People who consider themselves "transgendered" have long criticized DSM-IV and previous editions for labeling them with a mental disease when their problems, they believe, are purely somatic -- that is, they have the wrong genitalia and hormonal balance.
At the APA's annual meeting last May, members of the transgender community made a case for dropping gender identity disorder from DSM-V, but keeping some kind of "gender variance" diagnosis as a medical condition. Such an approach would eliminate the stigma of a psychiatric diagnosis while leaving a pathway for third-party (insurance) payment for gender transition treatments, they said.
Dr. William Narrow, the APA's research director for DSM-V, told reporters that the draft does remove the term "disorder" from the condition when applied to children, renaming it as "gender incongruence."
For adults, gender identity disorder will remain in DSM-V but with substantially altered diagnostic criteria, Narrow said.
But APA officials said the organization planned more discussions with members of the transgender community.
Kupfer, the DSM-V task force chairman, stressed that further changes in many diagnostic categories are likely following the comment period and field trials. Final revisions will be submitted in 2012 for approval by the APA's two governing bodies, the Assembly and the board of trustees.