medical evidence by the medical practitioners on the gender identity disorder (currently has been reclassified as gender dysphoria) was referred in the case of Muhammad Juzaili Bin Mohd Khamis & Ors v State of Government of Negeri Sembilan [2015] MLJ 65. The excerpts on gender identity disorders in the 4th edition of the DSM was exhibited in the case which explained that gender identity disorders “are characterized by strong and persistent cross-gender identification accompanied by persistent discomfort with one’s assigned sex”. 150. Currently, health care professionals were guided by the 10th revision of the ICD115 and 5th edition of the DSM. In the 5th edition of the DSM, gender identity itself is not a disorder that requires treatment. It is the dysphoria that comes with learning that one’s assigned birth sex is not aligned with their expressed gender that requires treatment. Therefore, the DSM had removed the term ‘gender identity disorder” and replaced it with “gender dysphoria”. However, the DSM and ICD is perceived by certain sectors of the society as adopting western and secular values abandoning local norms and culture. 151. In 2017, the Ministry of Health through its Family Health Development Division issued a Guideline on Handling of Gender related Health Issues in Healthcare Clinic116. The guideline, which is expected to be a reference for procedure and handling steps on gender related health issues. It served to identify gender related issues for baby, children, adolescent and elderly. The guideline also includes the usage of hormone and its side effect towards the users. The introduction of the guideline had involved local university academicians, government officials among other from Ministry of Education, Department of Registration, National Population and Family Development Board, Islamic State Authorities save for LGBT advocates or community. Moreover, the guideline has highlighted the stand of the government in prohibiting gender reassignment surgery, laws’ provisions with regard to carnal intercourse against the order of nature and the discussion on the case of Muhammad Juzaili Bin Mohd Khamis & Ors. It should be highlighted that If more aspects of healthcare concerns are dictated by religious sensitivity, this would negatively affect the health system in reaching out to marginalised individual which include transgender persons. 152. In addition, the classification of gender diversity as a mental illness contributes to the stigma experienced by transgender persons.117 However, in the Malay mail online reported that a research published in a journal entitled The Lancet Psychiatry found that violence and social rejection are the cause of mental distress and impairment among transgender people, not their gender identity.118 115 “ICD-10 was endorsed in May 1990 by the Forty-third World Health Assembly. It is cited in more than 20,000 scientific articles and used by more than 100 countries around the world”. Accessed via http://www.who.int/classifications/icd/en/ (accessed on 7 April 2017) 116 Garispanduan Pengendalian Masalah Kesihatan Gender di Klinik Kesihatan (translated from Malay into English). 117 Asia Pacific Transgender Network, United Nations Development Programme. Blueprint for the provision of comprehensive care for trans people and trans communities in Asia and the Pacific. Washington, DC: Future Group, Health Policy Project. 2015. P. 19 118 http://www.themalaysian online.com dated 29 July 2016 (accessed on 1 August 2016) 66 | Report On Transgender Persons In KL And Selangor