Friday DSM-V Post

Earlier this week the first draft of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was released for review and feedback. There are a number of issues in the DSM that are relevant to feminist concerns and, although it's hard to discuss them all here, the following is a brief overview.


Premenstrual Dysphoric Disorder, or PMDD, remains the subject of much debate. Recent research suggests that the percentage of women who would be diagnosed with PMDD if diagnostic guidelines were closely followed would be very tiny. Further, most of those who would rightly be diagnosed with PMDD have suffered serious trauma, abuse, or stress in their lives, suggesting that a diagnosis of PTSD might be more appropriate, and lending credence to the claim that the inclusion of this disorder amounts to a pharmaceutical fix of gendered social problems.

A number of changes in the definitions of gender identity "disorders" have been proposed. For the most part, there seems to be improvement in this area. For instance, the old diagnosis of "gender identity disorder" is replaced with "gender incongruence," which lacks the normative judgment and social stigma that the old label of "disorder" carried with it. Similarly, replacing "sex" with "assigned gender" looks to be a big improvement. This terminology is incredibly important in that it reflects and shapes the way we conceptualize various transgender and transsexual experiences. On the one hand, just including a description of one's gender identity in the DSM pathologizes the experience and behavior of a whole sector of the population, which is tragic when you think about the fact that it's our rigid, binary gender system that's the problem rather than the individuals who are unlucky enough to be born fitting into none of the pre-approved categories. But on the other hand medical treatments, and payment for treatments, and research, are all driven by or influenced by the DSM so that not including trans "conditions" in the DSM delegitimizes (in a way) the experiences of trans folk and makes it much harder for them to access the help and support they need. So the treatment of trans issues in the DSM is complex and problematic in a number of ways. For more discussion of this click here and here and here.

Also of interest in the latest version of the DSM is the way eating disorders are defined and diagnosed. One of the biggest changes would make Binge Eating Disorder a diagnosis independent of other disorders. As with gender identity issues, there is also some debate and progress made where word choice is concerned. Rather than characterizing anorexia as a "refusal" to maintain a healthy weight as it was in the DSM-IV, the move is to talk of an inability to maintain the weight, and there's a shift to focus on behaviors rather than choices. For more on these topics click here and here.

There was also an unsuccessful attempt to get a new eating disorder included in the DSM that's kind of interesting/disturbing to me. Orthorexia is the name for an excessive focus on eating healthy foods. Anyone who is obsessed with eating only healthy foods, or has such a strong compulsion to only eat healthy foods to the extent that it interferes with their social functioning or ability to live a normal life could be diagnosed with this. There are a number of things to consider here:

1. Some of the descriptions of orthorexia make it hard to distinguish from anorexia, as the issue becomes low weight, skipping meals, obsessively counting calories, and spending hours thinking about and preparing meals.
2. Obviously an obsessive behavioral element and some problem with normal functioning would be required to get a diagnosis here, but what counts as normal functioning, and how do we define compulsive behavior? I've known teens who decided to be vegetarian or limit other foods from their diets who experienced a lot of tension in their homes because of this. If a child learns about how meat is produced in factory farming and refuses to eat it, thereby angering/inconveniencing their omnivore parents, will this result in coercive diagnoses and treatments?
3. I also wonder about the definition of compulsive behaviors given the marginalized position that eating healthy, or being a "granola" type has in our culture. I'm not obsessive about healthy eating, and my kids eat the occasional store bought birthday cake that's full of hydrogenated oil and artificial colors and flavors and high fructose corn syrup no matter how much it makes me want to cringe. We even for the sake of convenience occasionally eat meals in restaurants where I know these kinds of ingredients are used. OK, it's really not very often, but sometimes... But these concessions don't stop some people from viewing me as a wacky conspiracy-theory type who won't let her kid eat the extremely-healthy-and-delicious school lunch. I see the rolled eyes and the knowing looks. And quite honestly I don't give a fuck about the judgment and gossip of ignorant people who are all too eager to swallow the corporate (or ag-conglomorate) coolaid. But given our tendency to view people who are invested in healthy eating and who don't mindlessly accept every claim of the megacorporatocracy when it comes to food production as paranoid and over-sensitive, what really does count as an obsession and compulsive behavior in this area? I'm a tiny bit wary here.
   
