u235

I know that labels can mean a lot, especially medically and legally. But there's another category that, to me, makes the most sense: reality.

SAN FRANCISCO (AP) -- Does a woman who strongly believes she was meant to be a man have a mental condition or a medical problem? Is a man who cross-dresses in need of psychological help? What about a boy who pretends to be a girl in make-believe games and chooses only female playmates?

The nation's psychiatric establishment is wrestling with these questions, among others, as it works to overhaul its diagnostic manual for the first time in almost two decades. [..] The most symbolic change under consideration so far for the manual's fifth edition, known as the DSM-V for short, is a new name for Gender Identity Disorder, the diagnosis now given to adults, adolescents and children with "a strong and persistent cross-gender identification." In the manual's next incarnation, individuals displaying "a marked incongruence between one's experienced/expressed gender and assigned gender" would be diagnosed instead with "Gender Dysphoria," a term that comes from the Greek word for emotional distress.

Once you're born your gender, as defined by the number of X and Y chromosomes you have, is fixed. Exempting those with medical disorder who have more than two, the rest of us are firmly in the physical category of either male or female. Now whether your mind agrees with that is a different issue entirely, but since birth we're labeled, tagged, printed and numbered, one of the key attributes that goes down to define a specific individual is gender.

Keep in mind, changing your external characteristics will *not* change your DNA. Murders, babies, will all still point back to you regardless of the edits you may have made to your appearance. This is what I was referring to when I said "reality" because like it or not, your DNA is your ultimate reality, binding and immutable. how you want to present yourself, however, is only limited by your imagination. And money. Which is where the real problem comes in...

"Let's say someone born a woman walks into my surgical office and says, `I would like my breasts removed.' What's the diagnosis?" Drescher said. "The procedure is a mastectomy, but if there is no diagnosis, it is cosmetic surgery and your insurance won't pay for it."

It's your body, how you want to modify it is your business, but how people view that modification is theirs. While it may help that the APA can add ambiguity to the definition of 'transgender' it will not resolve custody issues or encourage health insurance companies to ante up for surgery (remember they like premiums, not payments.)

The bottom line is this: being transgender *is* a difficult thing. Not calling it a dysfunction any more may make it seem more acceptable, but it won't make all the problems go away. If anything it simply foists the challenge of decision-making onto other, less prepared, less caring agencies. Is that better? It's hard to say, but changing the label won't change the body you're born with. That's totally up to you.