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重新审视酷儿诊断:《精神疾病诊断与统计手册》和《国际疾病分类》中同性恋及性别诊断的过去与未来

Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD.

作者信息

Drescher Jack

机构信息

a Department of Psychiatry , New York Medical College, New York University , New York , USA.

出版信息

Int Rev Psychiatry. 2015;27(5):386-95. doi: 10.3109/09540261.2015.1053847. Epub 2015 Aug 4.

Abstract

The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria'. The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process.

摘要

美国精神病学协会(APA)最近完成了一项历时数年的《精神疾病诊断与统计手册》(DSM-5)第五版修订工作。在此期间,有人反对保留DSM中的性别认同障碍诊断,并呼吁将其删除,就如同1973年同性恋从DSM-II中被删除一样。在DSM-5修订过程结束时,性别诊断得以保留,尽管形式有所改变,并采用了新名称“性别焦虑症”。本文作者是DSM-5性与性别认同障碍工作组的成员,目前在世卫组织性障碍与性健康工作组任职。这两个小组都面临着类似的任务:协调患者获得治疗的需求与被诊断为精神疾病所带来的污名。两部诊断手册的不同性质导致了两种不同的结果。作为背景信息,本文更新了DSM以及《国际疾病分类及相关健康问题统计分类》(ICD)中同性恋和性别诊断的历史,以及在当前ICD-11修订过程之后同性恋和性别诊断预计会发生的情况。

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