The (In)Visibility of Childhood Sexual Abuse: Psychiatric Theorizing of Transgenderism and Intersexuality

Abstract

Psychiatric diagnoses related to transgenderism span a wide range of terms, theories, and treatments. Similarly, intersexuality is coming increasingly under the psychiatric gaze, being incorporated into the “gender dysphoria” criteria as with or without a “disorder of sex development” (APA, 2013). Despite the diagnostic link between these two groups, histories of childhood sexual abuse within psychiatric theorizing are particularly visible within “gender dysphoria,” but markedly invisible within medical discourse on “disorders of sex development.” While sexual abuse has been problematically argued by psychiatry to play a role in the development of gender dysphoria, the potentially abusive touching of intersex children’s bodies in distressing or painful ways is legitimized and standardized. Thus pathological accounts of transgenderism and intersexuality are given prominence, whereas non-consensual touching is marginalized. The focus in both accounts is the pathologized body, rather than the normalization of sexualized violence or the experience of such touching as non-consensual and abusive. Ultimately, such discourses function to detract attention from the sexualized violence experienced by those who do not fit into the societally imposed gender binary and continue psychiatry’s framing of gender nonconformity, rather than sexual violence, as pathological.