{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:40:54Z","timestamp":1787013654775,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T00:00:00Z","timestamp":1698451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Sociology Health &amp; Illness"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    A formal Gender Dysphoria classification\u2014 as outlined in the fifth edition of the\n                    <jats:italic>Diagnostic and Statistical Manual of Mental Disorders<\/jats:italic>\n                    \u2014 is a prerequisite for the reimbursement of both gender\u2010affirming medical care and transgender mental health care in the Netherlands. Gender Dysphoria and its conceptual precursors have always been moving targets: moving due to research, policy, care practices and activism both within and outside of medicine. This raises the question of what Gender Dysphoria\n                    <jats:italic>is<\/jats:italic>\n                    exactly. To elucidate this question, we turn to the people who use the concept in clinical practice to come to a diagnosis and treatment indication: mental health professionals working in gender\u2010affirming medical care and transgender mental health care. Using a material semiotics approach, we reflect upon how Gender Dysphoria is done in clinical practice. Based on an analysis of seventeen practice\u2010based interviews with clinicians as well as an examination of clinical guidelines and texts, we describe four modes in which Gender Dysphoria is ordered. These modes of ordering illustrate that Gender Dysphoria is not one, but multiple. We illustrate how in the mode of\n                    <jats:italic>isolating,<\/jats:italic>\n                    Gender Dysphoria is something which is carefully isolated from mental disorders, while in the modes\n                    <jats:italic>doing the future<\/jats:italic>\n                    and\n                    <jats:italic>narrating,<\/jats:italic>\n                    Gender Dysphoria is done as a continuous and predictable object of care. Such orderings of Gender Dysphoria potentially conflict with a fourth mode of ordering: the\n                    <jats:italic>doing of diversity<\/jats:italic>\n                    in transgender health care. The study\u2019s findings provide empirical insights into how transgender health care is currently done in The Netherlands and provide a foundation on which ethical debates on what\n                    <jats:italic>good<\/jats:italic>\n                    transgender health care should entail.\n                  <\/jats:p>","DOI":"10.1111\/1467-9566.13727","type":"journal-article","created":{"date-parts":[[2023,10,28]],"date-time":"2023-10-28T11:33:03Z","timestamp":1698492783000},"page":"644-663","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Doing and undoing transgender health care: The ordering of \u2018gender dysphoria\u2019 in clinical practice"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0676-4314","authenticated-orcid":false,"given":"Wolter","family":"de Boer","sequence":"first","affiliation":[{"name":"Department of Anthropology University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1944-9759","authenticated-orcid":false,"given":"Bert C.","family":"Molewijk","sequence":"additional","affiliation":[{"name":"Department of Ethics, Law and Humanities Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0415-1127","authenticated-orcid":false,"given":"Marijke A.","family":"Bremmer","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Psychiatry Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9713-4835","authenticated-orcid":false,"given":"Baudewijntje P. C.","family":"Kreukels","sequence":"additional","affiliation":[{"name":"Center of Expertise on Gender Dysphoria Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Medical Psychology Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1233-6041","authenticated-orcid":false,"given":"Eileen M.","family":"Moyer","sequence":"additional","affiliation":[{"name":"Department of Anthropology University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8997-0596","authenticated-orcid":false,"given":"Karl","family":"Gerritse","sequence":"additional","affiliation":[{"name":"Department of Ethics, Law and Humanities Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Center of Expertise on Gender Dysphoria Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Department of Psychiatry Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,10,28]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12817"},{"key":"e_1_2_14_3_1","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"1980"},{"key":"e_1_2_14_4_1","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric 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