We respectfully disagree with many assertions made by the authors responding to our article “Psychological and Medical Care of Gender Nonconforming Youth.” First, the respondents' use of the psychiatric diagnosis of gender identity disorder (GID) is in itself problematic. The American Psychiatric Association changed this diagnosis in the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), to “gender dysphoria.” The psychiatric and pathologic focus is not on the cross-gender identity but instead on the distress stemming from the mismatch between “assigned” and affirmed gender identity and from societal stigma and lack of acceptance. Our center and other major professional organizations do not view gender nonconformity as pathologic, as our article discusses at length; this may be at odds with the stated perspective of the respondents. Furthermore, the respondents suggest that gender-nonconforming children suffer from delusions regarding their gender identity; symptoms of delusions are not included in any diagnostic...

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