4. On the topic of compulsive behaviors...what looks like a compulsion from one perspective may be a perfectly rational behavior from another perspective. If I know that a particular substance is toxic and I therefore avoid it, this is a rational behavior. But what if I'm living in a culture where many fairly toxic things are widely believed to be healthy, or at least harmless, due to the lobbying power of the corporations who produce these toxic things? Then my behavior seems irrational and compulsive, right? OK, this was just a repeat of number 3. Sorry.
   
5. But this brings me to the real root of my discomfort with the concept of orthorexia. We live in an environment that is pretty toxic when it comes to food. We know that things like hydrogenated oils and high fructose corn syrup and highly processed foods and various chemical additives contribute to real, widespread, devastating diseases like diabetes and heart disease and cancer. But we also have an incredibly powerful food industry and a complicit government that is unable or unwilling to bring about real change. And this leaves us adrift in a fairly toxic environment (where food is concerned). So some amount of suspicion and caution is called for. It is rational to take steps to defend yourself from toxins in your environment. This is what a normal, healthy person will do if they have the means to do it. But it is not a sign of health to be well-adjusted to a toxic environment, and to feel comfortable in it if you are aware of its toxicity. So what does "normal functioning" even mean here? Declining certain foods altogether and choosing not to eat in contexts where the only food available is unhealthy is listed as one symptom of orthorexia, but I think that eating something you know is toxic is a far better sign of mental illness. So here again we have a case where rather than acknowledging the sickness of the environment and the system you're living in, we pathologize the behaviors you develop in response to your environment. And that just seems ass-backwards to me. But maybe that's just me. And maybe it's just my neuroses speaking...

Have a good weekend y'all. Don't ingest any toxins out there...

The Cult of the Olympics

In our culture, the Olympics are sacred. We worship Olympic athletes, obsess over Olympic events, and spend exorbitant amounts of money on Olympic venues. And anyone who questions this obsession or the actions taken by local governments to protect the Olympics or the financial expenditure involved is depicted as irrational, paranoid, nitpicky, or even as a terrorist. Because what person in their right mind would question or critique the Olympics? Isn't that like critiquing Santa Claus or the Easter bunny? After all, opposing something that is Pure Good™ is a sure sign of irrationality, neurosis, evil intentions, or substandard intelligence. Right. So that's the mainstream media (read "dominant narrative") view of things.

So.... why would someone protest against the Olympics? Let's investigate.

Although hosting the Olympics is billed as a wonderful economic opportunity, it rarely ever actually results in an economic benefit for the city chosen to host when all the costs related to hosting are factored in. It's estimated that around $6 billion has been spent in Vancouver. Note that this $6 billion comes from public coffers, and is therefore tax money that is being diverted from other uses (like education, healthcare, social services, infrastructure development, etc). It's hard to imagine that this $6 billion will be recovered in tax revenues and other financial benefits that are supposed to result from Olympic activity.

Vancouver has also cracked down on the homeless population in an effort to make the city more presentable. This is an unspoken part of the agreement made by a hosting city. All the images associated with the Olympics must be bright, shiny, and happy. No seedy underbellies exposed, please. Let's not let reality interfere with out little fantasy. We are the world, and all that. Beyond the social image that must be created, there's always an environmental toll. In this case, forest land had to be disrupted to build a new highway out to Whistler, and all of the land that the new highway and Whistler sits on is land that was taken from native populations. But maintaining the Olympic mystique requires that we ignore inconvenient little facts like this. Because that would tarnish our bright shiny happy image too. The maintenance of this image has resulted in the loss of civil liberties for locals, and the criminalization of law-abiding protesters. Heightened security and surveillance, the refusal to allow protesters from other countries to enter Canada, and the harassment of local organizers in their homes and workplaces contribute to this.

But in spite of these facts, which are easily documented and not disputed by any reputable sources, protesters are still constructed as crazy fringe people in our social dialogue. On Twitter this morning, the Olympic protesters have been compared to Nazis (because exercising your freedom of speech to protest social injustice is totes like committing genocide, you guys), called morons and dickheads and jerks, described as ignorant and "the kids picked last in gym class." Some tweets recommend violence against them and invite protesters to go jump in a ditch, or the river, to stop wasting our time, to stop disrespecting veterans, to stop ruining the dream or their own personal Olympics experience, and on and on and on.

