A federal judge said being transgender is a mental disorder. Here's why he's wrong.

A federal judge on Monday dismissed a key legal argument that could allow a transgender teen to use the bathroom at his school that corresponds with his gender identity, telling the boy's attorneys that they now face an "uphill battle," BuzzFeed's Dominic Holden reported.

"I have no problem with transgender. I have a lot of problems with sex," US District Court Judge Robert Doumar said, according to Holden. "I am convinced he is a biological female who wants to be a male."

But the judge's reasoning seemed shaky — at times saying that being transgender is a "mental disorder," even though the American Psychiatric Association has explicitly deemed that untrue. And Doumar, by his own admission, decided all of this before any of the proceedings began.

LGBTQ advocates say the Civil Rights Act protects trans people

Philippe Lopez/AFP via Getty Images

Gavin Grimm, a trans boy in Virginia, is suing Gloucester County Public Schools, arguing that he should be allowed to use the boys' restroom in his public high school under Title IX of the Civil Rights Act, which bans sex discrimination.

Under the Civil Rights Act, sex stereotyping is prohibited. As Joshua Block, the American Civil Liberties Union attorney now leading Grimm's case, previously explained, discrimination against LGBTQ people could be unlawful because it hurts people for not meeting stereotypes attached to the gender assigned to them at birth — stereotypes that suggest, for instance, that men are supposed to be attracted to women, and trans women are supposed to be men.

This is now a mainstream view. The Equal Employment Opportunity Commission, which handles federal employees' workplace discrimination complaints, has ruled that the Civil Rights Act's protections against sex discrimination protect LGBTQ people. And several federal agencies, including the Department of Justice and Department of Education, interpret the Civil Rights Act to protect trans people.

Judge Doumar rejected the argument before a lawyer even got a chance to present the case, stating that he believes Title IX allows schools to separate children based on the gender assigned to them at birth. "Your case in Title IX is gone, by the way," Doumar told Block, according to Holden. "I have chosen to dismiss Title IX. I decided that before we started."

But Doumar appeared to approach this issue based on outdated and wrong medical rationale. He repeatedly referred to being trans as a "mental disorder." But the Diagnostic and Statistical Manual of Mental Disorders (DSM) doesn't qualify gender dysphoria — a state of emotional distress caused by how the gender someone was designated at birth conflicts with their gender identity — as a mental disorder. And the condition only severely affects some trans people, such as Grimm.

The judge fundamentally misunderstood gender dysphoria

When Block attempted to explain the DSM's definition of dysphoria, Doumar shot back, asking, "Where did you get your medical degree?" But as Block mentioned, this is all laid out in the DSM.

When the DSM's medical diagnosis of trans people changed from gender identity disorder to gender dysphoria in 2013, the American Psychiatric Association explained this in explicit terms: "Part of removing stigma is about choosing the right words. Replacing 'disorder' with 'dysphoria' in the diagnostic label is not only more appropriate and consistent with familiar clinical sexology terminology, it also removes the connotation that the patient is 'disordered.'"

Under the manual, gender dysphoria is treated as a temporary, treatable condition, not a permanent disorder. If left untreated, it can lead to distress, depression, and suicidal ideation, among other problems.

Most medical experts today, including the American Psychiatric Association and American Medical Association, agree that letting someone transition without social stigma can help treat gender dysphoria. And not all trans people deal with severe dysphoria in the first place. Both of these facts show that psychological distress and disability aren't inherent to being trans, so being trans doesn't meet the definition of a mental disorder (a psychological state that causes significant distress and disability).

Removing social stigma can be a crucial step to someone's treatment. For example, if a trans boy is allowed to use a bathroom that matches his gender identity, he won't face a regular reminder that society considers him to be somehow different and not really a man. By eliminating that constant show of discrimination, a school can eliminate a trigger for the boy's dysphoria.

So if anything leads to trans people having actual mental health issues, it's the kind of discrimination that LGBTQ advocates argue the Civil Rights Act prohibits. But judges need to be aware of the medical rationale for gender dysphoria to actually know that — and that didn't appear to be the case in Grimm's court proceedings.

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