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The argument that transness is new is one of the oldest lies in the toolkit. Just because we had no name for a thing does not mean it lacked root in reality or in the historical human experience. We name newly discovered species at the bottom of the ocean, more ancient than civilization, all the time. The absence of a label is not the absence of a life.

It is rooted in a history more ancient than most of us can imagine or remember. Before psychiatry named us disordered, the church named us abominations. This is not a loose analogy. The DSM's 1952 founding framework centered heterosexuality as natural on the grounds that non-procreative sex was unnatural, which is a theological argument wearing a lab coat. The same binary thinking that produced sodomy laws produced the diagnostic hierarchy. One borrowed authority from a deity. The other borrowed it from a professional association built in 1844 by thirteen men who ran institutions. The mechanism is identical. The target is the same.

Every word used to describe us carries weight through history, where it can be used against us in bad faith. "Cure" is one of those words. When you think about things that need cures, you think of cancer, deadly viruses, and global warming. To associate that level of necessity with our existence is the language of the oppressor. My aunt underwent electric shocks for her mental health in the '80s, and she is no longer with us. These barbaric methods are not that distant. The parallels between the treatment of women, BIPOC people, and queer people are blatant. Ignoring them is an active choice.

In 1973, the APA removed homosexuality from the DSM after sustained pressure from activists, including a gay psychiatrist who had to wear a mask to speak at his own profession's conference. Franklin Kameny told a room of psychiatrists in 1965: This is not science, this is faith. The 58% removal vote was immediately replaced by "Sexual Orientation Disturbance," which became Ego-Dystonic Homosexuality by 1980. Kameny compared the APA to a dog that keeps chewing a bone, burying it, digging it up, refusing to put it down. It could have been met with an apology. It wasn't. The name changed. The function did not.

Gender Identity Disorder became Gender Dysphoria in 2013, framed as destigmatization. It wasn't. Psychiatric involvement remained the prerequisite for care, giving individual clinicians the authority to decide who is trans enough to receive it. The terminology remained rooted in the language of the oppressor: "transvestic fetishism," "disorder," "disturbance," shaping how generations not so distant view the trans community and how parents teach their children to talk about us. There are trans people who do not experience clinical distress, and some who cannot or choose not to medically transition at all. The diagnosis does not account for the full breadth of what it claims to address. The National LGBTQ Task Force acknowledged it was stigmatizing and still supported keeping it in the DSM because, without it, insurance companies had no legal obligation to cover care. That is the trap made plain. The diagnosis is harmful, and it is the only key that opens the door, and that is by design, not accident.

I started hormones in 2016 in Maryland with several hoops to jump through: a gender dysphoria diagnosis from a psychiatrist, a year of therapy, a letter of clearance, and then an endocrinologist consultation. In 2023, I began them again. Signed an informed consent form in a primary care provider's office. Same body. Same state. Seven years apart.

HRT is not exclusive to trans people. Cisgender people receive the same hormones for menopause, for hypogonadism, for conditions that affect the endocrine system, without anyone demanding they document a year of suffering first. The need to other yourself, to prove it, sign papers, document your otherness is upsetting and lasting. When the cure for erectile dysfunction can come in the mail with little hassle, requiring trans people to spend years justifying access to the same class of treatment is not medicine. It is a political taxonomy of whose body counts.

A 2024 Johns Hopkins study named five categories of systemic failure for trans patients: acceptability, accommodation, affordability, availability, and accessibility. One participant spent a year and a half with a therapist who never intended to write the letter. Another was hospitalized for a suicide attempt, while staff refused to use her name. The study names everything we face within the sanitary walls of a medical institution. What it fails to name is one of the largest factors that lands us in psych wards: the behaviors, words, and actions of others breeding a lack of safety, comfort, self-love, and, in turn, joy. To see a spark ignite in someone and desire to extinguish it is not a clinical finding. It is a choice. And a system that declines to name it is not a neutral system.

In 2019, the WHO removed trans identities from its mental illness chapter. In January 2025, the Trump administrationcanceled the trans suicide prevention lifeline, defunded hundreds of millions in LGBTQ health research, and declared gender identity holds no "meaningful basis for identification." Any government that must decree something true when research and lived experience show otherwise is not rooted in fact. It is rooted in control and fear. It is more than pathologization. It is vilification. We were made to be demons, made to be lesser, and the DSM just gave it a billing code.

The failure to remove providers who refuse evidence-based trans care is not a matter of individual professional integrity. It is the integrity of the profession to allow these individuals to continue to practice. I know this system. I have lived inside it as a patient, studied it academically, and watched it fail people I love. I am an authority on both the truths and the lies equally. The holdouts are not applying rigorous science. They are accepting only the studies that confirm what they already believe. That is not science. Kameny named it in 1965. It is faith.

We were not born sick. We were diagnosed into it. And some of us have run out of fight.