This does not mean that our current DSM classifications are irrelevant to the broader assessment of being “queer” in contemporary societies. Clearly, the pathology of contemporary societies help to create or at least exacerbate a variety of mental health issues among those who are “queer” or gender neutral as well as those family members and friends who are living with (and hopefully provided support for) the LGBTQ or gender neutral person. Gender nonconformity is only provided with this label because there are those in our society who believe, with justification, that conformity is damaging their soul (or at least their psyche). The loosing of constraints regarding sexual preferences and expressions is being done because a loving society requires that love be acknowledged in its many forms.
Societal issues related to nontraditional sexual orientation and gender nonconformity can induce diffuse anxiety, depression and even paranoia among those being nontraditional and nonconforming. There might be specific traumatizing events that are associated with societal intolerance and ostracism escalating to physical and emotional violence. Clearly, any DSM diagnosis of sexual orientation or gender identity diffusion must be embedded in a broader assessment-based understanding of the social context within which LGBTQ is operating and in which a stance regarding gender identity is being taken.
Posttraumatic Stress Disorder
It is interesting and perhaps instructive to trace the use of terms to label and describe the kinds of emotional and mental dysfunctions that accompany the stress and threat inherent in combat and directed involvement in warfare. The term “Shell shock” was coined during World War I not by an American psychiatrist, but rather by a British psychologist Charles Samuel Myers. Building on several commonly used expressions (“I am shocked” or “I am in a state of shock”), this term was used to describe a particularly intense form of “shock” that left returning soldiers with confusion of thought (dysfunctional mental processes) often accompanied by a dampening or intensification of emotions (dysfunctional emotions).
A different term was used to label a similar outcome of combat following World War II. The new term was “battle fatigue”. The typical description of this form of fatigue was a bit more detailed then that used to describe “shell shock.” The person diagnosed with battle fatigue was typically numb at first when returning home (or recuperating in an armed forces hospital. This numbness often yielded to a state of depression as well as excessive irritability. Horrible nightmares often were experienced, and the fatigued ex-soldier often was “trigger-happy” leaping up or running way from any loud sound. The depression was often accompanied by “survivor guilt” (why am I alive and well when my comrades were severely wounded or died.
