I found myself reading parts of the WPATH SOC yesterday and I noticed a piece of the SRS qualifications that said words to effect that if you have RLE for a significant period of time (2 years or greater?) and an affidavit from a psychiatrist saying that your judgement is not impaired by any significant mental illness, that is sufficient to qualify for the surgery and still meet SOC guidelines.
I live in a small world called the San Francisco mental health care providers community that is more progressive on queer issues than many other places in the world. A number of psychiatrists and therapists I know don't consider GID to be a pathological condition. Our distress is do more to social pressure than gender identity. Many insurance carriers, including Medicare, will not pay for any services related to transsexualism. For billing purposes it's much easier to treat someone for depression or anxiety related to gender dysphoria. Giving an opinion that a person's judgement is "not impaired" is a much stronger position in terms of
risk management, a fancy way of saying you'll likely prevail in a lawsuit.
Given the financial and legal constraints I wonder if GID is going to remain a workable diagnosis?
