For those who think it's okay for TG to be a mental disorder

[Just Kate]

I agree Miniar.  If you treat the depression as the mental disorder and the depression is caused my by dysphoria, then you don't treat the cause just a symptoms.  Thinking about it along the same vein, if you treat the depression and it goes away, does it follow you don't need to be treated for the dysphoria since the symptoms (ie depression) are controlled?

We cannot have it both ways.  If depression is the only symptom of the disorder, treat the depression and you no longer have the dysphora - which means a nice mix of anti-depressants would be all we need.  If the dysphoria has other symptoms, if you treat the depression, you don't really stop the dysphoria, just mask it.  So the underlying problem is the dysphoria - another disorder apart from depression - something worthy of being in the DSM of its own right.

[Cruelladeville]

*Homosexuality is not a mental illness. But being unduly distressed over it, for any reason, is*....

I would agree.....

But let's look at this statement in a slightly new way shall we?

*Heterosexuality is not a mental illness. But being unduly distressed over it, for any reason, is*....

So why should being diagnosed with GID continue to be classed immediately as a mental illness...and in any different way to two previous statements?

And let's not forget... not long ago (in the UK) you could be locked up in Prison for being a practising homosexual.... at that point a criminal act.

UK law has changed btw....I have a female birth certificate now which enables me to marry a man with full legal blessing and all the spousal rights any GG woman would enjoy...

[Fencesitter]

*Homosexuality is not a mental illness. But being unduly distressed over it, for any reason, is*....

I would agree.....

But let's look at this statement in a slightly new way shall we?

*Heterosexuality is not a mental illness. But being unduly distressed over it, for any reason, is*...

Indeed, the DSM IV has a diagnosis which includes both cases, it's described as being unduly stressed about one's sexual orientation. So straight people who suffer from being stressed can get their therapy paid.

[Julie Marie]

Indeed, the DSM IV has a diagnosis which includes both cases, it's described as being unduly stressed about one's sexual orientation. So straight people who suffer from being stressed can get their therapy paid.

Yes, but you don't see heterosexuality listed as a mental disorder, nor was it ever.  Stress, regardless of the cause, is listed.  The disorder is stress, not homo- or hetero- sexuality.  It's about how a person reacts to it, not the "it" itself.  Which is what I've been saying about TG.

According to MHA, Utah is the most depressed state in the US.  Over 70% of the Utah population is Mormon.  Mormons are known to be very repressed.  Would you say Mormonism is a mental disorder?  Or is being a Utah resident the disorder?

[Cruelladeville]

Astutely put Julie Marie...

Let's get a 21st century take on the condition, (please) not a quasi-luddite one based on outmoded 18th century blinkered thinking...

Nice helm....btw....(sailing is one of my ongoing passions) stand by for the tack ...sheet in.... okay.... ready about .... lee ho.....

[Cindy Stephens]

Does heterosexuality or homosexuality involve surgically removing/reordering your sex organs in a major operation?  I suspect that if homosexuality did, then it would still be in the book.  I'm not a Luddite about it, just practical.  A surgery that could possible cause death, (they all can), failure of goal leaving sexless, etc.  People (as in powers that be) see this as serious stuff.  It probably will be for quite a while.     

[Arch]

Does heterosexuality or homosexuality involve surgically removing/reordering your sex organs in a major operation?  I suspect that if homosexuality did, then it would still be in the book.  I'm not a Luddite about it, just practical.  A surgery that could possible cause death, (they all can), failure of goal leaving sexless, etc.  People (as in powers that be) see this as serious stuff.  It probably will be for quite a while.   

True, but on the other end of the spectrum, few people question the mental stability of a person who wants corrective surgery for, say, a cleft palate.

[Cruelladeville]

*Does heterosexuality or homosexuality involve surgically removing/reordering your sex organs in a major operation?*

Millions of 'heterosexual' women electively go for breast augmentations, labiaplasty's and many other sexual signalling body enhancements with absolutely no mental stigma attached or anyone questioning there overall sanity at all?

Or them needing letters from two psychiatrists to do so.....

Or any gate-keeper medic deciding for them whether this would be a good idea or not?

[Just Kate]

*Does heterosexuality or homosexuality involve surgically removing/reordering your sex organs in a major operation?*

Millions of 'heterosexual' women electively go for breast augmentations, labiaplasty's and many other sexual signalling body enhancements with absolutely no mental stigma attached or anyone questioning there overall sanity at all?

