I now favor Gender Dysphoria, from a Greek root for distress, as a more descriptive title, but with a much more precise definition than proposed by the APA (see http://tinyurl.com/atk2png). It’s not a perfect term, but both “dysphoria” and “incongruence” are immensely better than Gender Identity Disorder, which was specifically intended by its key Clarke Institute authors to imply “disordered” gender identity– suggesting that our identities are in themselves pathological and represent confusion. The current GID title and diagnostic criteria were crafted to serve a business model of gender conversion/reparative psychotherapy.

I share your concern about mental disorder diagnosis for a medical problem with a medical solution. In the long term, I would like to see a new coding in a non-psychiatric section of the ICD that would obsolete the need for a DSM coding in North America (and the current psychiatric coding in the ICD).

Finally, it’s important to not forget the unconscionable Transvestic Disorder category in the DSM-5, which explicitly targets transsexual women and men and promotes Blanchard’s scientifically bankrupt theories of “autogynephilia” and “autoandrophilia.” This category needs to be deleted entirely.

While the justification for exclusion based upon “Current or history of psychosexual conditions (302), including but not limited to transsexualism, exhibitionism, transvestism, voyeurism, and other paraphilias”, may be removed to a certain extent, we should not forget that genital surgery for the purposes of transition constitutes an additional justification for exclusion: “History of major abnormalities or defects of the genitalia such as change of sex (P64.5) (CPT 55970, 55980), hermaphroditism, pseudohermaphroditism, or pure gonadal dysgenesis (752.7).”

The interesting thing about this is that waivers may also be requested and theoretically granted. Authority to grant waivers rests with the Secretaries of the various departments and the Commandant of the Coast Guard.

Here is an excerpt from something I wrote some time ago:

“While I am an advocate of removal of diagnoses related to gender identity and expression from the DSM, I agree with Mara Keisling that lifting of the DoD medical restrictions that either disqualify one from service or qualify one for separation from service should not be dependent on removal of the diagnoses…”

“If it is in fact the case that it is DoD policy to (as stated in the above referenced DoDI):

“Ensure that individuals under consideration for appointment, enlistment, or induction into the Military Services are: (1) Free of contagious diseases that probably will endanger the health of other personnel. (2) Free of medical conditions or physical defects that may require excessive time lost from duty for necessary treatment or hospitalization, or probably will result in separation from the Service for medical unfitness. (3) Medically capable of satisfactorily completing required training. (4) Medically adaptable to the military environment without the necessity of geographical area limitations. (5) Medically capable of performing duties without aggravation of existing physical defects or medical conditions.”

…then as far as I can see, there is no valid reason why the conditions noted as being unsatisfactory are valid concerns. Any medical expert familiar with the treatment of transgender and/or transsexual patients can tell you that there is no reason why a trans person in good health should not be able to meet the same physical performance requirements of other soldiers and meet the criteria of DoD policy I note here merely on the basis of being trans.”