Proposed Changes to Diagnoses Related to Gender Identity in the<i>DSM</i>: A World Professional Association for Transgender Health Consensus Paper Regarding the Potential Impact on Access to Health Care for Transgender Persons

Abstract

The World Professional Association for Transgender Health (WPATH) has prepared a consensus statement to inform the Diagnostic and Statistical Manual (DSM) 5th Edition Work Group on Sexual and Gender Identity Disorder as it redefines the transgender experience. As part of that initiative, the authors of this article (a designated WPATH work group) looked at options for changing (or not changing) the DSM 5 diagnoses related to gender identity, taking into consideration how each of those options might affect access to care for transgender persons. Drawing on a thorough review of the literature, the WPATH work group undertook to describe the current and possible future states of access to health care; “access” defined according to established human rights measures, the “transgender experience” defined according to current DSM and International Classification of Diseases (ICD) codes. The role of various parties that influence access was considered, including transgender persons, care providers, policy writers, and decision makers in government and industry. A change to the DSM 5 that supports a normative transgender identity with distressed states is recommended in the context of a continuing dialogue between stakeholders.