Or them needing letters from two psychiatrists to do so.....

Or any gate-keeper medic deciding for them whether this would be a good idea or not?

Are you therefore putting a TS's NEED for surgery on the same level as others' WANT for surgery?  Are you saying TS's are just wanting simple cosmetic surgery for none other than vanity?!  You do many of the people you are trying to defend a great disservice.  I'd rather be thought of to have a mental disorder than be considered just someone who has no real troubles and is only vain.

It is exactly our strong need for surgery and bodily change that separates us from others who desire cosmetic surgery.  If someone desired cosmetic surgery so badly to fix an otherwise unmarred body, but to satisfy some deep penetrating psychological need of wholeness that they otherwise are pervasively distressed over, they would be also be candidates for having a probable mental disorder as well.

[Cindy Stephens]

     While I hate to use him as an example, Dr. Phil has spoken about his part time work examining patients for high-end Plastic surgeons who want to ensure that the people they work on are NOT psychologically damaged > not going to be satisfied with work> will sue, ruining reputation.   Certainly, the mass market plastic surgeons only care that the check cashes.  Do you really want "Bobs' Pretty Good Surgery, no pesky psychology tests necessary" to be advertising GRS at a discount price on the back page of your local alternative paper?  Oh, Bob was a pretty good dermatologist before getting into this.  His medical license allows him to do it.
      An interesting perspective comes from sufferers of BIID or body integrity identity disorder.  They have a condition where they feel that their bodies are "wrong" and try to have limbs either cut off or paralyzed.  The condition hasn't been in the dsmv, which makes it very difficult to treat, because there are no standards at all-talk therapy and pills don't work.  They have been trying desperately to have it INCLUDED.  Before you say it, Google it and read up.  They feel that it is part of their "core" experience and cannot understand why surgeons won't do it, and people don't accept it.  I'm sure that most of us would have an immediate response that we (transsexuals) are different, more pure, more something-anything that makes us better than them.   Not that it would ever make a difference in how I feel, it still adds to the perspective.  I suspect that after reading a few articles about them, you will have the same attitude toward them that many people have toward us.  I'm sorry, but my personal, visceral reaction is "Damn, they're nuts!"   Sorry, It is hard not to feel this way, not experiencing nor really being able to empathize with their feelings.  I just can't do it.  Just as many non-transgendered can't with us.  I don't pretend to know how they should be treated, except that it should be with extreme kindness and consideration.   
     Finally, I think that everyone has gone through enough self doubt in Jr high school that we can commiserate and support someone's decision to fix a cleft palate, maybe even a truly unfortunate nose, without second thoughts.  I think that there is a split decision on breast implants.  Woman of my age say,"those are fake you know!"  Men my age say, "I don't care!"

[rejennyrated]

This one will run and run I feel. I doubt we will ever all entirely agree on this. The thing is I start from the other perspective. I look at myself and I think "Darn it a lot of my thoughts are pretty weird, but I'm still not willing to admit that I am crazy - just odd." So then I look at many of these other groups and I find myself thinking well if I'm not crazy, then perhaps they aren't either... unless they want to be.

I suppose my point is that if you don't represent any threat to anyone else and are happy with the way your thoughts run then that should be enough to place you in a kind of sub category where it is basically up to you whether or not to call yourself disordered. I personally choose not to do so, and yes I am happy to admit that my change of genital arrangements was a matter of vanity. Before I had the surgery I could live my life as a woman just as well as I can now. The surgery was, for me, largely a cosmetic change which enabled me to feel better about my bodily appearance.

I personally do not accept the definition of this as a mental disorder, because for me it is something I would have chosen to experience, such has been the richness of emotional experience and insight that I have gained. I understand that for some people it is a cause of unmitigated suffering, and I am not unsympathetic to that, nor do I wish to deny them the opportunity to call themselves disordered if they wish to do so. At the same time, as my aunt used to say, "please include me out" on that one. For me it has not been a cause of much suffering. In fact the vast majority of my experiences in life in relation to being trans have been positive. That is why I personally can never relate to the disorder label.

