We used to classify being gay as mental illness, so anything could be reclassified
Andrew Gold said:
“I've heard this argument before, I feel like it's tantamount to we used to say this was a mental illness and we were wrong. Therefore, anything that we say is a mental illness could be wrong, including feeling like you need to cut your genitalia off.”
The slippery slope framing sounds logically cautious: if past reclassifications were driven by social pressure rather than science, future ones might be too. It appeals to scepticism about institutional medicine.
Both reclassifications followed the same logic: when you remove the stigma, discrimination and barriers, the distress does not come from the identity itself, and a condition that causes no inherent distress does not meet the definition of a mental disorder. That is not a philosophical domino effect, it is a specific clinical test applied consistently. The comparison to wanting surgery also conflates two things: gender dysphoria is the condition, and surgery is one possible treatment for it, in exactly the way that a broken leg is the condition and an operation is the treatment. Treating the leg does not make the leg the disorder. What this framing costs, if it lands, is the scientific legitimacy of care that tens of thousands of people rely on, built on evidence accumulated over decades, dismissed in a single rhetorical move.
What I said at the time:
“We used to classify being gay as a mental illness and we realised, oh my God, that was so offensive to gay people. And then we used to classify gender incongruence as a mental illness. And now we're realising, oh my goodness, that is so offensive.”
Trans people, whose healthcare is made to seem scientifically illegitimate by implying that the removal of a stigmatising diagnosis was itself an error.