Continuing the previous Posts we will approach some controversies concerning sexuality (especially the ones related to sexual identity and Gender) taking PA as the main methodological reference (psychodynamic and developmental view). The goal is to highlight a few of the less evident clinical conflicts which might be overshadowed. In the first place, it is important to mention the criterion that will be used. Until the 1950 s, Gender was associated with Grammar (nouns and pronouns). The Second World War following years were precursors of sexual and moral Revolution at the end of the 60s and 70s. It’s witnessed the Gender Role theory arise (from the sexologist John Money), the boom of the sexuality as power theory from Michel Foucault, the Lacan’s structuralism and rise of feminist theories focused on Gender studies, which consider gender as social construction, whose prominent thinker is Judith Butler[1]; in social sciences. From that time on, we have been watching the dispute between scientists, intellectuals and mental health professionals over the nature of Gender: would it be intrinsic to sex, though, be binary- feminine or masculine? Or would it be a social construction, since it assumes “expectations over roles and behaviors associated with each gender/sex[2]? Thought-producers in these fields are, in short, divided into two main areas: 1) natural science researches – interested in biological aspects of the nature of sex. These researches are frequently focused on the “distinctions between male and female species and their influences on gender build[3]”. 2) social science researches – interested in gender understood as a social construction. We will use the nomenclature set by DSM (Diagnostic and Statistical Psychiatric Manual of Mental Disorder), whose goal is to establish boundaries between normality and psychopathology. Although this vocabulary may be a little restrictive to evaluate social identities, for instance, once it assumes biological premises, it is still the most important reference to evaluate psychopathologies and even controversies regarding cultural identities. The idea is not only to make distinctions between psychiatric and psychodynamic approaches[4], but also to point out how they can complement each other. Psychiatry works establishing mental states and conditions from syndromes diagnosis. Syndromes might be defined as a set of signs and symptoms. Disorders, in turn, define syndromes whose etiology is unknown (which means they have an emotional cause) and Spectrum is the variation area between two limits- which defines the level of the disorder. For example, Autistic spectrum goes from low functioning to high functioning autism, whereas Gender varies from feminine to masculine. Starting from this criterion: Transexuals are the individuals who undergo the transition from male to female body or vice-versa. Transgenders are the individuals who, transitionally or definitely feel in a different gender from the one assigned by birth. Gender identity, on the other hand, is a social identity category (not a psychiatric one) and could be included at any point alongside the spectrum. It refers to : “(…) a sense of collective/social Self that generates a common culture among participants[5]”. For today’s cultural claims, this nomenclature is controversial because, just to start, it assumes a binary nature of Gender, i.e, it assumes it is inborn, once not fitting the gender assigned by birth is the same as not fitting the sex assigned by birth. It also brings another arguable issue: not fitting the sex assigned by birth would be the same as not feeling in accordance with what is expected of your sex- roles and behaviors (gender role). This is not a reedition of the old dispute over nature or nurture behavioral boundaries (in this case, genetic or social constructed nature of Gender) nor even a dispute between progressive and conservative views. The controversies related to gender/gender identity are spiced up by its very imprecise terminology. For people interviewed by The Times[6] who consider themselves as non binaries, DSM statistics are imprecise since it counts exclusively on people who have made the transition into the other sex and, thus, have opted for a binary condition. Gender fluids are still excluded, what confirms the incomprehension of existential suffering related to these conditions so far[7].
To be continued in the next Post [1] “(…)Within feminist theory, terminology for gender issues developed over the 1970s. In the 1974 edition of Masculine/Feminine or Human, the author uses "innate gender" and "learned sex roles",[60] but in the 1978 edition, the use of sex and gender is reversed.[61] By 1980, most feminist writings had agreed on using genderonly for socioculturally adapted traits”. In:wikipedia: https://en.wikipedia.org/wiki/Gender [2] It is Worth noting that, by that time, most of the criticism over the supposed biological nature of gender/sex came from the claim for equal civil rights for both men and women. They aimed at equality in salary, at professional opportunities and respect regarding sexual preferences and choices , mainly concerning homosexual orientation. [3] Gender. In wikipedia: https://en.wikipedia.org/wiki/Gender [4] It is worth noticing that , from our point of view, psychotherapy and psychiatry are not excluding. On the contrary, they can and should be complementary, when it is the case, to help patients to recover humor and pragmatism in order to come back to life. In some cases, anxiety is so high that psychotherapy is unable to move forward efficiently. Medication helps with external contention, until the person recovers some balance to be able to dig into the psychotherapeutic process. [5] Social identity refers to the common identification with a collectivity or social category that creates a common culture among participants concerned”. In:https://en.wikipedia.org/wiki/Gender [6] In: The struggles of rejecting the Gender Binary. Bergner, D. in: New York Times magazine. June 4th , 2019. [7] Herman, Jody is a public-policy scholar at the U.C.L.A. School of Law’s Williams Institute, a think tank devoted to issues of gender and sexual orientation. In: The struggles of rejecting the Gender Binary. Bergner, D. in: New York Times magazine. June 4th , 2019.
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