Are LGBTQ people closed to who, why

139 8 Queer Perspectives in Psychology To date, psychology has largely closed itself to queer perspectives. Therefore, there are only a few theoretical explanations of a queer self-image in psychology (e.g. Barker / Hegarty 2005; Hegarty 2008; Minton 1997; Riggs 2007; special edition "Queer Theory and Psychology" of the journal Psychology & Sexuality 2011). We understand queer perspectives in psychology as scientific approaches that are shaped by their theoretical orientation towards the concept of deconstruction. Thematically, queer psychologies are interested in the construction processes of sexuality, gender and other social categories and their effects, especially with regard to their entanglement with power relations. In a very general sense, we understand queer research as a critical examination of socially powerful discourses about social categorization and standardization. As we have already described in Chapter 3, the field of queer psychologies is ›manageable‹, especially if we only consider the works that describe themselves as queer, such as the anthologies presented in 8.3 (Clarke / Peel 2007 ; Clarke et al. 2010). The following chapter describes trends in an emerging research area rather than an established subdiscipline. We have provided the following aspects for the presentation: First, the thematic and theoretical orientation of queer psychologies is explained (8.1). The following is a brief description of lesbian and gay psychology as a forerunner of queer psychology (8.2). As we have already explained in Chapter 1, we will forego a detailed description of this lesbian / gay tradition, but give a brief overview here. Furthermore, we present three book projects that take queer perspectives in psychology (8.3). Finally, we discuss one topic in detail as an example, namely queer criticisms of the gender and sexuality-related diagnoses of the classification systems of mental illnesses "International Classification of Diseases" (ICD) and "Diagnostic and Statistical Manual of Mental Disorders" (DSM) (8.4). We decided to present these debates because, in our opinion, it is a particularly good way of illustrating the specifically queer way of thinking and criticizing. This chapter is followed by an excursus on psychoanalysis from a queer point of view. 8.1 Theoretical and thematic orientation In Chapter 7, deconstruction was presented as a queer way of thinking. The criticism of discrete and especially dichotomous distinctions, especially the difference between women and men, as well as their subversive infiltration are characteristic of queer approaches. On the basis of a political and practical demand, queer approaches avoid defining, permanent identity categories, especially if these are not chosen and used by the individual himself. In addition, the concept of heteronormativity (Butler 1991, 1993) plays a central theoretical role. Butler points to the normative intertwining of the two social and hierarchically structured categories ›gender‹ and ›sexual orientation‹. She argues that the social norm of heterosexuality, firstly, devalues ​​other sexualities and, secondly, makes clear bisexuality necessary as a secondary norm. Butler shows that these norms are reflected in a discourse that defines biological dual gender as the supposed origin of social dual gender and heterosexual desire. This connection is presented as natural and serving the reproduction of the species. Heterosexual bisexuality is identified by Butler as the focal point of the power of discourse (and to a certain extent replaces the relationship of domination between men and women as the focal point of patriarchal power). In terms of heteronormativity, queer psychologies focus on deviations from the norms of bisexuality and heterosexuality. Therefore, they mainly work on homosexuality, heterosexuality and bisexuality as well as on trans11 (Clifford / Orford 2007; Johnson 2007; Speer / Green 2007) and intersexuality12 (Hegarty / Chase 2000). The topics of homo- and bisexuality as well as trans and intersexuality are often bundled, which is shown, among other things, by the abbreviations used such as LGBTI (see Clarke / Peel 2007) or LBGTIQ for lesbian, gay, bisexual, trans, intersex and queer. However, it is precisely these designations that also refer to identity-defining categories. The sensitivity to a 11 We use trans as a collective term for transgender, transsexuality and transidentity. Transgender people mostly see themselves as living between the sexes and do not permanently and clearly decide to live as a man or woman. Sometimes, however, the term is also used as a synonym for transsexual, which most often denotes the incongruence of a person's gender identity with their gender assigned at birth. Transsexuals often try to achieve congruence by changing their body - from targeted hormone intake to surgical alignment. The term trans identity was chosen as a self-designation (as opposed to the medical term transsexuality) by people who want to express that their identity is a legitimate way of life and not a pathological condition. 