The difficulty I have with this, as a mental health professional, is that I simply don't believe that Gender Dysphoria can be defensibly defined as a a mental disorder in the first place. Psychological diagnoses by definition require that there be something dysfunctional in your thinking, emotions or behavior. Dysphoria is not dysfunctional. It is a completely rational, necessary, even life-saving response to a significant medical condition.

Believe me though, I completely appreciate the concern about losing reimbursement (such as it is) for our treatment...I am currently in the thick of my own struggle reimbursement struggle. It is a maddening bind.

Still, I don't believe the diagnostic definitions as they are currently laid out are tenable. I am extremely concerned about the long-term cost we pay for hanging onto an inaccurate and injuious diagnosis in order to maintain coverage in the short term.

I believe that this diagnosis is and should be medical, not psychological. The problem with this is 1) that while I fully believe the condition is medical, I also acknowledge that the diagnosable symptoms at this point remain psychological in nature; 2) there is not yet an empirical process by which the underlying physiological condition can be assessed. But it's not like this is the first time in the history of humanity that people have suffered from a medical condition whose causes we don't fully understand and whose existence we can't yet test empirically. What do you do in that situation? You take it seriously, study the shit out of it, until you understand the physiological roots. Then fine tune the diagnosis around the resulting research.

But I just don't trust that this understanding will ever occur so long as the framework for the diagnosis is psychological rather than medical.