Disordering Gender Identity: Gender Identity Disorder in the DSM-IV-TR

vestic Fetishism in a psychiatric diagnostic nosology is a complex topic that is best understood within the larger context of the history and poli-tics of diagnostic classification systems. The diagnostic labeling of gen-der-variant individuals with a mental illness is a topic of growing controversy–within the medical and psychotherapeutic professions and among many civil rights advocates. An overview of both sides of this controversy is outlined, highlighting questions about the potential dam-age caused by using psychiatric diagnoses to label sexual behaviors and gender expressions that differ from the norm, and the ethical dilemmas of needing a psychiatric diagnosis to provide legitimacy for transsexu-Arlene Istar Lev is a social worker, family therapist, and educator addressing the unique therapeutic needs of lesbian, gay, bisexual, and transgender people. She is the founder of Choices Counseling and Consulting in Albany, New York, and on the ad