12 Intersex people have physical characteristics that do not allow a clear assignment of male or female gender. 142 8 Queer Perspectives in Psychology queer criticism of identity categories varies from work to work. Some continue to use socially existing categories - despite queer criticism - others try to do without them completely (which usually goes hand in hand with corresponding linguistic difficulties, some of which are solved by creating new words). Therefore, some works cannot be clearly labeled as queer and fall into a transitional area. As an example, we briefly present the development of the “genderism and transphobia scale” by Darryl Hill and Brian Willoughby (2005). The same applies, for example, to the “Heteronormativity Attitudes and Beliefs Scale” developed by Janice Habarth (2008). When Hill and Willoughby (2005) write about discrimination, they show great sensitivity to the effects of societal norms on norm-violators who disregard and undermine gender categories, and to the effects of the powerful discourse of transphobia. When developing their own scale to record prejudicial attitudes, however, they still have to fall back on identity-defining categories such as ›man‹, ›female‹ and the like (cf. e.g. Item 19 of the GTS Scale, Hill / Willoughby 2005: »Female boys should be from their problem will be cured. «). In doing so, they maintain an alleged meaning of the term 'female', which is worthy of criticism from a queer perspective. In contrast to queer psychologies, LGBTI people have long been a taboo subject in mainstream psychology, and in part they still are. This ignorance of LGBTI people is one side of heterosexism (Brown 1989; Ise / Steffens 2000) in psychology. Its other side is pathologization, which is reflected in psychiatric diagnoses such as gender identity disorder (DSM IV). We will go into this under 8.4. Consequently, the queer-oriented journal Psychology & Sexuality excludes articles from publication 143 8.1 Theoretical and thematic orientations that pathologize sexualities (Psychology & Sexuality 2011). Two other queer demands are reflected in the research literature on queer psychology. First, there is the demand for diversity, which arises from people belonging to different classes and cultures or age groups. Even if studies on white, educated and urban gays and lesbians still dominate the field of queer research, there is increasing research into what it means psychologically, for example in rural regions, in strongly religious communities or as black people in the USA as LGBTIQ -Human to live. Linked to this is the question of which special psychological offers are appropriate and helpful for the respective groups of people (whereby research on HIV prevention measures makes up a large part; e.g. Pequegnat et al. 2006; Wilton et al. 2009). Second, there was a demand for non-monogamous forms of life to be taken into account. Accordingly, polyamory has recently been researched psychologically from a queer perspective (Barker 2007; Barker / Langdridge 2009; Morrison et al. 2011; Ritchie / Barker 2006; Wosick-Correa 2010). Polyamory is understood to be a non-monogamous form of relationship in which, with the consent of all those involved, love and sexuality are not only lived with one partner, but (potentially) with several partners. Some understand the questioning of monogamy as a relationship norm not only as a personal concern, but as a queer-political project. Polyamory is interesting as a topic for queer psychology, among other things, because it can affect people regardless of their sexual orientation or gender identity, i.e. regardless of whether they are LGBTI and / or straight, and therefore offers the potential of queer as a topic implement the required inclusiveness in research. 144 8 Queer Perspectives in Psychology 8.2 Lesbian and gay psychology as a forerunner of queer psychology Clarke et al. (2010) cite gay affirmative psychology and lesbian and gay psychology as important precursors of LGBTIQ psychologies. It should be emphasized that queer has not replaced lesbian and gay psychology, but today both exist in parallel, with large content overlaps. Not all of the researchers working in this area describe themselves as queer; many also keep the term lesbian and gay psychology or use it like Clarke et al. (2010) both terms. Lesbian and gay psychology is not presented in detail in this introduction (for a list of publications see the "Selected bibliography of lesbian, gay, and bisexual concerns in psychology: an affirmative perspective"; American Psychological Association 1998). However, their research approach is very similar to the psychology of women presented here. While in one case the scientific blind spots of androcentrism