One of my dearest friends is a forensic psychiatrist who currently is at the top of the profession and refuses to join the APA due to the politics and control issues. We have discussed the current flap over the DSM V and both conclude there is a hidden agenda at work. By jettisoning the medical model and elevating AG as THE diagnosis the eventual end of most SRS will follow. AG as the official causality removes all medical justification for hormone and surgery as treatments. Zucker and Blanchard both state they approve of SRS for AG patients but the DSM is the diagnostic standard, not a treatment guide.

Why would anyone wish this? First you have to understand that the APA and the DSM are not pure science or medicine, they are the products of politics and drug companies. The same ultra conservative gay male members of the APA who pushed and won exclusion of homosexuality from the DSM have an almost pathological hatred of transsexual women and further many of them blame the TG activist movement for failure of ENDA to become law. If AG becomes the default diagnosis then effectively the official position becomes all GID related conditions are psycho-sexual disorders.....in other words HBS women become psycho-sexually disordered men along with the TGs. No politician is going to work for civil rights legislation for sexual deviant men, it will never happen and the entire TG activist movement becomes moot. These are patient men, they are willing to wait a couple of years for this to play out.

The current over the top reaction by TG activists was not only anticipated, it was counted on. It will cause an immediate "circle the wagons" mentality among those APA members who may totally disagree with Zucker and Blanchard but who's egos will not allow them to stand by without defending peers against outsider loud, obnoxious and at times vicious laypeople.

Currently AG is already in the DSM, expanded in the last revision. Privately most gender professionals will tell you the majority of those presenting for SRS fit a narrowed AG profile perfectly with HBS (classic transsexual) clients being the minority. AG is here to stay, has merit as a counter-indication of classic transsexuality and standards for distinguishing it from classic transsexuality that is now in place among the psychiatric profession, clear markers for both conditions. The best case scenario would be inclusion of AG as an exclusionary class for HBS (classic transsexuality) with recognition of multiple causalities thus preserving the pure medical model. This is a compromise position that preserves surgical treatment as standard.