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Richard Isay, M.D., in a rather lengthy Viewpoints column in the November 21, 1997, issue, proposes that the diagnosis of gender identity disorder in children be deleted from APA’s diagnostic manual. This is a predictable proposal because he believes that there is a biologic basis for homosexuality. This, of course, is not true, but Dr. Isay and others believe it is. It follows logically, then, that Dr. Isay would propose that gender distur-bances in children be viewed as normal.
I do not now propose to discuss the invalid claim of a biologic basis for homosexuality. Others have done so at length and with great clarity. The psychological basis, that is to say the developmental events, that lead to gender disturbances and to adult obligatory homosexuality are overwhelmingly represented in the psychiatric and psychoanalytic literature.
At a lecture Dr. Isay gave at Menninger’s in Topeka, he revealed his extremism "ad absurdum." I asked him that if I, a heterosexual psychoanalyst, converted a homo-sexual patient into a heterosexual person, had I created psychopathology in that person? He stated emphatically yes. Are we to throw out one of the most fundamental aspects of the animal kingdom, namely, the difference between male and female? The distinction between male and female exists in plants and even in languages. What Dr. Isay and others are asking us to do is equivalent to giving a grade of A to a failing student and thereby overlook his difficulties.
Of course, children with gender disturbances should be treated sympathetic-ally by their parents and others. However, children are very pliable, and disturbances in the children invariably reflect disturbances in the parents. Well-trained psychiatrists, and in particular child psychiatrists and child psychoanalysts, know this to be true. Treat the parents, and frequently the child will turn out just fine.
The time is long overdue for the psychiatric and mental health professions to call a halt to the ridiculous claims of those who wish to obliterate certain basic truths about the human condition, human development, and human psychopathology and deny children the help they need so they will become hetero-sexual adults.
Harold M. Voth, M.D.
Topeka, Kan.