are illuminated, in the other case the psychological life of lesbians and gays ignored by heterosexism is examined (Bohan 1996). Not only the narrowly defined area of ​​sexuality is examined, but also other stations and important elements in the life of gays and lesbians, such as health, age, partnership or parenthood. Much research work (especially early work in the 1970s) pursues the goal of showing that homosexuals are ›completely normal‹ people, partners or parents who do not show any specific pathologies. This tendency towards normalization can still be found today particularly clearly in the area of ​​research on so-called rainbow families (see Clarke et al. 2010, Chapter 9). Many researchers have shown that children with gay and / or lesbian parents do not show any particular development, especially not in the areas of gender and sexuality. Research results like these could be used politically as a forerunner of queer psychology to fight for the rights of homosexuals, for example in the case of the adoption rights for homosexual couples in Germany. However, this normalizing research has provoked criticism from within our own ranks since the 1980s. First, it was criticized that the health term used contained heteronormative ideas (cf. Clarke / Braun 2009). Second, there was a demand to highlight the peculiarities and, above all, the particular strengths of lesbians and gays, instead of measuring them against the norm of heterosexuality (and against what is considered to be ›healthy‹). Laura Brown (1989) includes, for example, the biculturalism practiced by homosexuals. Gays and lesbians are usually able to move in a heterosexual and homosexual culture at the same time, even if they differ greatly from one another. Michaele Ise and Melanie Steffens (2000) emphasize the special ability of lesbians to get along well with their former partners as friends. In contrast, feminist psychologies have often not proven to be the pioneers of LGBTIQ psychologies, even though sexuality is definitely an issue. As shown in this book, for example, sexuality emerges as a prominent topic in the psychology of women (see Chapter 4). For a long time, however, the sexuality discussed here is heterosexual, takes place in fixed, monogamous partnerships and is portrayed from the perspective of white, educated women. The critical work by Eagly on gender differences in partner choice presented in Chapter 5 also shows the heterosexism of feminist psychology: Without commenting on this in a self-critical manner, Eagly only examines heterosexual partner choice. This narrowing of the feminist perspective is criticized by feminist lesbians. They point out the invisibility of lesbian life and advocate research into psychological phenomena in connection with lesbian identities and lifestyles. The result of this criticism of negotiating lesbianism in separate chapters, referred to by Kitzinger (1996) as "token lesbian chapters", is also criticized. Kitzinger argues that this separatism does not question the heterosexism of feminist psychology, as well as of mainstream psychology in general. Accordingly, it demands a real inclusion of homosexuality and thus a consistent questioning of one's own heterosexism. A comparably problematic relationship exists between feminist psychologies and the concerns of trans and intersex people. Hegarty and Cheryl Chase (2000) report the ignorance of feminists towards the problems of intersex people. In various places (Clarke / Peel 2007; Clarke et al. 2010; Johnson 2007) transphobia is described by (some) feminists. However, lesbian and gay psychology must be clearly distinguished from another type of research work. These are studies that, while addressing an LGBTI population, do so in an almost pejorative manner (e.g. Johnson et al. 2007). For example, they try to show that sexual orientation can be recognized using visual cues (e.g. a person's gait). In doing so, they rely both on stable identity categories with regard to gender and sexuality as well as on their supposedly easy definability and they refer to supposedly biological conditions without criticizing powerful discourses about the same. In short, they conduct a psychology of LGBTI people as objects of research “from above”, guided by their mainstream ideas about gender and sexuality. In conclusion, it should be noted that the inclusive LGBTIQ psychologies are definitely a new development. The concept of heteronormativity and the development of queer ways of thinking has had a decisive influence on this. However, the feminist perspective tends to be left out. The queer-feminist perspective favored by us (see chap. 147 8.3 Three exemplary book projects, chapter 1) is seldom found in the area of ​​LGBTIQ psychologies. 