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 www.gendercare.com/library/GENDERASILLNESS.html

This article calls to light the ambiguity and unnecessary nature of incorporating transexual 'disorder' into the DSM (Diagnostic and Statistical Manual of Mental Disorders). I think it raises some excellent points that expand upon Roughgarden's brief descriptions involving Transsexuality in the DSM. 

I did find that in the DSM-V (a more recent version than the one discussed here), 'men' is replaced with 'people' in the description of Transvestic Fetishism. 

The article brings home the point that the DSM's Gender Identity disorder and Transvestic Fetishism stigmatizes individuals. 

Historically, the a major function the DSM manual is to provide diagnostic criteria in order to make a diagnosis of mental illness for the purposes of medical insurance.  It validate someone's condition. But not all medical insurance companies today offer health care for people wanting to have GRS surgery and hormonal medications. But maybe the healthcare support for these individuals will improve in the future, providing a potential function for the DSM to validate their need for medical intervention and financial support. 

RoughGarden suggests that the categories concerning gender identity disorder should be eliminated completely from the DSM. I definitely see where she is coming from. However, I do also see that there can be significant psychological issues, particularly in children, who have an atypical self-identity in the realm of gender. However, I think that the bulk of these issues come about from the fact that society (and many times parents) are not accepting of the condition. So, I think that an atypical gender identity should be classified a mental "disorder," but I do think that mental illnesses such as depression can definitely arise in people (particularly children) who are the victims of others who see it as "unacceptable" and as a "disorder."