• Should the diagnosis of gender dysphoria be retained in the DSM system, changed (and if so, how?), or simply dropped?

Explain. One of the most controversial issues that has long plagued the DSM system is whether to classify transgender identity as a mental disorder. The previous edition of the DSM, the DSM-4, diagnosed people with transgender identity as having gender identity disorder

(GID) if they experienced significant discomfort with their designated gender or gender roles. However, many people—including many advocates in the transgender community—argue that “difference”

should not be equated with “disease” and that the term gender identity disorder unfairly stigmatizes people whose identity is different than the norm by implying that they suffer from a mental disorder by dint of their gender identity.

We noted that the term gender identity disorder was replaced in the DSM-5 with a new diagnostic term: gender dysphoria. This new diagnosis emphasizes the intense discomfort or distress that transgender people may experience due to a mismatch between their gender identity and their designated gender. This change in labeling underscores the view that we shouldn’t consider gender identity itself to be a mental disorder. Rather, the emphasis is now placed on the discomfort that may accompany the perceived mismatch between one’s gender identity and one’s assigned or designated gender. However, it remains unclear whether the use of the more neutral term gender dysphoria will quell the debate.

Some people argue that whatever distress people with transgender identity may experience does not reflect a personal struggle with their gender identity so much as it does the many stresses and difficulties they face adjusting to living in a society that stigmatizes and discredits them.