Now I am truly sorry that my experience is different. I would love to be able to wave a wand and enable others to have the same positive outcomes, but sadly I can't. But I hope it is at least comprehensible why for me personally it has never been a disorder, more a vocation.  Further I feel that as society becomes more tolerant, there will be more people with my type of experience and the balance of opinion on this will undoubtedly shift.

[Julie Marie]

As I came to know other TGs, I saw an awful lot of them claimed they are different or weird or a little messed up in the head.  I always saw this as nothing more than parroting social concepts about the transgender condition.  Growing up I never thought I was weird or strange or screwed up.  I always understood it was society that had a screwed up idea of the transgender condition because I wasn't anything like those people who society used as an example to justify their feelings.

The idea that a mental disorder is determined by popular vote is seriously flawed.  How can something be a mental disorder in one culture but not in another?  History shows us that there have been cultures who are not only accepting but revering of TGs.  I doubt any TG back then felt they were mentally disordered.  Now, if you were a christian and about to be fed to the lions, I imagine you'd be questioning your sanity about your religious beliefs.  Would christianity back then be listed as a mental disorder? 

I'm sure many African-American slaves wished they could change their skin color to escape slavery.  And if that was possible I'm sure some would have done it.  I doubt anyone would have called them mentally disordered for wanting to change their skin color to escape persecution.  On the contrary, wanting to remain enslaved, whipped, beaten and persecuted would certainly raise the question of one's sanity.

On the subject of wanting major surgery to make mind and body more in-sync, what if it was simply the push of a button and you emerge the gender you wish?  Would you still be mentally disordered for wanting your physical gender changed?

[Kendall]

Hi
I have several comments about being in the DSM.
Julie Marie, a slave wanting to escape slavery was considered to be a psychiatric diagnosis in the 1800's. People in power oppressing and exploiting others want to feel justified and blame the victim for not being happy to be exploited.
Unfortunately, the DSM has been used as a tool of social control since its beginning. It has other uses such as making research possible, and of course controlling insurance payouts. But it is limited and I believe fatally flawed in understanding human behaviors and situations. For one there is a built in assumption of something "wrong." There is the arrogant assumption that an external "authority" can tell you what you need without your full participation and informed consent. There is the built in assumption that anything that varies from the "norm" is wrong and bad and must be labeled and fixed. I think I am saying this badly. But there are other ways of understanding peoples' situations that do not make them wrong, but still guide them towards functioning and coping more successfully.

I agree we would be better off not in the DSM, but there still needs to be frameworks for understanding our variations and helping us cope with them. The idea of medical diagnosis for medical treatment makes sense. But I agree no one answer will do for us all.

An additional point: diagnosis is sometimes misused to put people in a box. She's a "borderline." He's a "sociopath." It is better to think of people as whole and complex beings with conditions: She has "borderline traits." I know that sounds very "PC" but it helps remind one that a person is not defined by their DSM label. Their diagnosed condition is, and usually labeled incompletely and over-simply. I do not know how to label myself, but I do not think I have a "disorder." I am not wrong or damaged. I am different and confused and not at all what I was raised to be. But I am not a "transgender." I am a person with hidden depths coming out.

It is easier to get out of the DSM than it is to change society to think about diagnosis and intervention wholistically and flexibly. I think we need to do both. I do not just want to get us out of the DSM, I want to get the DSM out of practice totally. I am a psychotherapist, and I find it extremely problematic for almost all of the people I deal with, and no help to me in helping them.

As a last comment; I would like to say that the "brain" is part of the body. The "mind" is something different - it is many things, but at least it is how we experience the body/brain we inhabit. I believe it is useful to keep brain and mind separate conceptually.

Kendall

PS. I enjoyed everyone's comments - this is an interesting issue with no clear resolution.

[Sarah B]

Hi Julie Marie

What you say below is absolutely brilliant, amen, it also resonates with me more than I can put into words.

As I came to know other TGs, I saw an awful lot of them claimed they are different or weird or a little messed up in the head.  I always saw this as nothing more than parroting social concepts about the transgender condition.  Growing up I never thought I was weird or strange or screwed up.  I always understood it was society that had a screwed up idea of the transgender condition because I wasn't anything like those people who society used as an example to justify their feelings.

