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Current and Future Direction of Gender Dysphoria and Gender Incongruence Research.

T Journal of Sexual Medicine (JSM) has formally established “LGBTQi” as a returning fixture, thus acknowledging that transgender healthcare sits firmly in the field of sexual medicine. This is an important development and position statement that JSM should be applauded for, and one that has the potential to improve the lives of many trans* people. JSM is an official journal of The International Society for Sexual Medicine (ISSM), which aims are to establish a scientific Society to benefit the public by encouraging the highest standards of practice, education, and research in the field of human sexuality; to develop and assist in developing scientific methods for the diagnosis, prevention, and treatment of conditions affecting human sexual function; and to promote the publication and encourage contributions to the medical and scientific literature in the field of sexual function. All aims encapsulate and encompass the emerging field of transgender health care. One caveat is pertinent within this context. We do not wish to conflate sexual function with gender identity; rather, we would argue they tend to be intrinsically linked. Treatment concerning cross-sex hormones and surgeries involving primary and secondary sexual characteristics will impact on sexual function. It is of course equally possible to change gender (or present as nonbinary) without a change in sexual function. Although JSM is giving the message that transgender health care has a place within sexual medicine, this is not the case for the International Consultation on Sexual Medicine (ICSM). The fourth ICSM meeting in June 2015 in Madrid, Spain, consisted of 16 Committees, but none concerned transgender health care specifically.We call upon the ISSM leadership to add one committee dedicated to transgender health care at the 5th ICSM meeting. This will significantly benefit trans* people who decide to seek psychological support and/or physical interventions to reduce symptomatic gender dysphoria. Placing and embracing transgender health care in the wider field of sexual medicine is also congruous with the direction of diagnostic classification. The forthcoming 11th edition of the International Classification of Diseases and HealthRelated Conditions of the World Health Organization is scheduled to “declassify” transsexualism as a mental disorder; change the diagnostic terminology to Gender Incongruence; and very likely place gender incongruence within sexual and reproductive health as a separate category [1]. Interestingly, some Northern European countries, most notably the Netherlands, Belgium, and Sweden, which historically have been academic and clinical leaders in the field of transgender health care, have moved gender identity clinic services away from psychiatric service and within the department of medicine (endocrinology). These developments will not only reduce stigma associated with being trans*, but also serve as exemplary clinical service development models elsewhere. Moreover, it will stimulate research in a multidisciplinary setting firmly grounded in physical health care.