More than three decades after the American Psychiatric Association voted to remove the classification of homosexuality as a mental disorder, those who do not conform to their assigned birth-sex, either by inner identity or outer social expression, are labeled mentally ill in the Diagnostic and Statistical Manual of Mental Disorders (DSM) with grave consequences to their human dignity, civil liberties and, for transsexual individuals, access to medical transition procedures. Gender Madness in American Psychiatry: Essays from the Struggle for Dignity provides an overview of the literature and attitudes behind the current diagnostic nomenclature and a historical snapshot of the issues and challenges faced by gender transcendent people on the eve of publication of the Fifth Edition of the DSM.