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Late in May 2019, the World Health Organization (WHO) issued a statement that, in the then-forthcoming eleventh edition of the International Classification of Diseases, the diagnostic categories of “transsexualism” and “gender identity disorder of children” would be replaced with “gender incongruence of adolescence and adulthood” and “gender incongruence of childhood,” respectively. Both moved out of the “Mental and behavioural disorders” chapter and into the new “Conditions related to sexual health” chapter, in order to reflect “current knowledge that trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such can cause enormous stigma” (WHO, 2023). This development signified an important shift towards the long awaited depathologization of trans identities/lived experiences with the endorsement of a global authority. Up until now though, the dominant view in psychiatry and psychoanalysis regarding queer and trans patients remains that of pathologizing hermeneutics.
Six months later, Paul B. Preciado, a trans man, philosopher, and writer, was invited to give a talk during the 49th Study Day of the École de la Cause Freudienne on the theme “Women in psychoanalysis”, the same talk that was later published in its entirety as the book, “Can the Monster Speak? Report to an
Academy of Psychoanalysts“, which we are reviewing in this article. Preciado begins his recollection of that day mentioning his speech caused an earthquake, but another earthquake had already happened six months before, after decades of long, slow, and laborious shifting of the tectonic plates of mental health institutions.
The earthquake Preciado describes was unavoidable, no matter how accommodating he tried to be; accepting to talk about his being a trans man, in a day devoted to Women in Psychoanalysis, delineating his path, being frank about his assigned gender and expected gender role as a death sentence: “So crushed was I between the wa