Others have concerns about a proposal to change the name from “transsexualism” to “gender incongruence,” a name chosen to try to express “a discrepancy between a person’s experienced gender identity and their body,” said Dr. Reed, who was part of the working group that recommended the changes to W.H.O.

One problem is that “incongruence” resonates differently in different languages. “In English it sounds kind of neutral — my association is with geometry,” Dr. Reed said. “But in Spanish it sounds very bad, it sounds kind of psychotic.”

So, in Spanish, the proposal is “gender discordance,” which, he said, “in English sounds really bad.”

Language differences are only part of the issue. “The terminology is difficult because nobody likes anything,” Dr. Reed said. “People have made suggestions that have been all over the map. One of the people at one of the meetings said we could call this happy unicorns dancing by the edge of the stream and there’d be an objection to it.”

The issue is reminiscent of the change in the way homosexuality was treated in the American bible of psychiatric diagnoses, the Diagnostic and Statistical Manual of Mental Disorders, known as the D.S.M. In 1973, the book, published by the American Psychiatric Association, changed the diagnosis of “homosexuality” to “sexual orientation disturbance,” and later to “ego-dystonic homosexuality” before dropping it altogether in 1987.

Transgender identity has changed in the D.S.M. too, classified under “sexual deviations” in 1968, “psychosexual disorders” in 1980 and “sexual and gender identity disorders” in 1994. In the fifth and most recent edition, D.S.M.-5 in 2013, the designation was changed to “gender dysphoria,” and was defined to apply to only those transgender people who are experiencing distress or dysfunction, said Dr. Jack Drescher, a psychiatrist and psychoanalyst at New York Medical College, who serves on the W.H.O. working group and served on a similar working group for the D.S.M.-5.

Dr. Drescher said he supported removing the diagnosis from the D.S.M. entirely, but he noted that the I.C.D. was different because it has categories for every disease and condition, not just psychiatric ones, and retaining some code for transgender identity might be the only way for some to receive medical care. Inmates, including Chelsea Manning, have received access to hormone treatments partly based on the fact that transgender identity belongs to a medical category, Dr. Drescher said.