The idea that a mental disorder is determined by popular vote is seriously flawed.  How can something be a mental disorder in one culture but not in another?  History shows us that there have been cultures who are not only accepting but revering of TGs.  I doubt any TG back then felt they were mentally disordered.  Now, if you were a christian and about to be fed to the lions, I imagine you'd be questioning your sanity about your religious beliefs.  Would christianity back then be listed as a mental disorder? 

and of course Rejennyrated's comments

I personally do not accept the definition of this as a mental disorder, because for me it is something I would have chosen to experience, such has been the richness of emotional experience and insight that I have gained. I understand that for some people it is a cause of unmitigated suffering, and I am not unsympathetic to that, nor do I wish to deny them the opportunity to call themselves disordered if they wish to do so. At the same time, as my aunt used to say, "please include me out" on that one. For me it has not been a cause of much suffering. In fact the vast majority of my experiences in life in relation to being trans female have been positive. That is why I personally can never relate to the disorder label.

Now I am truly sorry that my experience is different. I would love to be able to wave a wand and enable others to have the same positive outcomes, but sadly I can't. But I hope it is at least comprehensible why for me personally it has never been a disorder

One of the many reasons while I never say anything to anybody about me, I knew instinctively that family, friends and society could 'condemn me' and hence make my life a misery and as much as they can call me all the names under the sun, I will not respond in anyway, but, deep inside it will hurt me to some extent,  yes society is changing and there are a lot of people out there that are totally accepting and do not bat an eye, when they are told about someone's condition.  Yes, there are times, even when I'm tempted to say something.

I grew up knowing something was different and I wanted to be a girl and these thoughts and feelings would occur often over the years.  The reason why I was not able to put things together and realise that I was a female was from a lack of knowledge and understanding.  The question one needs to ask and this will help me answer one of the questions I have always asked of myself, after reading all the posts of other girls and how they suffered.  Is, why did other girls suffer extensively from dysphoria and I did not? 

First one of the things was, I never wanted to be like other people, that is I did not want to be one of the 'sheep' so I always tried to do things that were different from others.  Secondly, I never let anybody get to me in terms of people calling me names or putting me down. Finally, society was not able to put any expectations on me, because I would not perform to those expectations and I kept my personal life to myself.

Because I did not have the expectations on me to perform, I never got the anxiety or the depression and hence I never got dysphoric to the extent that other girls got it.  Yes, I did feel unease at times before I left, in fact this unease was getting stronger and stronger and was one of the reasons, why I finally left my friends and family, the other reasons being, I realised I was in love with a young guy at the time and I could not doing anything about it, I wanted to go to university and my knowledge at that time of 'Transgendered' people made me finally realise that I was a female and I had always been so and nothing short of having surgery was ever going resolve my issues.

So it is societies expectations, conditions and interference in our lives that make people anxious and depressed and hence dysphoric.  Yes there is that unease within ourselves and how strong it is within us, but this unease virtually goes away when one has the knowledge, understanding and the options on what you can do about it.  So that you can live a happy full filled life.  So being 'Transgendered' is not a mental illness or disorder, it is societies interference, lack of knowledge and understanding which will make you dysphoric and mentally ill.

Kind Regards
Sarah B

[Tammy Hope]

True, but on the other end of the spectrum, few people question the mental stability of a person who wants corrective surgery for, say, a cleft palate.

indeed.

Or a BA.

or a nose job.

surgical modification of appearance is NOT considered proof of a disorder by itself - in most other regards.

Whether or not this is a disorder, the election of surgical modification would be a damned flimsy reed to prop the idea up with.

[Tammy Hope]

Are you therefore putting a TS's NEED for surgery on the same level as others' WANT for surgery?  Are you saying TS's are just wanting simple cosmetic surgery for none other than vanity?!  You do many of the people you are trying to defend a great disservice.  I'd rather be thought of to have a mental disorder than be considered just someone who has no real troubles and is only vain.

It is exactly our strong need for surgery and bodily change that separates us from others who desire cosmetic surgery.  If someone desired cosmetic surgery so badly to fix an otherwise unmarred body, but to satisfy some deep penetrating psychological need of wholeness that they otherwise are pervasively distressed over, they would be also be candidates for having a probable mental disorder as well.

Before you reply - let me just say that my above reply is not meant to be in conflict with your "need v. want" thesis.

But it is true that to the disapproving, our surgery is a "want" too.

