Transgender, Transsexual and Nonbinary people are under attack in the united states, and worldwide, based on specious arguments that we are groomers, preying on children, and forcing people to transition. 

The truth is, for myself, and many other transsexuals, gender affirming medical care (hormones and surgery along with therapy) has been LIFE SAVING. There are countless stories of transgender youth and adults who have stated, pointedly, that access to affirming medical care is life saving. 

I know it was for me.

 

 

 

 

 

This is why it is so important to remove Gender Dysphoria from the DSM. The DSM is the Diagnostic and Statistical Manual of Mental Disorders, and is used by the American Psychiatric Association to track mental illness in the united states. Gender Dysphoria is the diagnosis that allows transexual people to access gender-affirming medical care, specifically the hormones and surgeries often needed to address Gender Dissonance.

Gender Dissonance is the awareness that one's subconscious sex (aka gender identity) is at odds with one's physical sex. This means someone may be born with male typical sex characteristics, such as a penis and a testosterone-based hormonal system, but as they grow they realize their body is supposed to be female typical, having a vulva/vagina and a estrogen-based hormonal system. This awareness typically develops in childhood, however it may take years or decades before any given individual is able to express this internal knowledge.

The Gender Dysphoria diagnosis is a problematic one because it at least partly conflates Gender Dissonance with the anxiety caused by being perceived to be a different sex than one knows/wishes to be. It locates the distress in the realm of mental illness instead of as a sexual health condition. 

 

This is dangerous for multiple reasons:

1. This mental illness related diagnosis stigmatizes transsexual people. People don't see us as people whose bodies needed to be aligned with our mind, but as confused and sick individuals. In the Trump era, this is being used to further marginalize and attack us, and call us crazy.
   
   
2. Gender Dysphoria is primarily marked by mental distress, rather than a strong internal awareness that one's physical sex is incorrect. Because of the mental focus, anti-trans activists have been successfully able to argue that denying gender affirming care to minors isn't an issue of sex discrimination, which is a protected category.  The 2025 SCOTUS decision United States v. Skrmetti explicitly uses the diagnosis of Gender Dysphoria as the basis on which it allows the denial of care for youth to proceed.
   
   
3. The Gender Dysphoria diagnosis is outdated. The World Health Organization updated their transition related guidelines in 2019, with a medical diagnosis. Gender incongruence is a big deal in terms of diagnoses related to transgender and transexual people, as it is moved "out of the “Mental and behavioural disorders” chapter and into the new “Conditions related to sexual health” chapter." This is important because, "This reflects 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."
   
   

We need to act now to remove Gender Dysphoria from the DSM and replace it with a medical diagnosis akin to the one forwarded by the World Health Organization. This is an imperative to ensure that trans/sexual children and adults continue to receive the necessary affirming care WE NEED. The new diagnosis would undermine efforts to paint us as mentally ill, and allow us to argue in our defense on the basis of sex discrimination. 

American Psychiatric Association and American College of Physicians, you have the power to do the right thing and make this change so you can continue to be leaders in the realm of American healthcare. So you can continue to save lives.