'Is Transgender a Mental Illness?' - Trump's Transgender Military Tweets Spark Rise in Mental Illness Searches

Image: Michael Browning
Trump declared in a short series of tweets on Wednesday that he has decided to ban transgender individuals from serving "in any capacity" in the US military.

"Our military must be focused on decisive and overwhelming victory and cannot be burdened with the tremendous medical costs and disruption that transgender in the military would entail," he wrote. 

Though it's unclear if Trump's tweets will lead to actual policy changes, his apparent decision could affect thousands now serving in the military as well as many military hopefuls.

Trump's words have caused a steep increase in Google searches for terms such as "is transgender a mental illness?", "transgender bible", "Christian view transgender", and "is transgender wrong?"

As recently as the 1980s, homosexuality was considered a mental illness. Since then, public opinion has shifted to reflect increasing acceptance of homosexuality and homosexuals. This shift can even be seen within the Christian church, with all Christian denominations reporting increased acceptance and tolerance of same-sex marriages.

Public opinion and categorization of transgender individuals is also shifting dramatically. One could argue that we are in the epicentre of a culture war regarding transgender rights.

The Shifting Categorization of Transgender

At the beginning of 2017, the Danish parliament became the first country in the world to officially remove the classification of transgender as a mental illness. This came at a time when several Western medical institutions had already stopped seeing transgender individuals as mentally ill.

Though being transgender is still considered "gender dysphoria" in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition), as of 2013 it is no longer classified as "gender identity disorder".

Dysphoria: a profound state of unease; may accompany depression, anxiety, or agitation; opposite of euphoria. 

The language here is important. In previous versions of the DSM, the words "gender identity disorder" pathologized transgender individuals, and made the state of being transgender a problem that needed diagnosing and treatment. The term "gender dysphoria" shifts the focus to the extreme distress caused by "a marked incongruence between one's experienced/expressed gender and assigned gender."

A study published last year in The Lancet Psychiatry showed, however, that the distress and dysfunction experienced by transgender individuals is "more strongly predicted by experiences of social rejection and violence than by gender incongruence itself."

In other words, being transgender is not a mental illness. 

Mental illness in some transgender people, according to this new understanding, may be the logical result of existing in a society that enacts prejudice and government-backed condemnation towards those who deviate from conventional standards of gender and sexuality.

"Stigma associated with both mental disorder and transgender identity has contributed to the precarious legal status, human rights violations and barriers to appropriate care among transgender people," says lead author Professor Geoffrey Reed.

"The definition of transgender identity as a mental disorder has been misused to justify denial of health care and contributed to the perception that transgender people must be treated by psychiatric specialists, creating barriers to health care services. The definition has even been misused by some governments to deny self-determination and decision-making authority to transgender people..."

The World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD), 10th revision, continues to classify being transgender as a mental illness. This may change, however, as the 11th edition is due in 2018.

Many expect that proposed changes -- specifically, a focus on the feeling of gender incongruence, and the removal of transgender as a mental illness -- will be accepted and reflected in the 11th revision of the ICD.