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For trans people who want to receive gender-affirming medical care such as hormone treatments or surgery, one requirement is often a diagnosis of “gender dysphoria,” which the Diagnostic and Statistical Manual of Mental Disorders defines as deep psychological distress around one’s gender. But not all trans people experience gender dysphoria. Many are just searching for the feeling of gender euphoria.

Rather than have insurers cover medical care based on a “diagnosis” that conflates a social identity with a mental disorder, they should cover care based on medical necessity defined by accepted standards of medicine. Or as Dallas Ducar, the founding CEO of Transhealth Northampton, suggests, it’s time to provide gender-affirming care to trans people because they are trans, not because they have a specious diagnosis.


In this week’s “First Opinion Podcast,” Ducar discusses issues around gender dysphoria and the need for trans-inclusive providers to take a holistic, person-based approach to care.

“If we by necessity say that dysphoria is part of the trans experience, we are inadvertently pathologizing an identity, and we are linking dysphoria with an identity either consciously or unconsciously,” Ducar said.

This conversation emerged from her First Opinion essay, “Giving gender-affirming care: ‘gender dysphoria’ diagnosis should not be required.” Be sure to sign up for the weekly “First Opinion Podcast” on Apple PodcastsStitcherGoogle Play, or wherever you get your podcasts.


And if you have any feedback for us — First Opinion authors to feature on the podcast, vocal mannerisms the host needs to jettison, kudos or darts — email us at [email protected] and please put “podcast” in the subject line.

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