It seems to me there ought to be room in the mental health field to have a rubric for identifying a condition - i.e. a "state of being" - which is divergent from the "norm" (mentally) but is not in and if itself a "disorder" of the sort which causes harm to the person or others....as apart from other disorders (severe depression for instance) which are precipitated by the condition.

but the bottom line is, until they get everything right, I'm worried about alterations that make our situation more easy to dismiss as frivolous.

[Arch]

It seems to me there ought to be room in the mental health field to have a rubric for identifying a condition - i.e. a "state of being" - which is divergent from the "norm" (mentally) but is not in and if itself a "disorder" of the sort which causes harm to the person or others....as apart from other disorders (severe depression for instance) which are precipitated by the condition.

but the bottom line is, until they get everything right, I'm worried about alterations that make our situation more easy to dismiss as frivolous.

I agree.

[Fencesitter]

It seems to me there ought to be room in the mental health field to have a rubric for identifying a condition - i.e. a "state of being" - which is divergent from the "norm" (mentally) but is not in and if itself a "disorder" of the sort which causes harm to the person or others....as apart from other disorders (severe depression for instance) which are precipitated by the condition.

but the bottom line is, until they get everything right, I'm worried about alterations that make our situation more easy to dismiss as frivolous.

Hm, when I look up the DSM IV, 302.85 Gender Identity Disorder, it stresses a lot the fact that you suffer a lot from it otherwise no diagnosis. Three of the criteria are:

" Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex"
"The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning."
"There is strong discomfort with the patient's own sex or a feeling that the gender role of that sex is inappropriate for the patient"
" These symptoms cause clinically important distress or impair work, social or personal functioning."

I mean, they could not have stressed that any better, it's even quite repetitive. They just don't specify the symptoms caused by the distress, which is also good as it leaves room to atypical symptoms. 

Source: http://www.psychnet-uk.com/dsm_iv/gender_identity_disorder.htm

[Sarah B]

Assume that one has to have satisfy the conditions of the DSM IV TR to be labeled Gender Dysphoric, hence you must be Mentally Ill or have a Mental Disorder.  I have lifted the relevant text from the DSM IV TR page 578 and assigned a corresponding analysis to each of those Criterion.

There are two components of Gender Identity Disorder, both of which must be present to make the diagnosis.  There musty be evidence of a strong and persistent cross gender identification, which is the desire to be or the insistence that one is, of the other sex (Criterion A).

"Evidence for who?"  I never told my psychiatrists anything about my 'strong desire' or 'desire' to be a female or insistence that I was a female or better still, we can discount 'insistence' because I never once voiced it to any one so lets discount that, shall we?

Lets count how many times during my life that I wanted, wished, imagined, dressed, played or part took in activities that were for girls or females only.  From a rough count I would say about 30 for the first 30 years of my life.  But lets say there are actually 90 and this occurred between the ages of 20 and 30 just before I actually changed.  This translates roughly to 1 event per month per year up and till I actually changed.  So this does not indicate a strong and persistent cross gender identification or does it?  So I should have failed the diagnosis of Gender Dysphoria for Criterion A

This cross gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.

This one is easy, I would have no advantage because I was going to become the weaker sex, less pay, more easily be assaulted and job options limited.  So I most certainly did not do it for any cultural advantage.  Oh wait maybe my swimming prowess might give me an advantage, well lets see, I was good at the 50m and 100m free and 50 Butterfly, anything beyond that or style, I was just like another stone in the pond. So for this perceived advantage I should also fail the diagnosis of Gender Dysphoria.

There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex (Criterion B).

I did not have any persistent discomfort in my assigned sex at the time, it was just part of me.  I knew I did not want to act the part of my assigned gender role that was given to me at birth.  So I should have failed the diagnosis of Gender Dysphoria for Criterion B

The diagnosis is not made if the individual has concurrent physical intersex condition (e.g. partial androgen insensitivity syndrome or congenital adrenal hyperplasia (Criterion C).

Well I don't know if I have these conditions.  Lets assume that I do not have these conditions.  So the Diagnosis for Gender Dysphoria can be made for me in this case.

To make the diagnosis, there must be evidence of clinically significant distress or impairment in social, occupational, or other important ares of functioning (Criterion D).

