The Diagnostic and Statistical Manual of Mental Disorders (DSM) has a number of features. First of all, every disorder is identified using a name and a numerical code. In addition, the manual provides the criteria for diagnosing each disorder as well as establishes subtypes of a disorder and examples that would illustrate the disorder. The manual goes further by addressing the typical age of onset, culturally related information, gender-related information, prevalence of a disorder, typical clinical course of a disorder, typical predisposing factors of a disorder and genetic family patterns of a disease (Summers, 2009). The DSM-IV is a tool that is used by mental health practitioners and social service workers. As has been demonstrated prior, the manual provides many types of diagnoses, but there has been concern that the diagnoses are biased. Several types of bias, including gender, culture and ethnic bias, have been associated with how disorders are assessed.
Gender biases might have inherently been incorporated into the DSM because the creation of the DSM has been consistently and predominately handled by white males. The development of the DSM includes defining healthy and unhealthy behaviors (Zur and Nordmarken, 2010). Several factors have been pinpointed as specific gender biases, including “…attributes traditionally classified as feminine, such as the tendency to value emotional attachment and interdependence and the tendency to be cautious in expressing disagreement with others, have been codified as personality or other disorders” (Zur and Nordmarken, 2010). The creation and diagnosis of Premenstrual Dysphoric Disorder (PMDD) is viewed as gender bias because there is no equivalent diagnosis pertaining to testosterone deficiency in males nor are there gender-neutral categories for hormonal imbalances (Zur and Nordmarken, 2010).
Personality disorders have a sex prevalence rate and there has been some suggestion that those rates reflect gender bias. The bias concerns derived from the “conceptualization of personality disorders, the wording of diagnostic criteria, the application of diagnostic criteria, thresholds for diagnosis, clinical presentation, researching sampling, the self-awareness and openness of patients and the items included within self-report inventories” (Butcher, 2009, p. 356). Studies have failed to prove that there is significant gender bias in the DSM. However, research has showed there is gender bias within clinical judgments. For example, gender related items would be included within self-report inventories (Butcher, 2009). Clinicians tend to judge female patients as being mentally ill more readily than male patients, even when the symptoms are the same. Moreover, women are more likely to be cast as overly emotional, have a need for mood-altering medication and require ongoing monitoring/treatment (Zur and Nordmarken, 2010).
Sexual orientation has also caused considerable bias. Homosexuality was...