Ophelian, Annalise (Director). (2009). Diagnosing Difference [film]. San Francisco, CA: Floating Ophelia Productions, LLC.
“My difference isn’t pathological. It’s just infrequent.” This quote, spoken in the first minute of the film, really sets the tone for this powerful documentary. Diagnosing Difference presents the experiences of 13 transgender activists, artists, health providers, and scholars with the DSM-IV diagnosis of gender identity disorder. As Susan Stryker states, “the DSM-IV has tremendous power over people’s lives.” Doctors hold all the power in the provider-patient interaction, and trans people must say the right things in order to get care.
Miss Major, an original Stonewall riot survivor, talks about how trans women shared their stories together in order to build the proper narrative to help each other get care. Gatekeeping has traditionally been very racist and classist, in addition to only recognizing one narrative. Various interviewees discuss how there are many gender identities beyond the binary, meaning there is not really a monolithic “transgender community”. There are many different transgender communities, and lots of people do not identify as being part of a trans community at all. Furthermore, medical and/or surgical transition is desired by some trans people and not others, and it’s important to understand that even somebody who wants to have medical or surgical transition-related care often cannot due to financial cost, gatekeeping, or health reasons.
What struck me most about this film was the diversity of experiences and viewpoints. I appreciated hearing people’s opinions about gender identity as a pathology, and the tensions between the need for personal authenticity and the need for patient care. A common sentiment was that society creates the problems for transgender people: “Most of our problems have to do with transphobia, not with being trans” (Jeanna Eichenbaum). And “I don’t think most people suffer from gender identity dysphoria, I think the world suffers from gender perception disorder” (Cecilia Chung).
While I was surprised that the filmmaker chose to remain silent (an interesting discursive choice; an attempt at removing any hint of bias perhaps?), the interviews are fantastic and I wish I could hear them in their entirety. Diagnosing Difference was an official selection for both the 2009 San Francisco Frameline LGBT Film Festival and the 2009 Montreal Image + Nation International LGBT Film Festival. This film is vital for medical and mental health providers; even though there are now new standards of care for transgender people, many providers have not yet gotten the memo that transgender people are people and deserve respectful care.