Transsexualism is a medical condition and the diagnosis is controversial as, for some, it feels like the problem is being pathologized inappropriately. This can often lead to people feeling labelled or stigmatized and so many people do not agree with the medical model.

However there are some very clear advantages of using a diagnosis and having a medical understanding of the condition. It is generally accepted that the diagnosis serves the purpose of justifying medical and psychological treatments (and the development of specialist services) so it is essential to retain the diagnosis to ensure access to care. Also by having a medical approach, it allows scientific study and research, so that professionals and the Transgender Community itself can have a better understanding and improve the services and support available.

There is no simple test for transsexualism. The diagnosis is made after taking a careful history by asking questions with emphasis on gender, sexual and relationship matters.

Certain medical health professionals may be able to make a tentative diagnosis and refer the individual on to see a specialist in gender identity disorders, usually a consultant psychiatrist.

The psychiatric assessment can be a daunting process for some, but it is not intended to cause any anxiety or stress, and is a vital component in terms of accessing the right support. A more detailed description of what this involves can be found on the Psychiatric Assessment page.

The diagnostic criteria used for diagnosing transsexualism (or gender identity disorder) are described in the Diagnostic and Statistical Manual, 4th edition (referred to as DSM-IV) by the American Psyciatric Association. Outside the USA, including the UK and the rest of Europe, a similar description is given by the International Classification of Diseases, 10th edition (ICD-10) devised by the World Health Organization (WHO).

The key features of transsexualism, or gender identity disorder, are:-

1. A strong and persistent identification with the opposite gender.

2. Persistent discomfort with the assigned sex and its associated gender role (gender dysphoria).

3. Absence of any physical intersex condition.

4. Clinically significant distress or impairment of social or occupational functioning.

The diagnostic features have attracted a number of criticisms and still remain somewhat controversial.

The DSM-IV accepts the expression of "desire to be the opposite sex", or the assertion that one is of the sex opposite from the assigned one at birth, is sufficient to be diagnosed as transsexual.

Similarly, ICD-10, uses the definition "the desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment".

This is a view not held by all in the Transgender Community. Many transsexuals do not identify themselves as being or desiring to be the opposite sex, but as being another gender, or the gender that they have always felt to be.

What are your views about the advantages and disadvantages of the use of a diagnosis? Tell us your views on the Blog.