Transnormativity in the psy disciplines: Constructing pathology in the diagnostic and statistical manual of mental disorders and standards of care

The psy disciplines (i.e., psychiatry, psychology, psychoanalysis, and psychotherapy) have played a significant role in shaping understandings of transgender people's lives in ways that are transnormative (i.e., by emphasizing one particular account of what it means to be transgender). This article documents (a) how the rise of the psy disciplines created opportunities for transgender people to access treatment (but that such access often required tacit acceptance of transnormativity), and (b) how transgender people have resisted transnormative accounts within the psy disciplines. More specifically, this article explores how both the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, and what is now the World Professional Association for Transgender Health's Standards of Care, have often enshrined highly regulatory accounts of transgender people's lives, while also changing over time, in part as a result of the contributions of transgender people. The article concludes by considering recent contributions by transgender people in terms of the use of informed consent models of care and clinical research, and highlights the ongoing marginalization of transgender people in terms of access to ethical, transcompetent care.