Whose Bodies Count? How Experience Working with Transgender Patients Shapes Conceptualizations of Transgender Identity

Abstract

In 2013, the American Psychological Association released the fifth edition of the <em>Diagnostic Statistical Manual</em> (DSM). Previous editions of the DSM had used the term “gender identity disorder” (GID) to classify people who felt that the gender they were assigned at birth was incongruent with the gender identity they currently hold. The DSM-5 task force devoted to sexual and gender disorders spent years receiving feedback about the diagnosis and concluded that the gender dysphoria (GD) diagnosis would replace GID. This research project seeks to understand the personal conceptualizations of transgender identity advanced by medical and mental health practitioners, particularly in light of the newly constructed GD diagnosis. I conducted 15 semi-structured, in-depth interviews with therapists, psychologists, and psychiatrists in New York City; Westchester County, New York; and Los Angeles. I found that practitioners with extensive experience working with transgender patients overwhelmingly advanced social constructionist and agential conceptualizations of transgender identity, whereas those with some or no such experience overwhelmingly advanced essentialist formulations. In addition, I inductively found that practitioners who received “feminist teachings” tended to advance a social constructionist understanding of transgender identity, but those without this background maintained mostly essentialist conceptualizations of transgender identity.