When a Hybrid Account of Disorder is not Enough

IF 0.7 Q4 ETHICS European Journal of Analytic Philosophy Pub Date : 2021-12-01 DOI:10.31820/ejap.17.3.5
Kathleen Murphy-Hollies
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引用次数: 4

Abstract

In this paper I discuss Wakefield’s account of mental disorder as applied to the case of gender dysphoria (GD). I argue that despite being a hybrid account which brings together a naturalistic and normative element in order to avoid pathologising normal or expectable states, the theory alone is still not extensive enough to answer the question of whether GD should be classed as a disorder. I suggest that the hybrid account falls short in adequately investigating how the harm and dysfunction in cases of GD relate to each other, and secondly that the question of why some dysfunction is disvalued and experienced as harmful requires further consideration. This masks further analysis of patients’ distress and results in an unhelpful overlap of two types of clinical patients within a diagnosis of GD; those with gender-role dysphoria and those with sex dysphoria. These two conditions can be associated with different harms and dysfunctions but Wakefield’s hybrid account does not have the tools to recognise this. This misunderstanding of the sources of dysfunction and harm in those diagnosed with GD risks ineffective treatment for patients and reinforcing the very same prejudiced norms which were conducive to the state being experienced as harmful in the first place. The theory needs to engage, to a surprising and so far unacknowledged extent, with sociological concepts such as the categorisation and stratification of groups in society and the mechanism of systemic oppression, in order to answer the question of whether GD should be classed as a mental disorder. Only then can it successfully avoid pathologising normal or expectable states, as has been seen in past ‘illnesses’ such as homosexuality and ‘drapetomania’.
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当混乱的混合描述还不够时
在本文中,我讨论了韦克菲尔德对精神障碍的描述,并将其应用于性别焦虑症(GD)。我认为,尽管这是一种将自然主义和规范性元素结合在一起的混合解释,以避免将正常或可预期状态病理化,但仅凭这一理论仍然不够广泛,无法回答GD是否应被归类为一种疾病的问题。我认为,混合账户未能充分调查GD病例中的伤害和功能障碍是如何相互关联的,其次,为什么某些功能障碍被忽视并被视为有害的问题需要进一步考虑。这掩盖了对患者痛苦的进一步分析,并导致两种类型的临床患者在GD诊断中出现无益的重叠;性别角色焦虑症患者和性焦虑症患者。这两种情况可能与不同的危害和功能障碍有关,但韦克菲尔德的混合账户没有识别这一点的工具。这种对GD患者功能障碍和伤害来源的误解可能会导致患者治疗无效,并强化同样的偏见规范,而这些偏见规范最初有利于该状态被视为有害状态。为了回答GD是否应该被归类为精神障碍的问题,该理论需要在令人惊讶且迄今尚未被承认的程度上与社会学概念相结合,如社会中群体的分类和分层以及系统性压迫的机制。只有这样,它才能成功地避免病态的正常或可预期状态,就像在过去的“疾病”中所看到的那样,如同性恋和“窗帘癖”。
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来源期刊
European Journal of Analytic Philosophy
European Journal of Analytic Philosophy Arts and Humanities-Philosophy
CiteScore
1.50
自引率
0.00%
发文量
4
审稿时长
22 weeks
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