I worked, lived and played, spent time with my friends and family.  I dated enough to just throw the hounds of the scent, to prevent others thinking, I was gay (and no I was not) and when I left and changed, I worked, lived and played, spent time with my friends, dated and gradually I become involved with my family again.  I just wonder if my psychiatrist thought I was distressed?  I doubt it because I was just living virtually a normal life as a female.  So I should have failed the diagnosis of Gender Dysphoria for Criterion D

So lets sum all of this up shall we.  Diagnosis can be made because of Criterion C.  However, by Criterion's A, B and D.  I fail totally and utterly.  But wait, there's more, my psychiatrist in his letter to my surgeon stated basically the following.

"Sarah B was referred to me in March 89 and has been seen by her endocrinologist and her other psychiatrist, both of whom have written to you.  I believe she is suitable for gender reassignment surgery."

It would have been very interesting to know what he wrote in his notes about me when I was visiting him. However, I will never know because those records were destroyed 20 years ago.  Did my psychiatrist make a mistake or did he get it right? I will never know unless I go back and ask him.

So according to me the DSM IV TR says I do not have Gender Dysphoria and I guess they are right and I would agree with them.  Oh me, Oh my, but I had surgery!  My surgeon stated in a letter and I quote (virtually verbatim).

"This is to certify that Sarah B, born in February 1959, has undergone gender reassignment surgery from male to female in February 1991.  She is to all intents and purposes a female.  The surgery is irreversible."  Thank god for that.

You see the problem is, I have always been female and I always will be and I never did have Gender Dysphoria, the reason I keep saying this is because I have knowledge and understanding.  I have never been as happy as I have been the last 20 years of my life and I have done more in that time than I ever did before I changed.  I love my life, I'm happy and I have never ever regretted my decision.

So am I, the exception to the rule?  Did my psychiatrist not follow the correct procedures? Or am I stark raving mad for doing what I did?  How about, I manipulated the information to the desired outcome? Well, I'm giving you an honest account, maybe all this should have been done twenty years ago and if it had, then maybe I would not be here today.  Only you can decide on the veracity of what I have said.

Because if there is one exception there are others.  Therefore the diagnosis for Gender Dysphoria is fatally flawed.

Kind regards
Sarah B

[Julie Marie]

Well Sarah, let Dr. Julie give her diagnosis.  You are loony, completely bats, totally whacked out and perfectly normal.  As for your gender, you're a chick.    I clicked with everything you said, except for the swimming parts - I swam distance freestyle. 

If I were an outside observer (that is, outside this society that clings so tightly to the idea that a professional degree makes one correct) I would think the mental health professionals were nuts.  The GRS letter requires one to be clear thinking and of sound mind.  Satisfying the necessary criteria for a GID diagnosis would certainly put into question clear thinking and, in severe cases, sound mind.

But honestly, if you take your argument to the mental health professionals I think you'd have them scrambling.  Or they would just say one needs to allow for some latitude when interpreting the DSM.  Whatever the case, taking the DSM literally AND issuing a GRS letter would create conflicting issues for the professional.

In a general sense, WPATH has a more positive approach but admits it still doesn't know everything.  In the Epidemiological Considerations section of the Standards of Care it states:

Four observations, not yet firmly supported by systematic study, increase the likelihood of an even higher prevalence (of incidence of GID):
1) unrecognized gender problems are occasionally diagnosed when patients are seen with anxiety, depression, bipolar disorder, conduct disorder, substance abuse, dissociative identity disorders, borderline personality disorder, other sexual disorders and intersexed conditions;
2) some nonpatient male transvestites, female impersonators, transgender people, and male and female homosexuals may have a form of gender identity disorder;
3) the intensity of some persons' gender identity disorders fluctuates below and above a clinical threshold;
4) gender variance among female-bodied individuals tends to be relatively invisible to the culture, particularly to mental health professionals and scientists.

It's certainly not an exact science.  Maybe they should provide an opt out clause, or better yet, an opt in clause.  That way the TG person is assumed perfectly sane (not disordered) except those who insist they have a disorder.  The social stigma would gradually subside and discrimination and prejudice would go along with it.  Who knows, maybe some companies would even WANT a TG person working for them and maybe even be their representative in the business world without needing the TG to be perfectly passable. 

Okay, I'm dreaming.

Sarah, I anxiously await to see how the proponents of GID in the DSM answer your post.  It will be interesting.  In the meantime, let's hit the pool!  I need a good workout.