It's not my sense of self that's unstable, it's the world's sense of me: the harms of the construct of 'personality disorders' towards transgender communities
It's not my sense of self that's unstable, it's the world's sense of me: the harms of the construct of 'personality disorders' towards transgender communities
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DOI：
10.1332/147867321x16862340840414
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发表时间：
2023-07-10
期刊：
影响因子：
--
通讯作者：
Porter, Hattie
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文献类型：
--
作者：
Porter, Hattie
研究表明，变性人比顺性人更容易被诊断为人格障碍。虽然这种相互关系是复杂和多方面的，但本文讨论了根植于社会和历史背景的跨性别人群中不成比例的人格障碍诊断率；这表明变性人并不是更有可能患有人格障碍，而是他们更有可能被诊断患有人格障碍。历史上，跨性别身份一直被认为是一种精神疾病的表现，与身份和人格的固有方面相对立。这被认为将对跨性别身份的理解局限于病理学参数，使跨性别社区沉默和边缘化。我认为，跨性别者中不成比例的人格障碍诊断率是这种历史病理的延伸。由于个人价值观和对跨性别经历的不熟悉，临床医生的偏见可能导致对跨性别者人格障碍的不适当诊断。然而，偏见也更深地植根于人格障碍本身的结构中，这似乎是对严格的性别规范和期望的固有病态偏离。这对诊断结构的伦理和本体论基础有影响。
Research indicates transgender people are more likely to be diagnosed with a personality disorder than cisgender people. While this interrelationship is complex and multifaceted, this article discusses the disproportionate rates of personality disorder diagnosis in transgender people as rooted within social and historical contexts; suggesting transgender people are not more likely to have a personality disorder, rather they are more likely to be diagnosed with a personality disorder. Transgender identities have historically been framed as a manifestation of mental illness as opposed to an identity and inherent aspect of personhood. This is argued to confine understanding of transgender identities to the parameters of pathology, silencing and marginalising transgender communities. I suggest the disproportionate rate of diagnosis of personality disorders in transgender people is an extension of this historical pathologisation. Clinician bias may contribute to inappropriate diagnosis of personality disorders in transgender people due to personal values and unfamiliarity with transgender experiences. However, bias is also more deeply rooted within the construct of personality disorders itself, which appears to inherently pathologise deviation from rigid gender norms and expectations. This has implications for the ethical and ontological basis of the diagnostic construct.