The Diagnostic and Statistical Manual of Mental Disorders is a document published by the American Psychiatric Association, currently being reworked into its fifth edition, which provides a set of standards and criteria by which mental disorders are to be classified and diagnosed.

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For a profession centred around telling people what is wrong with them and how they should live their lives, psychiatry has a surprisingly good reputation. This article, however, isn’t about what psychiatry does inside people’s minds but rather what it does in the world outside of them.
Despite the complexity of the theory that underlies it, psychiatry, like all other sciences, is based on some assumptions about the world. This isn’t an issue unto itself, but it does mean that it might be wise to think about the way we approach “socially deviant behaviour.”

In short, psychiatry is, and traditionally has been, something practiced by privileged members of Western societies on people from marginalized communities. From demonic possession to the afflictions in the DSM, the labels we apply — sometimes forcefully — to some segments of society are the fabrications of their creators and not god-given.

People in positions of privilege tend to categorize others for a reason, and generally, it’s a less than respectable one. We must then keep in mind who is diagnosing whom; psychiatry takes place inside the office, but its effects are largely in the world outside. With this fact in mind, as well as the historical trend of medicalizing people to marginalize them, it would then probably be wise to take a closer look at the way we categorize and treat those whose behaviour doesn’t conform to societal norms.

DIAGNOSES THROUGHOUT HISTORY

Abnormal Ethiopian Perception/Dysaethesia Aethiopica

The first of two disorders identified by American physician and racist Samuel A. Cartwright, dysaethesia aethiopica was a term created in the 19th century to offer a medical explanation for what whites at the time saw as rampant laziness and “rascality” among the black population.

Drapetomania

Cartwright’s second contribution: caused by white people who “made themselves too familiar with [slaves], treating them as equals,” drapetomania was the condition that caused black slaves to imagine that a better life was possible and compelled them to flee. The prescription for drapetomania was — contain your surprise — whipping.

Hysteria

The catch-all diagnosis for women who, for some reason, were discontented with some aspect of men running their entire lives. Sometimes treated with sex, masturbation, and the use of electric vibrators, this illness was removed from the DSM in 1980, but luckily for everyone, the treatments have remained.

Homosexuality

Removed from the DSM in 1980, homosexuality was a diagnosable condition which allowed the forceful institutionalization of people who were physically attracted to those of the same gender and had the gall to express it.

Gender-Identity

Still present in the DSM, this diagnosis is for those whose gender (between their ears) does not line up with their sex (between their thighs) in a way that society finds acceptable. This diagnosis, for the time being, takes control of their bodies away from trans* individuals and puts it into the hands of (probably cisgendered) doctors.