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  • Writer's pictureKalen Zeiger, MS, tLMFT, CCTP, CFTP

DSM-5's Language Harms Genderqueer People

Updated: Aug 10, 2023

This time last year, I published a peer-reviewed article, with co-author Mary Ball, titled "How the Compulsory Gender Binary Language in the DSM-5’s Category of Sexual Interest Disorders Interacts Negatively with Patients’ Nonbinary and Genderqueer Identities" in the scientific journal, Sexuality & Culture.

That is a really long and technical sounding title that essentially boils down the idea that the very language of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5's) can hurt genderqueer people- in this case, specifically in regard to sexual disorders.


That's an important concept, as the ostensible purpose of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is to provide clear parameters for diagnosis so that people can be treated for disorders and other mental health related issues. That treatment should be helpful, and helping someone is theoretically the opposite of harming someone.


Unfortunately, being helped has often not been the experience that nonbinary and genderqueer people, along with many minorities, have gotten when they seek mental health care. Historically, the mental health field has harmed genderqueer people just like it has harmed so many marginalized populations. Making this problem of the DSM being harmful not new.


What is new, is that the DSM-5's language actually took a bit of step back from what was more gender neutral language around working with sexual disorders in the fourth iteration of the DSM. The DSM-IV had a disorder called Hypoactive Sexual Desire Disorder that was non-gendered. While the more recent iteration removed access to this non-gendered diagnosis and replaced it with disorders called Female Sexual Interest/Arousal Disorder and Male Hypoactive Sexual Desire Disorder.


In part, this was stated to be done in order to make the diagnosis more accessible to women. However, there were certainly ways to do that which would not have been done at the expense of genderqueer and nonbinary people. Further, and something not discussed in the published article, is that this fits a distressing trend of rising gender essentialism in both popular media and scientific literature that historically has harmed both women as well as the trans and genderqueer populations.

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