Editing Gender dysphoria (section)

=== Classification as a disorder ===
The [[mental disorder|psychiatric diagnosis]] of gender identity disorder (now gender dysphoria) was introduced in DSM-III in 1980. [[Arlene Istar Lev]] and [[Deborah Rudacille]] have characterized the addition as a political maneuver to re-stigmatize homosexuality.<ref>{{cite book |vauthors=Lev AI |url=https://books.google.com/books?id=LwxvazLRmiEC&q=homosexuality+dsm-iii+transsexuality&pg=PA172 |title=Transgender Emergence: Therapeutic Guidelines for Working with Gender-Variant People and Their Families |publisher=Haworth Press |year=2004 |isbn=978-0-7890-2117-5 |page=172 |author-link=Arlene Istar Lev |access-date=November 11, 2020 |archive-date=January 23, 2021 |archive-url=https://web.archive.org/web/20210123073430/https://books.google.com/books?id=LwxvazLRmiEC&q=homosexuality+dsm-iii+transsexuality&pg=PA172|url-status=live}}</ref><ref>{{cite book |vauthors=Rudacille D |title=The Riddle of Gender: Science, Activism, and Transgender Rights |date=February 2005 |publisher=Pantheon |isbn=978-0-375-42162-4 |author-link=Deborah Rudacille}}{{page needed|date=May 2016}}</ref> (Homosexuality was [[Homosexuality in the DSM|declassified as a mental disorder]] in the DSM-II in 1974.) By contrast, [[Kenneth Zucker]] and [[Robert Spitzer (psychiatrist)|Robert Spitzer]] argue that gender identity disorder was included in DSM-III because it "met the generally accepted criteria used by the framers of DSM-III for inclusion."<ref name="Historical Note">{{cite journal | vauthors = Zucker KJ, Spitzer RL | title = Was the gender identity disorder of childhood diagnosis introduced into DSM-III as a backdoor maneuver to replace homosexuality? A historical note | journal = Journal of Sex & Marital Therapy | volume = 31 | issue = 1 | pages = 31–42 | date = Jan–Feb 2005 | pmid = 15841704 | doi = 10.1080/00926230590475251 | author2-link = Robert Spitzer (psychiatrist) | s2cid = 22589255 | author-link = Kenneth Zucker }}</ref> Some researchers, including Spitzer and Paul J. Fink, contend that the behaviors and experiences seen in transsexualism are abnormal and constitute a dysfunction.<ref name="PsychNews">{{cite news | vauthors = Hausman K | date = 18 July 2003 |title=Controversy Continues to Grow Over DSM's GID Diagnosis|publisher=Psychiatric News|url=http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106462|access-date=2014-05-22|archive-date=2014-05-22|archive-url=https://web.archive.org/web/20140522142507/http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=106462|url-status=live}}</ref> The American Psychiatric Association stated that [[gender nonconformity]] is not the same thing as gender dysphoria,<ref name="What Is"/> and that "gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition."<ref name="DSM-5 fact sheet"/>

Individuals with gender dysphoria may or may not regard their own cross-gender feelings and behaviors as a disorder. Advantages and disadvantages exist to classifying gender dysphoria as a disorder.<ref name="Standards of Care" /> Because gender dysphoria had been classified as a disorder in medical texts (such as the previous DSM manual, the DSM-IV-TR, under the name "gender identity disorder"), many insurance companies are willing to cover some of the expenses of sex reassignment therapy. Without the classification of gender dysphoria as a medical disorder, sex reassignment therapy may be viewed as a cosmetic treatment, rather than medically necessary treatment, and may not be covered.<ref name="Zack Ford">{{cite web| vauthors = Ford Z |title=APA Revises Manual: Being Transgender is No Longer a Mental Disorder|website=[[ThinkProgress]]|url=http://thinkprogress.org/lgbt/2012/12/03/1271431/apa-revises-manual-being-transgender-is-no-longer-a-mental-disorder/?mobile=nc|url-status=dead|archive-url=https://web.archive.org/web/20130202082602/http://thinkprogress.org/lgbt/2012/12/03/1271431/apa-revises-manual-being-transgender-is-no-longer-a-mental-disorder/?mobile=nc|archive-date=February 2, 2013|access-date=April 7, 2013}}</ref> In the United States, transgender people are less likely than others to have health insurance, and often face hostility and insensitivity from healthcare providers.<ref>{{Cite book| vauthors = Mallon GP |title=Social Work Practice with Transgender and Gender Variant Youth|publisher=Routledge|year=2009|isbn=978-0-415-99482-8|location=New Jersey}}</ref> The [[Americans with Disabilities Act]] covers individuals with gender dysphoria,<ref>{{cite news |author=Devan Cole |title=Federal appeals court says Americans with Disabilities Act protections cover 'gender dysphoria,' handing a win to trans people |url= https://www.cnn.com/2022/08/16/politics/americans-with-disabilities-act-transgender-gender-dysphoria/index.html |access-date=5 September 2022 |work=CNN |agency=CNN}}</ref> provides some legal protections against discrimination which may aid transgender people in accessing legal protections they otherwise may be unable to.{{Original research inline|date=October 2024}} Some researchers and transgender people support declassification of the condition because they say the diagnosis [[pathologizes]] gender variance and reinforces the [[Gender binary|binary model of gender]].<ref name="Karl Bryant" />

