Recently, Bruce Jenner, the Olympic gold-medalist and step-father to the famous Kardashians, came out as a transgender female on ABC News 20/20 with Diane Sawyer. He expressed that since he has not yet completed his physical gender transformation, he invited others to continue to use the male pronouns “him/he” when referring to Jenner. He described knowing that he was a different gender since he was a young child and feeling as though he had the heart and soul of a female. He remembers having a strong desire to dress in girl’s clothing and would sneak into his sister’s room and wear her clothes. Growing up he had a great love of sports and was very competitive. Eventually he would excel so far in the sports world that he would win the gold medal in the Men’s Decathlon at the 1976 Summer Olympics. He described experiencing great shame in feeling that he was a woman and had to hide it for the greater part of his life. In the 1980’s he began taking female hormones and had some plastic surgery done to his face, which received media attention and questions started about his sexuality. He has been married three times, all to women and he considers himself to be a heterosexual.
Prior to Jenner’s interview, the transgender community has recently received more acknowledgement in the media with Laverne Cox being the first transgender person to be on the cover of Time Magazine and to be nominated for a Primetime Emmy for her role as Sophia Burset on the Netflix series, Orange Is The New Black. In the last Golden Globes, the Amazon show Transparent won Best TV Series for it’s comedy drama about a man preparing for gender reassignment surgery.
From Disorder to Dysphoria
Jenner’s story as well as that of other transgender people is one of emotional struggle to belong and be accepted in our society. The mental health community, which has been a safe haven for some transgender people, historically has not been accepting of those struggling with gender identity issues. Until recently, gender identity issues were considered a mental disorder. In the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR), Gender Identity Disorder was used to describe those who are transgender. In the newest edition of the DSM that was released in 2014, Gender Identity Disorder has been changed to Gender Dysmorphia, signifying a more compassionate change in the attitude and language to describe the transgender person and experience.
In the DSM-IV-TR, Gender Identity Disorder is described as a mental disorder, that the course tends to be “chronic” but “spontaneous remission has been reported”, as if it is a condition that needs to be treated and reversed. Furthermore it is defined as:
A strong and persistent cross-gender identification.
Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex.
The disturbance is not concurrent with a physical intersex condition.
The disturbance causes significant distress or impairment in social, occupational, or other important areas of functioning.
In the DSM-V, Gender Dysmorphia focuses on the distress that a transgender person experiences, rather than as an identity disorder. In the DSM-V, it is furthermore described as being “more descriptive than the previous DSM-IV term gender identity disorder and focuses on dysphoria as the clinical problem, not the identity per se.” The diagnostic criteria is distinct for children and adolescents/adults. It also allows the inclusion of a disorder of sex development such as a congenital adrenogenital disorder, which was not allowed in the DSM-IV criteria.
The DSM-V defines Gender Dysphoria for children and adolescents/adults as a marked incrongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration. For children, some of the criteria must include a strong desire to be or insistence that one is another gender, a strong preference to cross-dress, a strong preference for cross-gender roles in play, a strong dislike of one’s sexual anatomy and a strong desire for the sex characteristics of the experienced gender.
For adolescents/adults, the criteria are similar to that of children but there are a few differences. One distinction is the strong desire to be rid of one’s sex characteristics because of a marked incongruence with one’s experienced gender or the desire to prevent the development of the anticipated secondary sex characteristics. Another distinction is a strong desire to be treated as the experienced gender and a strong conviction that one has the typical feelings and reactions of the experienced gender.
Praise & Criticism
The response to Jenner’s televised interview has been met with both positivity and criticism. Many have praised Jenner’s courage, vulnerability and genuineness as he described the torment he experienced growing up knowing he was female while having to live the life of a male. However, some criticism has come up in regard to not only his white privilege but also his wealth and access to resources and that this is not the typical transgender story. Many people suffering through the turmoil of gender identity issues are people of color, and/or without the privilege and resources that Jenner has. In addition, there has been much violence against transgender females of color in particular, making it all the more difficult for these individuals to come out as their true selves. Thus, it is important to note that Jenner’s story, though it is an important one for the transgender community, is not typical for the many who are suffering and their stories have not been told in the mainstream media. The hope is that by Jenner coming out with his story, perhaps it will help shed light on this issue that is affecting so many outside of the limelight.
American Psychiatric Association. (2014). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Sawyer, D. (Writer). (2015). Bruce Jenner: The Interview. [News Program]. United States: American Broadcasting Company.