Some More Thoughts on Gatekeeping

The truth is, whether you call it “Gender Dysphoria” or “Gender Idenitity Disorder,” I find the fact that my identity is considered to be a psychiatric condition somewhat degrading. However, I’m not sure whether it’s possible, in practice, to ever completely de-pathologize.

Of course, the comparison is always made to homosexuality; same-sex attraction is no longer a diagnosis, why then should transgenderism be? The problem, though, is that in many (probably most) cases, transgender individuals seek-out specific medical procedures as a direct result of their transgenderism–procedures without which quality of life would be severely impaired by depression or suicidal tendencies. Simply put then, transgender identification is at least partially a medical condition in that it sometimes requires medical intervention. Moreover, some of these interventions can be dangerous (and here I am referring to hormone replacement therapy) without supervision by a specialist.  And when it comes to surgical intervention (sexual reassignment, in particular), how would you go about accessing such a medically-necessary procedure (and more to the point, having it covered by health insurance) without having a mechanism in place to show that in your case it is, indeed, medically necessary?

Don’t get me wrong; I am not especially enamoured of the diagnostic criteria. But with the medical establishment being structured the way that it is, I’m not honestly clear how you could ever get around it entirely.