective terms, but in societal deviance their 'offence' to society's norms are comparable (medicalisation has replaced criminalisation in many cases to control perceived deviance).

There are many reasons why the mental illness classification for transsexuality/G.I.D. is not in the service users' best interests and I'll name a few:

- The name itself Gender Identity Disorder, implies the issue is psychological disturbance of one's gender identity (a problem in the mind) and justifies layman's misconceptions such as the old chestnut of 'a transsexual woman is really a man who thinks she's a woman'. 87% of transsexual people in my study felt that the name of the disorder, and its mental illness categorisation, negatively affected how laymen viewed the condition and also contradicted their basis for argument against transphobia.

- Mental illness classification relies upon criteria that is agreed upon by a panel of experts rather than the referral to biological data. This means in reality that people sit down and decide what gender dysphoric people should be allowed treatment. i.e. will allowing X to transition, will X then become a more socially acceptable person?'. If the answer is no, they will have to jump through a heck of a lot of hoops and suffer disrespect from people (doctors) who they have turned to, often in distress.

For example, a post-transition trans man on a morning TV show a year or so ago was also a cross-dresser (transvestite) and did drag shows in caberet bars. So, here we had this man who was assigned a female sex role at birth, who happily lives as a gay man but also likes to, on weekends, dress as a drag queen and perform in gay bars. This exists in non-transsexual men, so of course can exist in transsexual men also. But, had he disclosed this during consultation, he would almost certainly have been denied treatment despite his hobby and sexuality having nothing to do with whether or not his brain sex is male.

I believe personally that it would benefit more from being listed as physical condition as, unlike 'other' mental disorders, successful treatment does not focus on altering thought patterns and behaviours, but to correct the secondary sexual characteristics of say, a female infant who was born with a penis and subsequently raised as male.

The mental illness system is useful of course in a lot of circumstances, but our current knowledge just means that it can be more detrimental in some cases than good due to its lack of objectivity.

It is undeniably detrimental to many individuals. But it still doesn't answer the issue of the fact that it is most likely a brain-based disorder that causes maladaptive perceptions and behaviour. As the disorder cannot be treated at the brain level, it is instead treated by bringing the body in line with the perceptions.

The problems such as medical professionals and laymen considering it "someone who is really a man who considers himself a woman" (note the incorrect pronoun, which is also common) or vice versa is a separate problem that needs to be addressed by itself. Avoiding this by making it no longer a mental disorder is just covering up the problem that already exists. It is also worsening the general stigma of mental disorders - if someone with GID says "see, I'm not crazy, it's not a mental disorder!", what does that imply for mental disorders? I have seen so many people with GID who make comments which really do deepen this stigma, and show their own stigma towards the label of mental disorder. There is an issue here that it should not be shameful to have a mental disorder - but some people with GID think that it is.

[RandZul'Zorander]

(Original post by OU Student)
Whereas I would consider them to be mentally ill.

I would say that there are definitely times where a person can be suicidal and not be 'mentally ill'. For example you can have a cancer patient who has undergone years of surgery. They are now in such a stage where they experience sever pain all the time. They are immobilized by pain and medications are helping anymore. There are no more surgeries to do. Medically they have run out of options. The only thing they can do is take more pain meds and try to enjoy the time they have left. Rather than waiting however long it might be this person wants to end their life to minimize their suffering. I see that as perfectly rational nor is it a sign of mental illness in any way.

[memomemootoo]

(Original post by lightburns)
Labelling is like democracy. You can argue against it and poke holes in it until it's almost all air for all the problems it's got. But it's the best option we've got, and we couldn't do without it.

Labelling allows for research and treatment of mental disorders. If you don't label people, and see everyone as having their own unique individual symptom-set, then you cannot treat them. You cannot do research to find out what helps. Put a label of them of a group that they roughly fall under with similar symptom-sets, and you can do research to find out a cause that groups them all together, and which treatments work and do not work.

see that's the thing.. is it always necessary to "treat" whatever is labelled as mental illness? Some of the greatest people in history can be classified as mentally ill, and i doubt that they would have come close to achieving what they had if they were "treated" and homogenised into what society considers normal.

[RandZul'Zorander]

(Original post by lightburns)
It is undeniably detrimental to many individuals. But it still doesn't answer the issue of the fact that it is most likely a brain-based disorder that causes maladaptive perceptions and behaviour. As the disorder cannot be treated at the brain level, it is instead treated by bringing the body in line with the perceptions.

It's not a matter of necessarily treating it at the brain level. As with homosexuality GID isn't in and of itself a maladaptive thought pattern or behavior. It is social stigma which causes such maladaptive perceptions. If it were socially acceptable to change one's appearance and fluidly transition their gender regardless of sex then there wouldn't be many problems for transgendered or transsexual people. It would be seen similar to those who feel that they are goth, or whatever other social identity you can think of. They change their appearance and behaviors accordingly. So it doesn't necessarily seem to be an actual mental disorder but rather a trait with a social stigma, similar to homosexuality.

The problems such as medical professionals and laymen considering it "someone who is really a man who considers himself a woman" (note the incorrect pronoun, which is also common) or vice versa is a separate problem that needs to be addressed by itself. Avoiding this by making it no longer a mental disorder is just covering up the problem that already exists. It is also worsening the general stigma of mental disorders - if someone with GID says "see, I'm not crazy, it's not a mental disorder!", what does that imply for mental disorders? I have seen so many people with GID who make comments which really do deepen this stigma, and show their own stigma towards the label of mental disorder. There is an issue here that it should not be shameful to have a mental disorder - but some people with GID think that it is.

What would it imply for mental disorders if GID wasn't a mental disorder? It might reinforce the stigma that mental disorders are 'bad' and that challenge the stigma that GID is...but I don't really see any other implications on mental disorders as a whole.