Gender Dissonance

Abstract Since its appearance in 1980, the diagnostic category “gender identity disorder” (GID) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) has sparked concern among gender variant people and their advocates that it contributes to hurtful stigma and social barriers faced by gender variant individuals, while at the same time it contradicts the medical legitimacy of sex reassignment for the treatment of gender dysphoria. This paper examines the GID diagnosis of adults and adolescents and the social and medical consequences posed by its implication of “disordered” gender identity. Parallels are drawn to the removal of homosexuality and ego dystonic homosexuality from the DSM in the 1970s and '80s. At issue is the label of mental illness for behaviors that are otherwise ordinary or even exemplary based only on natal anatomical sex. Finally, a path forward is proposed to replace GID with a new diagnosis unambiguously defined by chronic distress rather than social nonconformity.