It's interesting that nobody can actually engage with the claims of the protesters to honestly attempt to refute them. Instead all you see is one ad hominem after another. And whenever this is the case, it's a good indication that there is no good response. What if a representative of the Olympics, or one of the poor dears on Twitter whose Olympic experience is being destroyed by peaceful protesters were to just explicitly voice the claim that surely must be thought to justify all of this? What if someone just came right out and said "I know there's a large and heavy human cost that accompanies the Olympics, but it's worth all of that." What if they just said it out in the open like that? Well, the vast majority of the population that has bought into that implicit line of thinking might actually stop and think about it for a minute. They might question whether it really is worth the cost. And some people might decide that it's not worth the cost. And the Olympics would lose some of its mystique and cultural power. But we're very very careful not to allow that to happen. Because that's the thing about cults. They have built in mechanisms that protect them from critique and maintain their momentum and their psychological power.

Video of the Day

In response to this pathetic Superbowl ad.

If embedding isn't working, click here.

Transcript:
I will get up and pack your lunch at 6:30 a.m.
I will eat half a grapefruit for breakfast.
I will get the kids ready for school.
I will ignore your smelly loser friend who is crashing on our couch.
I will make $.75 for every dollar you make doing the same job.
I will assert myself and get called a bitch.
I will catch you staring at my breasts but pretend not to notice.
I will put my career on hold to raise your children.
I will diet, Botox, and wax... everything.
I will assure you that size doesn’t matter.
I will be a lady in the street but a freak in bed.
I will turn a blind eye to your ever encroaching baldness.
I will humor your fantasy baseball obsession.
I will pretend not to notice when you cry at the end of Rudy.
I will watch TV shows where fat, stupid, unattractive men have beautiful wives.
I will allow you to cheat on me with other women.
I will see Paul Blart: Mall Cop. Twice.
I will elect male politicians who will make decisions about my body.
I will listen to Rush and tell you, yes, if there were a gold medal for air-drumming, you would win it.
I will get angry, and you will ask if it’s that time of the month.
I will watch Superbowl commercials that depict men as emasculated and depressed, and I will feel so fucking sorry for you.

Revisionist history, revisited

I have to admit I was a bit surprised by the little debate caused by my earlier post on what it means to call a historical account "revisionist." I guess I just take it for granted that our cultural narratives are, for the most part, told by the dominant mainstream group, and because of this, events impacting marginalized individuals are all too often overlooked or misrepresented. But based on some of the comments and emails generated by that post, I'm reminded that this isn't common knowledge for everyone, and that this idea meets with some resistance from conservative quarters.

So when the story of Shoshana Johnson popped up in one of my news feeds, I thought it was a good opportunity to illustrate my point. Most people in America can tell you who Jessica Lynch is. They can identify her picture and tell you her story. Most people in America have no idea who Shoshana Johnson is. And why is that? Was Lynch's story any more fascinating or heart-warming than Johnson's? Is there some significant difference between the two women that makes Lynch a more admirable character? No and no. Then what is the relevant difference? Why did Lynch receive hour upon hour of media attention while Johnson's ordeal and rescue were barely mentioned? I suspect you know the answer to these questions. But just in case you don't, here's Johnson's analysis: "If I’d been a petite, cutesy thing, it would’ve been different."

So there you have it. If Johnson had looked right, if she had fit into the right demographic, if she had conformed to the image we have of "woman rescued by gallant uniformed men" in the collective imagination, she would have received the media coverage too, and we all would recognize her name and be able to tell her story. But because of who she is, she never became a part of our history.* And that's revisionism, right there, built into the dialogue and thus having a profound impact on the way we remember things.


*"History" with a lowercase "h"... our shared recollection of things...

But what does torture do to the torturer?

This story about a soldier who "waterboarded" his 4 y/o daughter for refusing to recite the alphabet made me think about Jeffrey Reiman's argument against the death penalty. His argument includes, among other thing, a consideration of what it means to have executioners living among us, and what impact having a job like executioner (or torturer) has on a person over time. I don't have the time or energy to lay out the entire argument again, but go read my previous post, because I think it's really relevant to this case:

Torture and Capital Punishment

An excerpt:

Being a civilized nation entails that we turn away from cruel and horrible ways of treating people. We like to believe that we've evolved past the enjoyment of public hangings, drawing-and-quartering criminals, and displaying the heads of beheaded criminals on public fenceposts. But to evolve past this, we need to also move past the necessity to have executioners among us. What does it do to an individual to be the one whose job it is to kill people? Can someone who has this job comfortably live among others in a civilized nation? And what must our self-conception be if we're OK with the fact that our criminal justice system necessitates the existence of executioners?

