Abstract

According to the ICD-11 and DSM-5, transgender people’s experienced gender is incongruent with their natal sex or gender and the purpose of gender affirming-healthcare (GAH) interventions is to reduce this incongruence. Vincent argues that this view is conceptually incoherent—the incoherence thesis—and proposes that the ICD and DSM should be revised to understand transgender people as experiencing a merely felt incongruence between their gender and their natal sex or gender—the feelings revision. I argue that (i) Vincent in fact gives us no reason to believe the incoherence thesis and that (ii) we may want to resist the combination of the incoherence thesis and the feelings revision because this combination seems to imply that all transgender people have feelings that are misplaced and are, in an importance sense, incorrect or mistaken. I then give a fit-based account of how trans people’s experienced gender can be incongruent with their natal sex or gender and how GAH can reduce this incongruence.