Giordano Simona
CSEP/iSEI, University of Manchester, School of Law, Williamson Building, Oxford Road, Manchester, M13 9PL, UK.
Med Health Care Philos. 2012 Feb;15(1):31-40. doi: 10.1007/s11019-010-9303-y.
Gender Identity Disorder (GID) is regarded as a mental illness and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It will also appear in the DSM-V, due to be published in 2013. The classification of GID as a mental illness is contentious. But what would happen to sufferers if it were removed from the diagnostic manuals? Would people lose their entitlement to funded medical care, or to reimbursement under insurance schemes? On what basis should medical treatment for GID be provided? What are the moral arguments for and against funded or reimbursed medical care for GID? This paper starts out with a fiction: GID is removed from the diagnostic manuals. Then the paper splits in two, as in happened in the Howitt's 1998 film Sliding Doors. The two scenarios run parallel. In one, it is argued that GID is on a par with other body modifications, such as cosmetic and racial surgery, and that, for ethical reasons, treatment for GID should be privately negotiated by applicants and professionals and privately paid for. In the other scenario, it is argued that the comparison between GID and other body modifications is misleading. Whether or not medical treatment should be funded or reimbursed is independent of whether GID is on a par with other forms of body dissatisfaction.
性别认同障碍（GID）被视为一种精神疾病，并被纳入《精神疾病诊断与统计手册》（第四版）。由于将于2013年出版，它也将出现在《精神疾病诊断与统计手册》（第五版）中。将GID归类为精神疾病存在争议。但如果它从诊断手册中被删除，患者会怎样呢？人们会失去获得公费医疗或保险计划报销的权利吗？应该基于什么理由提供GID的医疗治疗？支持和反对为GID提供公费或报销医疗护理的道德论据是什么？本文从一个虚构的情景开始：GID从诊断手册中被删除。然后本文一分为二，就像在豪伊特1998年的电影《滑动门》中那样。两种情景并行展开。在一种情景中，有人认为GID与其他身体改造，如整容手术和种族手术相当，并且出于伦理原因，GID的治疗应由申请者和专业人员私下协商并自费支付。在另一种情景中，有人认为将GID与其他身体改造进行比较具有误导性。医疗治疗是否应该得到资助或报销与GID是否与其他形式的身体不满相当无关。