Video of the Day

Have a great weekend, y'all.

Support our Troops

Via

By all means, protect the poor dears

Gates: Don't rush to lift ban on gays in military
This just in: lifting the ban on gays openly serving in the military will take much longer than expected because we need to take about a year to study the effects of a new policy on "those who will be affected by it." If you're like me, you probably assumed that this referred to gay and lesbian servicemembers, right? But you would be wrong. No, the people who are really affected by the service of gay and lesbian individuals are their fellow servicemembers who are straight. Because, once again, it's all about the privileged majority.

Gates has commissioned two reviews, one by the outside consultant Rand Corp. and one to be led by a four-star Army general and the Pentagon's top lawyer. The reviews will look at attitudes about openly gay service among the armed forces, with particular emphasis on those in combat.
The reviews are supposed to look at the effect that lifting the ban could have on soldiers' trust and reliance on one another, as well as practical and legal issues, military officials said.

First of all, it's not like the new policy would require all gay and lesbian members of the military to openly claim their orientation. The change would just make it so that being open about it would not result in immediate discharge. And secondly, if straight servicemembers have attitudes that make them unable to serve with their gay peers, then they're the problem. So launch some reeducation initiatives, and let it be known that bigotry will not be tolerated. The point is, work on the people who are the problem, rather than making the problem all about the group that has been historically treated unfairly. It's not fucking rocket science.

Video of the Day

This one's for you Burn, and AssMan, and CowboyDan. Don't say I never gave you anything.

For real

Netflix just recommended this movie to me based on my other selections:

When her boyfriend leaves her high and dry in Tokyo, spoiled American tourist Abby (Brittany Murphy) finds solace in a neighborhood ramen noodle house run by a cantankerous old chef (Toshiyuki Nishida), who agrees to take her on as an apprentice cook. But will the dirty grunt work and endless criticism drive Abby away before she discovers the serene beauty in the perfect bowl of soup -- and in herself?

WTF? I'm totally not making this up. Do they know me at all? I have to say my feelings are a little bit hurt. And I'm dying to see the algorithm that goes into generating recommendations. Pandora Radio does it successfully, for free, so it doesn't seem like rocket science. And why didn't they just give this film a subtitle like "Cultural appropriation and shallow comedy produced by flaunted ethnic stereotypes" or something. Then I could at least appreciate the honesty involved.

Maternal mortality rate soars, obese mothers blamed

More women dying from pregnancy complications; state holds on to report

Some interesting facts:

• Doctors and some researchers immediately want to blame the increase in the maternal mortality rate on obesity, even though the research doesn't support this claim at all.
• Most medical professionals completely fail to see any link between the sharp increase in c-sections and the staggering increase in maternal deaths - even when hemorrhaging from C-sections is included as a possible contributing factor.
• Similarly, most medical professionals completely fail to see any link between the increase in inducing labor early, which is standard practice now, and the increase in maternal deaths. Because letting a woman's body go through the natural processes that occur prior to and during labor would just be silly now, wouldn't it?
• The state wasn't terribly enthusiastic about sharing this info.
• When they say "doctors and nurses are eager to help after seeing the numbers," that's probably actually code for "doctors and nurses are eager to increase the number of interventions during labor and delivery," since they cannot seem to get it out of their heads that medical micro-management = safe births and healthy babies. And this isn't likely to change, no matter how many statistics to the contrary and maternal deaths there are.

Lesson to be learned: If you're planning on having a baby anytime soon, your best bet is to stay the fuck away from the hospital. Which is, of course, a luxury reserved for the privileged.

Clarification

Since his death last week, NPR commentators have referred to Howard Zinn as a "revisionist historian" twice. And this strikes me as strange and inaccurate. It only makes sense to call someone like Zinn a revisionist if you believe that there is such a thing as history-with-a-capital-H. Like History from the God's-eye-view, or The Way Things Really Were. Period. But nobody believes that anymore, do they? I mean, don't we all pretty much accept the fact that History is just history told from the dominant, mainstream perspective, and that all the histories that are told from the marginalized view are just as valid; they're just coming from a different perspective? And in this sense, it's not only nonsensical to call the histories from marginalized perspectives "revisionist," but it positions the mainstream view as the right one - the best one - and all the rest as somewhat suspect, if not flat-out illegitimate. So let's cut it out already with the "revisionist" talk.