Medical Abuse of GLBT Youth
by Courtney Sharp
In recent years, the medical abuse of youths has become more prevalent, and is, for the most part, being conducted without the awareness of individuals and organizations concerned about the treatment of gay, lesbian, bisexual and transgender youth.
Clearly, transgender youth are at great risk for abuse; however, advocates for gay and lesbian youths should be equally concerned, and should not assume that gay and lesbian youths are not at equal risk. Many gay and lesbian advocates fail to realize that abuses which occurred prior to 1973 to correct the "mental disorder" of homosexuality are now being carried out under the "mental disorder" of Gender Identity Disorder. Adults can argue about the "labels" used to justify the abuse but that does not alter the fact that youths are being abused.
In 1973, the American Psychiatric Association eliminated homosexuality from it's list of mental disorders. However, this elimination did not result in the elimination of homophobia within segments of the psychiatric community. It is still possible for influential "homophobic" psychiatrists to serve on sub-committees which develop criteria for psychiatric diagnoses within the Diagnostic and Statistical Manual (DSM) of the APA.
The publication of DSM-III in 1980, was hailed by gay advocates as a significant breakthrough; however, what received little attention is that a new "mental illness" appeared in the DSM-III in 1980: "Gender Identity Disorder of Childhood (GIDC)." Receiving even less attention is the fact that the criteria for receiving a diagnosis of GIDC are being broadened with each revision of the DSM and that substantial numbers of gay and lesbians are being diagnosed with GIDC. While there are legitimate arguments that children with "true" gender identity disorders benefit from receiving appropriate medical care, recent evidence would indicate that significant portions of children with Gender Identity Disorder are receiving inappropriate and abusive, but approved, psychiatric therapy.
Dr. Susan Coates, a clinical psychologist who runs the Childhood Gender Identity Project at Roosevelt Hospital in New York, the largest gender treatment center for children in the U.S., when asked what can happen in the offices of psychiatrists and psychologists all over the world to children who refuse to behave "like a girl" or "like a boy" replied, " You'd be shocked, you would be very shocked, at what goes on even at this age level." The evidence indicates Dr. Coates is not exaggerating. She fears that these children will be referred to therapists who use "intense behavior modification" and drug therapy. A recently published book, "Gender Shock", exposes these abuses.
In 1980, with the publication of DSM-III, Gender Identity Disorder of Childhood is described as "apparently rare," and it was estimated that approximately one percent of children were affected. In 1994, with the publication of DSM-IV, the condition is stated to occur in two to five percent of children. Further research reveals that the criteria for being classified for Gender Identity Disorder are being broadened with each subsequent revision of the DSM and that more and more children are meeting the less stringent diagnostic criteria and are subject to abuse.
Transsexuality is not becoming more prevalent, although more transsexuals are seeking treatment as they become aware that medical treatment is available. Certainly they do not comprise from two to five percent of children! Most common estimates for the occurrence of transsexuality range from 1 out of 23,000 individuals to 1 out of 40,000 individuals. Transvestitism or cross- dressing is much more common, but even then, estimates are about 1or 2 percent of the population and most of them do not show obvious cross- gender behaviors as adolescents. Most hide their activities, confine cross-dressing behaviors to private settings, and would not be exposed and referred to psychiatrists for treatment. Evidence and logic indicates that substantial numbers of gay, lesbian, and heterosexuals youths who demonstrate behaviors which are considered to be "gender variant" are receiving abusive therapy to correct their gender deviant behavior.
There are few legal protections for these children and youths. The parents are granted broad rights and, if a psychiatrist convinces a homophobic parent that he can cure a child of his or her gender disorder by confining the child to an institution for long term corrective therapy, there is no legal remedy for the child. Children who resist treatment simply meet the criteria for an additional diagnosis of Oppositional Defiant Disorder. If they have actually engaged in sex, they qualify for the diagnosis of sex offender, since it is illegal for underage youths to have sex with each other in most states. In cases of consensual heterosexual sex between adolescents, it is rare for them to be declared sex offenders and placed in programs with convicted rapists. Richard Green, a psychiatrist with extensive experience with treating GID, a member of the GID DSM sub-committee, and an attorney, states in "Gender Shock", " parents have the legal right to seek treatment to modify their child's cross- gender behavior to standard boy or girl behavior, even if their only motivation is to prevent homosexuality." In 1987, Green recommended direct behavior modification activities, discouraging in every way the free expression of cross gender role behavior through negative reinforcement, extinction, and positive role modeling.
In 1995, George A. Rekers, a UCLA and Harvard- trained clinical psychologist with extensive experience with GID, published the "Handbook of Child and Adolescent Sexual Problems" which is designed to assist the general practitioner and pediatrician when he or she is presented with a gender non- conforming child. Reker's behavior modification therapies, rather that being an aberration, are now being presented as a diagnostic and treatment model. Rekers has recently published an article highlighting the success of his therapies with children and has asked the APA to revisit their 1973 decision which eliminated homosexuality from the DSM. In view of recent information offered by Rekers, homosexuality is a mental disorder and is treatable. The motivations of these prominent and well educated psychiatrists and psychologists are not fully understood. It is known, however, that Green and Rekers have received substantial funds through National Institute of Mental Health Grants. At least 1.5 million dollars were awarded by NIMH to study gender deviant behavior since the early 1970's. Reker's himself claims that the NIMH has funded him over a half a million dollars. The biased goals of the research is revealed in the language of the grant applications where references to atypical sex roles, atypical gender identity, modification of deviant behavior, and pre-transsexual behavior are included in the grant proposals. Other agencies funding gender corrective therapies are the Foundation Fund for Research in Psychiatry, the Research Scientist Development Award fund, the Public Health Service's clinical research grants, and the National Institute of Health's Biomedical Research Support grants.
It is extremely difficult to differentiate between a gay, lesbian, transgender, or heterosexual youth! Usually, later, the youth can determine their true identity. A youth who initially identifies as gay, or lesbian, or transgender may be mistaken in their original assessment and may later learn that they fall into another category. Significant numbers of individuals who are female-to-male transsexuals identify as lesbians for many years before they recognize their identity. Indeed, some PFLAG leaders in other areas of the U.S. have children who demonstrate this fact.
There are many understanding and supportive therapists who are not abusive. Morton Shane, M.D. and Estelle Shane, Ph.D, in their article "Clinical Perspectives on Gender Role/Identity Disorder" state, " The fear evoked now concerning the intractable course and outcome of gender disorders in childhood can lead to anxiety and despair, and may not create the optimal atmosphere for learning about and treating such conditions. Our safest stance is one of uncertainty, humility, and empathy.