We’ve entered a strange era in American public health where cancer, of all things, is being dragged into the culture war. According to recent reporting, policy changes tied to the Trump administration will require federally funded cancer registries to track patients only as “male,” “female,” or “unknown,” effectively erasing gender-diverse classifications from future cancer data.
Supporters frame this as a return to “biological clarity.” Critics see it as an act of political erasure that will obscure who actually gets sick, how they respond to treatment, and where disparities exist. And both sides, in their own way, are missing something essential:
This isn’t just about biology or identity anymore. It’s about ideology overriding medical reality at the institutional level.
That phenomenon is what I call Psychological Gender Dysmorphia.
Not as a psychiatric diagnosis. Not as a personal attack. But as a descriptive label for a state-level belief error where government systems reshape reality to fit politics, even when public health pays the price.
Important Clarification
The term “Psychological Gender Dysmorphia” is not a diagnosis in the DSM-5 and is not intended to be one. It is a rhetorical and analytic label for an institutional behavior pattern, not a psychiatric condition in individuals. The concept describes how government agencies and political systems distort medical reality under ideological pressure, not how any group of people experiences identity.
This distinction matters. The critique here is of policy-driven distortion, not of patients, minorities, or personal identity.
What Cancer Registries Are Actually For
Cancer registries exist for one reason: to track reality accurately.
They tell us:
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Who is getting sick
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At what rates
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With what outcomes
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Under what conditions
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In which populations
This data drives:
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Screening guidelines
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Research funding
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Drug development
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Public health interventions
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Insurance policy
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Hospital planning
When you alter how people are classified, you don’t just change language. You change what reality looks like on paper. And in medicine, paper reality is what determines who gets seen and who gets ignored.
How Ideology Breaks Medical Data
Under the new framework reported, if a person’s biology, medical history, or lived identity doesn’t fit neatly into the approved binary categories, they risk being classified as “unknown.” In epidemiology, “unknown” doesn’t mean mysterious. It means statistically disposable.
You can’t:
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Track trends
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Measure disparities
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Identify risk factors
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Or justify targeted interventions
for a population that technically does not exist in the data.
That’s not science. That’s narrative control through administrative simplification.
What I Mean by “Psychological Gender Dysmorphia”
Psychological Gender Dysmorphia, as I use the term, refers to:
The institutional compulsion to distort medical classification in order to satisfy political narratives about gender, even when that distortion damages scientific accuracy and patient outcomes.
It’s not about transgender people.
It’s not about personal identity.
It’s about bureaucracies losing their grip on empirical reality under ideological pressure.
In past years, critics argued that some agencies were privileging gender identity over biological sex in medical contexts where sex clearly matters. Now the pendulum is swinging hard the other way: identity itself is being erased when it becomes inconvenient.
Both directions represent the same underlying failure:
Medicine being subordinated to politics.
Trump’s Role in the Pattern
This policy shift fits a broader Trump-era pattern that extends far beyond health care:
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Redefining agencies by loyalty rather than expertise
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Treating data as a political enemy
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Framing complexity as corruption
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Calling scientific nuance “woke”
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Replacing institutional neutrality with narrative enforcement
The result isn’t conservative governance or progressive reform. It’s state-mandated simplification of reality.
That’s how Psychological Gender Dysmorphia becomes systemic rather than rhetorical.
Why This Is Dangerous Regardless of Where You Stand
You don’t have to agree on gender politics to see the danger here.
If you support transgender rights:
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This policy erases visibility, making disparities harder to prove and easier to deny.
If you prioritize biological classification:
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This policy corrupts data integrity, because medical reality is always more complex than two boxes.
If you care about public health at all:
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This policy introduces blind spots into cancer science, and blind spots kill.
This is not inclusion versus exclusion. This is accuracy versus ideology.
Cancer Does Not Care About Politics
Cancer does not:
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Vote
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Watch cable news
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Attend rallies
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Or recognize executive orders
It follows biology, exposure, genetics, hormones, environment, stress, access to care, and treatment timing. When political systems try to compress that reality into neat ideological categories, cancer doesn’t comply. People just get miscounted, misclassified, or missed.
The Real Question
The real question is not:
“Is this inclusive enough?”
or
“Is this biologically pure enough?”
The real question is:
Who benefits when medical reality is rewritten to make politics feel simpler?
Because patients don’t benefit.
Doctors don’t benefit.
Researchers don’t benefit.
Public health doesn’t benefit.
Only narratives do.
Final Word
Psychological Gender Dysmorphia isn’t about individuals being confused. It’s about institutions becoming ideologically dysmorphic. When governments decide which kinds of people are allowed to exist statistically, science stops being discovery and becomes compliance.
And history is very clear about where that path leads.
Cancer doesn’t care what we call it.
But patients will.
Cheers! Sláinte! Na zdravie!
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