An analysis of the Samoan third gender ''fa'afafine'' suggests that the DSM-IV-TR diagnostic component of distress is not inherent in the cross-gender identity; rather, it is related to social rejection and discrimination suffered by the individual.<ref name="fa'afafine" /> Psychology professor Darryl Hill insists that gender dysphoria is not a mental disorder, but rather that the diagnostic criteria reflect psychological distress in children that occurs when parents and others have trouble relating to their child's gender variance.<ref name="PsychNews" /> Transgender people have often been harassed, socially excluded, and subjected to discrimination, abuse and violence, including murder.<ref name="Davidson-2012" /><ref name="Giordano-2012" />

In December 2002, the British Lord Chancellor's office published a ''Government Policy Concerning Transsexual People'' document that categorically states, "What transsexualism is not ... It is not a mental illness."<ref>{{cite web|year=2003|title=Government Policy concerning Transsexual People|url=http://www.dca.gov.uk/constitution/transsex/policy.htm|url-status=dead|archive-url=https://web.archive.org/web/20080511211217/http://www.dca.gov.uk/constitution/transsex/policy.htm|archive-date=May 11, 2008|work=People's rights/Transsexual people|publisher=U.K. Department for Constitutional Affairs}}</ref> In May 2009, the government of France declared that a transsexual gender identity will no longer be classified as a psychiatric condition,<ref>{{cite news|date=May 16, 2009|title=La transsexualité ne sera plus classée comme affectation psychiatrique|work=Le Monde|url=http://www.lemonde.fr/societe/article/2009/05/16/la-transsexualite-ne-sera-plus-classee-comme-affectation-psychiatrique_1193860_3224.html|access-date=May 31, 2009|archive-date=February 26, 2018|archive-url=https://web.archive.org/web/20180226213224/http://www.lemonde.fr/societe/article/2009/05/16/la-transsexualite-ne-sera-plus-classee-comme-affectation-psychiatrique_1193860_3224.html|url-status=live}}</ref> but according to French trans rights organizations, beyond the impact of the announcement itself, nothing changed.<ref>{{Cite news |date=May 17, 2011 |title=La France est très en retard dans la prise en charge des transsexuels |trans-title=France is far behind in caring for transsexuals |language=fr |work=Libération |url=http://www.liberation.fr/societe/2011/05/17/la-france-est-tres-en-retard-dans-la-prise-en-charge-des-transsexuels_736344 |quote=En réalité, ce décret n'a été rien d'autre qu'un coup médiatique, un très bel effet d'annonce. Sur le terrain, rien n'a changé. |trans-quote=In reality, this decree was nothing other than a media stunt, a very good publicity effect. On the ground, nothing has changed. |access-date=March 11, 2018 |archive-date=November 30, 2014 |archive-url=https://web.archive.org/web/20141130231929/http://www.liberation.fr/societe/2011/05/17/la-france-est-tres-en-retard-dans-la-prise-en-charge-des-transsexuels_736344 |url-status=live}}</ref> Denmark made a similar statement in 2016.<ref>{{Cite news |vauthors=Worley W |date=May 14, 2016 |title=Denmark will become first country to no longer define being transgender as a mental illness |work=[[The Independent]] |url=https://www.independent.co.uk/news/world/europe/denmark-will-be-the-first-country-to-no-longer-define-being-transgender-as-a-mental-illness-a7029151.html |access-date=March 22, 2018 |archive-date=March 11, 2018 |archive-url=https://web.archive.org/web/20180311201855/http://www.independent.co.uk/news/world/europe/denmark-will-be-the-first-country-to-no-longer-define-being-transgender-as-a-mental-illness-a7029151.html |url-status=live}}</ref>

In the ICD-11, GID is reclassified as "gender incongruence", a condition related to sexual health.<ref name="icd11-gc" /> The working group responsible for this recategorization recommended keeping such a diagnosis in ICD-11 to preserve access to health services.<ref name="pmid27717275">{{cite journal |vauthors=Reed GM, Drescher J, Krueger RB, Atalla E, Cochran SD, First MB, Cohen-Kettenis PT, Arango-de Montis I, Parish SJ, Cottler S, Briken P, Saxena S |display-authors=6 |title=Disorders related to sexuality and gender identity in the ICD-11: revising the ICD-10 classification based on current scientific evidence, best clinical practices, and human rights considerations |journal=[[World Psychiatry]] |volume=15 |issue=3 |pages=205–221 |date=October 2016 |pmid=27717275 |pmc=5032510 |doi=10.1002/wps.20354}}</ref>