Having gender variance classified as a mental disorder and relying on that for health insurance coverage is a bit of false logic. Most insurance companies in the U.S. exclude treatments for Gender Identity Disorder, but there hormonal imbalances are covered for all kinds of conditions that are not related to GID. People who need to have medical support to manage their gender variance can and should be able to access competent medical care through health insurance, but for the most part right now a GID diagnosis must be avoided if coverage is expected. There are transgender health advocates working to address this issue systemically, both from the activist side as well as from the health care provider side. Thanks, by the way, for your generally excellent responses to the questions raised about this sorely neglected and unfortunately too long obscured topic.
It's Not as Simple as Pink or Blue
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Dallas, TX: Why are people afraid to call this what it is - a mental illeness? This behavior is not legitimate or healthy and is a sickness.
Debra Rosenberg: There's a lot of debate about whether transgenderism is a mental disorder or a biological anomaly. Right now it is classified in the psychiatric manual, DSM-IV, as a mental disorder called Gender Identity Disorder. But homosexuality used to be classified in that manual too—then gays and lesbians campaigned to have it removed. Some transgender people are campaigning to have GID removed too. Others appreciate that it's classified as an illness, mental or physical. Being in the DSM-IV also opens to door to insurance coverage for counseling—something that's mandatory if you want sex-reassignment surgery.
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Los Angeles, CA: I am a 46 year old pre-operative transsexual female. By all outward appearances, I am a robust male. However, for my whole life, people have referred to me as she. Once, my aunt said that I was a good girl. I do not correct people because they are nt mistaken. My question is whether transsexuality is a progressive condition, namely, does it become harder for people to maintain their biological roles as they age? For years, I did nothing to alter my appearance. However, for the past year, I have been shaving my underarms and legs. I get embarrassed when people ask me if I shave my legs. However, why can't everybody explore their feminine side?
Debra Rosenberg: I don't know whether it becomes harder in a biological sense for people to maintain their biological roles as they age. But psychologically we heard many stories of people who grew weary playing roles they didn't think fit them. In the past, most people who had sex-reassignment surgery were at least in their 30s or 40s. (Now younger people are getting it too.)
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