Transsexualism entered the DSM in 1980, and the later changes were "not only based on research"
Beek, Cohen-Kettenis and Kreukels trace the manual: "A diagnosis of 'transsexualism' appeared first in DSM-III in 1980", with a childhood diagnosis beside it. Later changes were shaped by "social and political factors" too.
Weak or heavily disputed. Treat as a question, not an answer. how we score evidence
Caveat on this rating: Written by participants in the classification work from a single specialist clinic. The paper's own point, that social and political factors shaped the diagnosis, applies to every edition including the current one.
This is the short history of how the DSM has filed gender identity, written by three people at the Amsterdam clinic that produced much of the research behind the later editions.
Significant findings
The paper "discuss[es] the changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification of gender identity-related conditions over time, and indicate[s] how these changes were associated with the changes in conceptualization."
The starting point is precise: "A diagnosis of 'transsexualism' appeared first in DSM-III in 1980. This version also included a childhood diagnosis: gender identity disorder of childhood."
From there the label moved edition by edition, to "gender identity disorder" and then, in DSM-5 in 2013, to "gender dysphoria": "As research about gender incongruence/gender dysphoria increased, the terminology, placement and criteria were reviewed in successive versions of the DSM."
The sentence that matters for anyone reading the manual as settled science: "Changes in various aspects of the diagnosis, however, were not only based on research. Social and political factors contributed to the conceptualization of gender incongruence/gender dysphoria as well."
The other direction
The authors are from a specialist gender clinic and were involved in the classification work they describe; a history written by participants is a history with a point of view. Saying that social and political factors shaped the diagnosis cuts both ways: it is an argument against reading the 1980 entry as pure science, and equally against reading the 2013 rename as pure science.
What this does not show
A classification history reports no outcomes. It does not say what gender identity is or where it comes from. It does not compare treatments or recommend any. The DSM still contains a diagnosis, gender dysphoria; this paper explains how it got its current name, not whether it should exist.
Worth asking
When a diagnosis is renamed, what changed: the people, the evidence, or the people writing the manual?
Source
Gender incongruence/gender dysphoria and its classification history — Beek TF, Cohen-Kettenis PT, Kreukels BP (2016)
Indexed peer-reviewed journal
Read the source: https://doi.org/10.3109/09540261.2015.1091293
DOI: 10.3109/09540261.2015.1091293
How this was scored
- Study design
- Narrative review
- Funding
- Funding not disclosed
- Published in
- Indexed peer-reviewed journal
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published September 29, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "contested". Weak or heavily disputed. Treat as a question, not an answer. It scores 29 out of 100 on our published rubric. One caveat travels with that badge: Written by participants in the classification work from a single specialist clinic. The paper's own point, that social and political factors shaped the diagnosis, applies to every edition including the current one. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Gender incongruence/gender dysphoria and its classification history — Beek TF, Cohen-Kettenis PT, Kreukels BP (2016). Published in: Indexed peer-reviewed journal. DOI: 10.3109/09540261.2015.1091293. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Narrative review. Funding: Funding not disclosed. Independence from the proponent is not recorded. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.