8.3 Three exemplary book projects Three interesting book projects that can be assigned to a queer psychology are presented here as examples. This is initially the anthology Out in Psychology: Lesbian, Gay, Bisexual, Trans and Queer Perspectives by Clarke and Peel (2007). Queer, trans, bisexual, gay and lesbian are presented on the one hand as differentiated perspectives, on the other hand as sharing a common concern. This becomes clear from the use of the abbreviation LGBTQ, but also from the common position »out in psychology«. As the authors make clear, the preposition »in« is deliberately chosen: »We are› outing ‹psychology as a discipline that already, if sometimes ambivalently or unwillingly, incorporates LGBTQ perspectives. [...] It is vital that we engage with, and contribute to, the broader discipline «(Clarke / Peel 2007, p. 1). Although one might think that the perspectives gathered in this volume can be summarized under the term queer, the authors give good reasons for listing them separately.They point out that all five positions are marginalized by mainstream psychology, but also mutually by themselves. Clarke and Peel, for example, name voices that advocate a separate psychology for lesbians. This is the only way to prevent specific psychological issues in the lives of lesbians from being scientifically ›forgotten‹ and not being covered up by the dominance of the thematization of male homosexuality (e.g. Jeffreys 2003). Furthermore, Clarke and Peel (2007) show that bisexuality is a blind spot in psychology - it is ignored by mainstream psychology, feminist and gay and lesbian psychology alike. The situation is similar with the trans perspective, 148 8 Queer perspectives in psychology, as has already been shown. The chapter by Clarke and Peel (2007) "From Lesbian and Gay Psychology to LGBTQ Psychologies: A Journey into the Unknown (or Unknowable)" gives a good overview of the diverse - both political and scientific - differences and coalitions between LGBT and Q. From our point of view, however, it should be noted critically that Clarke and Peel do not take up any feminist perspectives and ignore the connection between LGBTQ and feminist psychologies. In the first two introductory chapters there is almost no mention of feminist approaches. If feminism is mentioned, it is almost always different from queer. Clarke and Peel thus operate the separation of LGBTQ and the provincialization of feminism through queer, as we described in our first chapter. But not only feminism, queer is also shortened by this demarcation: From our point of view, for this reason the analytical coupling of sexuality and gender that is characteristic of queer is missing. This is particularly annoying because the authors repeatedly call for the inclusion of other social categories of marginalization (in addition to the category of sexuality), but neither describe this demand as queer, nor emphasize the possibility of coalition with feminist approaches. As an anthology, Out in Psychology combines a wide variety of psychological approaches, political positions and topics, "from positivist or essentialist perspectives to experiential or contextual perspectives, to critical, constructionist and discursive perspectives" (Clarke / Peel 2007, p. 6f.), From L to Q and from historical perspectives to topics such as identity, work, leisure, health, partnership. This range is ensured by the diversity of the authors who publish in the anthology. With the introduction of Out in Psychology 2010 to Lesbian, Gay, Bisexual, Trans & Queer Psychology. An Introduction, Clarke and Peel, together with Sonja Ellis and Damien Riggs, pursue a different strategy. The consistent research approach in all chapters results from the uniform authorship. The understanding of LGBTQ psychologies presented here roughly corresponds to that in Out in Psychology. An enrichment compared to the previous book are the two introductory chapters, of which the first gives an overview of the historical development of LGBTQ psychologies and the second presents research methods. The problems that arise in the creation of meaningful samples in the LGBT sector are reported in detail here. These range from the definition (who is actually a lesbian and when is someone bisexual?) To the recruitment of test subjects to questions of representativeness. Furthermore, Clarke et al. (2010, p. 72f. "This list is supplemented by advice for researchers who do not themselves belong to the group of people examined. 