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A lot of transgender people do not regard their cross-gender feelings and behaviours as a disorder. They question what a "normal" gender identity or a "normal" gender role is supposed to be. Sometimes, even the very existence of a "normal" gender identity or gender role is examined, and often rejected by sectors of modern gender studies. They often point out that not everyone who is born male is stereotypically masculine, and not everyone born female is stereotypically feminine.

Some people see "transgendering" as a means for deconstructing gender. However, not all transgender people wish to or feel that they are deconstructing gender.

Other transgender people object to the classification of GID as a mental disorder on the grounds that there may be a physical cause, as suggested by recent studies about the brains of transsexual people. Many of them also point out that the treatment for this disorder consists primarily of physical modifications to bring the body into harmony with one's perception of mental (psychological, emotional) gender identity, rather than vice versa.

Even though the preponderance of evidence suggests that transgender behaviour has a neurological etiology, clear and convincing evidence has yet to show whether the etiology of transgender is mental or physical. Thus the psychiatric diagnoses will continue to carry authority, and remain useful for medical billing purposes and potentially for the classification of research results, unless those diagnoses are debunked. However, little or no research into transgenderism or transsexualism is actually being conducted, especially in North America. The mental illness diagnoses are also enshrined in the HBIGDA-SOCs; they persist because no other medical diagnoses are available.

However, it should be noted that there are numerous diagnoses included in the DSM for which there is strong evidence of a genetic and neurobiological etiology such as schizophrenia, autism, and bipolar disorder. Dividing conditions into 'biological' versus 'psychological' is not a scientifically supported dichotomy. Therefore, the medical community recognizes that psychiatric illnesses often have their origins in disorders of chemistry, not of character. Psychiatric conditions are not separate from biological disorders, but rather a subset of biological disorders.

In a landmark publication in December 2002, the British Lord Chancellor's office published a Government Policy Concerning Transsexual People document that categorically states "What transsexualism is not...It is not a mental illness." It would appear to be likely that other countries will follow this lead. Nonetheless, existing psychiatric diagnoses of gender identity disorder or the now obsolete categories of homosexual disorder, gender dysphoria syndrome, true transsexual, etc., continue to be accepted as formal evidence of transsexuality.

The official politics in many countries interpret transgenderism as an undesirable behavior that must be prohibited, or as a psychiatric disorder, which should be cured. See Heteronormativity

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