Sexual and Gender Identity Disorders

Abstract The author responds to Hill et al.'s “Gender Identity Disorders in Childhood and Adolescence: A Critical Inquiry,” Winters' “Gender Dissonance: Diagnostic Reform of Gender Identity Disorder for Adults,” and Moser and Kleinplatz's “DSM-IV-TR and the Paraphilias: An Argument for Removal.” As a clinician, the author is loathe to relegate these conditions to mere legal problems and have those affected by them go to jail as the only consequence where they will not get treated as they would by psychiatry or other mental health professions. The author, who has evaluated over 40 transsexuals for sex reassignment surgery, believes psychiatrists should remain the patient's ombudsman in these procedures. He also does not believe that the diagnosis stigmatizes anyone worse than the stigma that the transsexuals receive every single day. In regard to paraphilias, the author believes there must be some way of differentiating between the normal and abnormal ways in which people get aroused, excited, and fulfilled. The author argues that psychiatrists have multiple roles and even though a diagnosis may be offensive to some, it is still important that society maintain the diagnosis in order for psychiatrists to find a way to save some people from jail and others from themselves.