150 8 Queer Perspektiven in der Psychologie" [They] should - reflect on their motivations for conducting the research and the ways in which the findings will be used […] - reflect on their understandings of social marginalization issues […] - develop partnership with members of the community investigated and seek advice on the conduct of their research - communicate effectively with the community […] and be clear about their ethical obligations - avoid making assumptions about what it means to be a member of the community; they should learn about the community and, where appropriate, participate in community activities - be prepared for objection to their research […] - ideally produce research that leads to meaningful outcomes for members of the community "(Clarke et al. 2010, p. 73). In parts two and three of their introduction, Clarke present et al. (2010) Psychological Research Results on LGBTQ People. Part two is dedicated to the main topic of social marginalization and addresses diversity within the communities, discrimination, prejudice and the question of the health of LGBTQ people. Part three looks at the experiences of LGBTQ people "across the lifespan", especially with regard to the topics of youth, coming out, identity development, partnerships, parenthood and family, aging and old age. Clarke and Virginia Braun (2009) present a more generally formulated proposal for a queer feminist psychology. They emphasize that a feminist and queer psychology must be directed against or critically reflect upon the following practices: »(1) The binary construction of sex / gender, with sex belonging to the biological realm and gender the psychological and cultural realm; (2) the reification of gender - the treatment of an idea as a real or living thing; and (3) the regulatory role of psychology in upholding normative conceptions of gender and gendered beings "(Clarke / Braun 2009, p. 239). 151 8.3 Three exemplary book projects They further define: “Here, we are defining a feminist critical psychology approach as one in which assumptions, categories and implications of gender are interrogated within psychology and the wider society. A queer critical psychology goes further - it seeks not just to interrogate or reveal but to dismantle the normative gender and sexuality categories within, and beyond, the discipline "(ibid.). The third book that we are presenting here shows a completely different orientation. It's about heterosexuality. A Feminism and Psychology Reader by Wilkinson and Kitzinger (1993). For this publication, the authors wrote to various women who are self-confessed feminists and are outed as heterosexual or who are not known to be lesbian. They were asked to comment on their heterosexuality from a feminist perspective. In keeping with the queer critique of psychology's heterosexism, Wilkinson and Kitzinger attack the hegemony of heterosexuality in their book by making it in need of explanation and explanation (the journal Psychology & Sexuality pursues a similar strategy by expressing heterosexuality as part of its subject area counts). Instead of implicitly assuming heterosexuality, they address it explicitly and thus lead to a denaturalization of the phenomenon. The authors' revealed homosexuality has another destabilizing effect. The question frequently asked to the authors "what would we lesbians have to say about heterosexuality [...] why would we, as lesbians, want to add to the heterosexual deluge?" (Wilkinson / Kitzinger 1993, pp. 1f.) Already exposes that Heterocentrism in psychology and the "ghettoization" with which one reacts to homosexuality. This reveals the identity assumption that bisexual, homo- or heterosexualities can only be researched by scientists who live the respective sexuality. We think Wilkinson and Kitzinger's book is a very good example of the strategy of deconstruction discussed in the previous section. Although Kitzinger (1996) and Wilkinson and Kitzinger (1993) do not use the term queer, we attribute their work to queer-feminist approaches. It can be assumed that they do not refer to queer themselves, because at the time of the publication of both texts the debate about queer was still marginal. In a later text on heterosexuality they definitely use the term »queer heterosexuality« (Kitzinger / Wilkinson 2010, p. 404). 8.4 Different Discourses on a Topic: Classification into Gender- and Sexuality-Related Mental Disorders Some psychological deviations from heteronormative gender and sexuality are defined as mental disorders in the DSM and ICD. These diagnostic categories are the subject of numerous queer-feminist debates that are also of interest to psychology. Four of these debates are presented here. Institutionalization as a mental illness The two classification systems of mental disorders DSM and ICD have always classified certain forms of sexual orientation and gender as pathological in their different versions. In this context, psychology and psychiatry can be understood particularly clearly as a »institution of meaning« (Saar 2007; see Chapter 7) that encompasses both the dichotomous category »sick / healthy« and bisexuality and the distinctions between heterosexuality and homosexuality as well as other forms of sexuality Orientation (e.g. exhibitionism, sadomasochism) stabilized. On the one hand, there is a dispute here as to whether medical professionals or psychologists have the institutionalized sovereignty to define mental illnesses. This discussion is related, among other things, to the historical development of