Inclusion in DSM to reach surgery

This piece shall remain short, although it opens up several complicated and hot topics, such as pathologising Body Integrity Identity Disorder, and the need for it. At this point, it is not a well developed argument, merely jotting down some thoughts before they evaporate from my mind.

I have long advocated the similarities I saw between Body Integrity Identity Disorder (BIID) and Gender Identity Disorder (GID). Some people disagree, rather vehemently, saying there's no relationship between the two. Interestingly, the majority of people who say there's no relationship have GID. This is something worth exploring further down the track.

I have also long advocated in favour of including BIID in the DSM. It is, in my opinion, the only way to see movement in the direction of surgery being openly offered as an accepted treatment option for people who have BIID.

One of the detractors of this position adds that there were surgical options for people with GID long before GID was included in the DSM. This is both true, and an important issue to consider. Indeed, if we accept there are similarities between GID, and surgery was an option before inclusion in the DSM, it can be argued that BIID need not be included in the DSM to have surgery offered as a viable treatment alternative.

So, this tells me, yes there are similarities, but they are not the same thing. One of the major differences is society's attitude towards "gender" and towards "disabilities". Setting aside the very real discrimination against women, the fact is, society as a whole isn't as against women than it is against people with disabilities. Perhaps "against" is not the correct word here. But there is most certainly a bias against disabilities that is not present with gender (I'm taking F-to-M GID outside the equation for the purpose of this discussion). Or perhaps it should be said that we all know men and women, but not all of us have contact with people who have physical disabilities, and hence don't know as much about it, etc.

I really believe that in order for both the medical community and society at large to accept surgery as a treatment for BIID, it must be included in the DSM. There is too much misunderstanding, fear and bias against disabilities to make it acceptable in any other way. It will be a long time before people with disabilities are completely accepted and integrated in society. Until that happens, neither doctors nor society will be willing to accept "voluntary disablement" as a viable option for BIID sufferers, no matter how convincing an argument is presented.

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