Columbia University doctoral student, Sahar Sadjadi, MD, with the guidance of Dr. Carole Vance, will undertake comparative research on psychiatric diagnoses and the influence of western diagnostic tools across cultures. The focus of the research will be current clinical practices around gender disorders in children, in both diagnosis and treatment, since 1980, and the use and influence of the diagnostic categories recently revised by the Diagnostic and Statistical Manual of Mental Disorders Task Force of the American Psychiatric Association. The research will be carried out in two clinics, one in Boston, MA, and the other in Tehran, Iran. The researcher will collect data through participant observation in the Task Force and clinics; through interviews with clinicians, patients, and parents; and through study of the Diagnostic and Statistical Manual texts and technical instruments.
The research is significant because it will be the first cross-cultural anthropological study of these particular disorders in children. More generally, it will elucidate the increasing world-wide influence of the Diagnostic and Statistical Manual. The research also will develop new methodologies for moving among the multiple, connected, and unequal scales of global expert knowledge, and local clinical practice. Supporting this research also supports the education of a graduate student.
This project studies recent biomedical developments regarding Gender Identity Disorder of Childhood (GIDC). It examines the relationship between the concept and clinical practice of GIDC,and the links and discrepancies between the production of global expert knowledge and the unfolding of events in local clinics. The research contributes to our understanding of how new treatment ideas and practices emerge and diffuse, as well as how they are received by doctors, family members, and patients. This 18-month multi-sited ethnography studied 1) the revision of the psychiatric category of Gender Identity Disorder of Childhood (GIDC) by the expert committee at the American Psychiatric Association’s DSM 5 (Diagnostic and Statistical manual of Mental Illness) Task Force; and 2) the diagnostic and treatment practices at two major specialized clinics in the US, one mainly psychiatric and one endocrine. The analysis examines how scientific and medical knowledge and practices are shaped by their socio-cultural context and how, in turn, they influence, alter, or confirm cultural beliefs. Important themes include the relation of body, identity and self in the medical approaches to gendered and sexual differences; the status of children as clinical subjects in establishing scientific evidence; and the convergence of medical diagnosis and identity. Culturally complex ideas about gender, identity, childhood, and normalcy support and are in turn produced by these medical practices, and ideas about culture play an important role in expert debates on the global validity of the diagnosis. In addition, the project analyzes changing scientific theories about the brain as the location of gender identity, drawing on culturally specific conceptions of the body and modern accounts of the self.