classification systems and the recent strengthening of the psychological position, which, however, does not belong as a topic in this book. On the other hand, queer feminist and gay affirmative scientists and activists have criticized psychology and medicine for the stabilization of certain norms through the classification systems and in some cases successfully brought about revisions of the classification systems. For example, the diagnosis of "homosexuality" was introduced in the ICD in 1968 and only removed again in 1993. In the DSM, the diagnosis of "homosexuality" was introduced in 1952 and deleted again in 1973. That this diagnosis was linked to the labeling effect and pathologization, such as the forced therapy of homosexuals (which is still practiced by some, despite the deletion of the diagnostic category; see Clarke et al. 2010, p. 12), is to be considered and gives particular importance to the successful revision. Since then, the ICD-10 has included the notice that sexual orientation itself should not be viewed as a disorder. The diagnosis of “ego-dystonic sexual orientation” contained in the ICD-10 must be made if people are dissatisfied with their sexual orientation regardless of the direction of their sexual orientation and want to change it. The DSM IV only contains the category "sexual disorder not otherwise specified", which can also include suffering from one's own sexual orientation. The DSM introduced transsexuality as a diagnosis in 1980 and replaced it in 1994 with the diagnosis »gender identity disorder«, which has been retained to this day. The current version of the ICD continues to list transsexualism as a sub-category of »gender identity disorders«. While homosexuality has been removed from the diagnostic manuals, transsexuality remains in the ICD-10 as a sub-category of gender identity disorders. In addition to transsexuality, the ICD-10 lists 154 8 queer perspectives in the psychology of dual-role transvestism, gender identity disorder of childhood and other gender identity disorders among the gender identity disorders. It is interesting that although the suffering of the person concerned is emphasized in transsexuality (who feels uncomfortable in their body), in transvestism it is emphasized that 'those affected' choose the opposite sex appearance, »in order to enjoy the temporary experience of membership of the opposite sex «(ICD-10). How can pleasure be the hallmark of mental illness? This question arises in the same way for the group of "disorders of sexual preference", including sadomasochism, fetishism or voyeurism. In some cases, for example exhibitionism or pedophilia, it can be argued that other people are suffering from the sexual preference here. However, this does not yet justify the classification as a mental illness, because such actions could ultimately also be defined as criminal offenses. In this way, the manifest behavior would be punished, but the sexual preference itself would not be pathologized. Another argument for the classification as mental illness could be that the people themselves suffer from their deviating sexual or gender preferences - the ICD-10 does not list this condition as a criterion for transvestism or disorders of sexual preference. The main point of criticism of queer feminist psychologies is the normative devaluation and pathologization of transgender, transsexual and people with certain sexual orientations associated with the diagnosis. These diagnostic categories define the boundaries of 'normal' gender identities and gender performances as well as normal sexuality and thus reinforce their normativity. Transsexuality, gender identity disorders or so-called sexual paraphilias form the negative contrast film from which “healthy men” and “healthy women” can and must distance themselves. For this reason, a depathologization and the unmasking of the heteronormative basic assumptions is also 155 8.4 Different Discourses on a Topic… a feminist, but definitely a queer-feminist concern. Johnson (2007) provides an example of a critical examination of the powerful discourse on transsexuality. She describes very impressively that the psychiatric-psychological discourse determines how transsexuals present themselves. People striving for physical gender reassignment are assessed by psychiatrists or psychologists who have normative ideas about phenomena such as femininity, masculinity and transsexuality. Accordingly, the former try to conform to the norms of the latter in order to achieve their goal - diagnosis. An analysis of these entanglements in psychiatric practice with heteronormative positions of power can certainly be described as curled. This also applies to Kessler's (1990) work. It exposes the constructive nature of the gender binary by revealing medical corrections or pathologizations of all bodies that are described as biologically deviant. It shows how intersex children are operated on without