Is Gender Dysphoria a diagnosis that solicits fraud?

New Criterion, Anthony Daniels, MD

"The object of political correctness not being to spread truth but to exercise power, the more it violates common feeling or opinion while at the same time exercising a moral terror against dissenters, the more effective it is. It is not surprising, then, that it should grow ever more extreme, and attach itself to ever more arcane subject matter. Thus the first article in the edition of the New England Journal of Medicine for July 14, 2016—Bastille Day, appropriately enough, considering that there were only seven prisoners when the Bastille was stormed—was titled “Beyond Bathrooms—Meeting the Health Needs of Transgender People.”

...The article in the NEJM begins:

One might have to go back to the era of racial desegregation of U.S. bathrooms to find a time when toilets received so much attention.

But even the fifth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association puts the prevalence of what it calls Gender Dysphoria Disorder at about 0.005 percent: and the DSM V is not generally conservative in its estimates of prevalence, for example putting that of Dissociative Identity Disorder (DID) at 1.5 percent (that is to say, 3,000 times more common than Gender Dysphoria Disorder), though this condition and its diagnosis have more recently gone out of fashion, having enjoyed a phase of great popularity which gender dysphorics can only envy and aspire to emulate. ...

To mention the psychological peculiarities of one person in twenty thousand in the same breath as the travails of a tenth of the American population before the Civil Rights movement might seem insensitive, not to say insulting, but the politically correct can see offense given only by others, never by themselves. They generally do not have much a sense of humor either, for only they could read the following without a smile at the very least:

bathrooms matter for health. Transgender people who are barred from using bathrooms where they feel safe might feel they have no choice but to suppress basic bodily needs. Delayed bathroom use can cause health problems including urinary tract or kidney infections, stool impaction, and hemorrhoids.

But this is mad. Any decent transvestite—let alone transsexual—could use a women’s lavatory without undergoing the slightest interrogation as to his chromosomal sex.

More importantly, the article demands of the reader that he performs feats of doublethink, according to which he should keep in mind that transsexualism both is and is not an illness:

In 2013, the American Psychiatric Association (APA) revised its guidelines to indicate that being transgender is not a mental disorder and that gender-affirming treatments are a valid focus of care for people who desire them; the APA has included gender dysphoria in its guidelines partly to cover people who have substantial distress or impairment and to ensure access to and coverage of desired medical interventions and treatments . . .

In other words, wishing to change your outward sexual appearance is not pathological, but when you are sufficiently unhappy at not being able to do so at your own expense, you become ill and should be able to do so at someone else’s expense.

This is perilously close to soliciting fraud, for of course anyone can manufacture “substantial distress and impairment” at not getting what he wants."