This was also a major problem with the diagnosis "gender identity disorder", which was defined in the DSM (Diagnostic and Statistical Manual of Mental Disorders) IV as "A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex)."

In the DSM V, the diagnostic name "gender identity disorder" was replaced with "gender dysphoria", and other important clarifications, including the need for a formal diagnosis of gender dysphoria to go ahead with gender transition surgery.

I wonder if anything has changed since 2004.