medical indication in order to be able to clearly assign them to a gender, which is therefore a purely normative intervention (with considerable physical consequences). Heteronormative entanglement of gender and sexuality By definition, sexual orientation and gender identity have nothing to do with each other. Both terms designate two independent phenomena. As already shown, however, heteronormative discourses combine both phenomena. This can be seen, among other things, in dealing with homosexuality and transsexuality in the classification systems. Jillian Weiss (2003) describes that until the 1950s, transsexuals or transgender people were classified as homosexual and only afterwards sexual orientation and gender identity were negotiated as two separate phenomena. Conversely, it has long been assumed that gays do not want to be men and lesbians do not want to be women. Johnson (2007) confirms that heterosexuality has long been considered a defining characteristic of transsexuality and that individuals were not allowed to undergo gender reassignment if they expressed homosexual tendencies. The temporarily coinciding classification of trans- and homosexuality reveals a historical confirmation of heteronorms. It becomes clear how heterosexual bisexuality as a regular standard is normatively differentiated from deviations (through the diagnosis healthy or sick). Anyone who has a different gender is automatically also sexually different. Kathy Gainor (2000) argues that even today, treatment of children with gender identity disorder is often done to prevent the development of homosexuality. Powerful position through the status of gatekeeper For people who want to carry out gender reassignment in Germany (we have not carried out any research for other countries), the psychiatric / psychological diagnosis of gender identity disorder or transsexuality plays an important role. Both for the "small solution" (change of first name) and even more so for the "big solution" (change in civil status after surgical gender reassignment and induced reproductive incapacity), a psychiatric report is required that diagnoses a gender identity disorder or transsexuality. The same opinion is also a prerequisite for medical measures for gender reassignment, i.e. for the prescription of appropriate hormones or the implementation of surgical measures. Above all, without a corresponding diagnosis, the costs will not be covered by the health insurance companies.Due to this legal situation, psychiatrists or psychologists have the function of gatekeepers. Nobody can get past them who wants to undergo a legal and / or medical gender reassignment process. 157 8.4 Various discourses on a topic. This is particularly interesting because gender identity disorder is the only diagnosis in the classification systems that people can only make themselves. The decisive criterion of the perceived incongruence between experienced gender identity and a biologically differently defined body can only be determined by the individuals themselves, i.e. not by outsiders. Nevertheless, reviewers hold on to their power of definition, as Johnson (2007) points out, among others. From a queer-feminist perspective, the power relations that determine who becomes gatekeeper and who is given the power to define are criticized. Here normative ideas about health play just as much a role as the question of responsibility for psychological suffering and its processing and treatment. For example, with regard to the deletion of the diagnosis from the classification systems, it is relevant to consider the connection between diagnosis and accessibility of medical offers and legal regulations. As an isolated strategy, removing the diagnosis could ultimately target transsexuals or transgender people. More extensive changes in how society deals with gender reassignment must therefore be called for. For example, one could envision public funds being made available for gender reassignment if it is recognized that these people suffer from societal norms of gender. The resulting suffering would then no longer be rooted in an individual pathology but in a social problem of integration. The desirable role of psychologists must also be thoroughly reconsidered. Your powerful position as gatekeeper should be viewed critically. As therapists and counselors, however, psychologists could still serve trans people well if they offer them appropriate support, if necessary and desired, during the entire process of gender reassignment and afterwards. This actual psychological help is often made impossible by the current regulation: Trans people know exactly what to say in order to receive the appropriate diagnosis (Johnson 2007). Individual counseling is not possible on the basis of these stereotyped interactions between patients and therapists. In addition, the responsibility of the psychological profession for trans people ends with a gender reassignment. But it is possible that psychological support for life in the new role - at least in many cases - would be necessary, at least helpful and sensible, especially afterwards. Neglecting cultural diversity Finally, it should be pointed out that the gender identity disorders category creates massive problems in intercultural contexts (Newman 2002). At least the ICD claims to be an international classification system. However, the Western system of normative bisexuality does not do justice to the gender and sexuality orders that apply in different cultures. The same is true for disorders of sexual preferences. Louise Newman (2002) describes that culture-related difficulties also arise in the diagnosis and treatment of (alleged) gender identity disorders in children from families with a migration background. Against the background of these diverse problems and discussions, it is extremely exciting to see how both the ICD and the DSM will be revised in the future. A revision is pending for both diagnostic manuals. We are currently working on the two new versions DSM V and ICD-11, which are to be published in 2013 and 2014. Queer activists are calling for the gender identity disorder category to be lifted, for example in the stop trans pathologization 2012 campaign or in a letter to the DSM V task force written by the Callen-Lorde Community Health Center and the Lesbian, 159 Digression: Psychoanalysis and queer approaches Gay, Bisexual, and Transgender Community Center of New York City (Gaycenter 2010). You are critical of the APA's proposal to replace gender identity disorder with gender incongruency. This revision proposal continues the pathologization of trans people and does not facilitate the accessibility of medical and psychological help offers. The following arguments are put forward for a complete deletion: Nonconformity with gender norms is not in itself a mental illness. The associated suffering does not arise from the phenomenon itself, but from the discrimination experienced. Not the individual, but society is dysfunctional. Specific medical care for trans people is better to be guaranteed with the help of a medical diagnosis rather than a psychiatric one. The psychological problems are covered by other psychiatric diagnoses, for example depression. The diagnoses gender identity disorder or gender incongruency served as a justification for the use of therapies against transsexuality (similar to therapies against homosexuality; see above), which are extremely discriminatory and harmful for trans people. Excursus: Psychoanalysis and queer approaches The relationship between queer approaches and psychoanalysis is ambivalent. On the one hand, many queer, postmodern and deconstructivist theories are (also) based on psychoanalytic concepts. Above all, the theories of Freud and Lacan have been widely received. The work by Irigaray (1979), Wittig (1992) and Butler (1991, 1993) should be mentioned, among others. In none of these works are psychoanalytic theories accepted uncritically. The criticism is directed primarily against the 160 8 Queer Perspectives in Psychology normativity of Freud’s theory. Freud sees bisexuality and heterosexuality as characteristics of healthy psychological development. By this standard, LGBTI people appear pathological. Nevertheless, Freud does not simply use the heteronormative discourse. According to him, neither bisexuality nor the heterosexual fixation of desire are self-evident or natural, but rather the result of a complex development process on which the family (and thus also its culture-specific characteristics) has a decisive influence. Bell (2004) shows that Freud's postmodern approaches mainly adopt this diversity and variability of gender, his emphasis on individuality and the centrality of the body (which Freud always uses as a social body) and his ideas of universal and healthy heterosexuality deny. Overall, psychoanalytic theory can be seen as productive for queer psychologies. On the other hand, many queer psychologists reject psychoanalysis, psychoanalytic organizations and therapists because of their homophobia. This is how Udo Rauchfleisch (1997) describes a study from the 1990s that showed that only six of the 35 depth psychology training institutes surveyed in German-speaking countries allow lesbians and gays to take part in therapy training. The online encyclopedia Wikipedia (2010, article: Homosexuality) reports that the APA pushed through the deletion of homosexuality as a diagnosis from the DSM in 1974 against the opposition of the American Psychoanalytic Association (for which the psychoanalytic organization apologized in 1991). These highlights of psychoanalytically based homophobia advise caution when dealing with psychoanalysis. Nevertheless, the baby should not be thrown out with the bathwater and psychoanalysis categorically rejected - it is theoretically far too diverse and interesting for this.