TOPEKA — State Sen. Steve Fitzgerald, R-Leavenworth, stirred controversy and discussion Wednesday when he said transgender individuals suffer from a form of “insanity” and that society should not respond by accepting it.

His remarks came during debate over a nonbinding resolution condemning the Obama administration’s new guidelines on Title IX compliance that instruct schools to allow transgender students to use restrooms and locker rooms and to participate in other sex-segregated activities that correspond to their gender identity.

“You’re either male or you’re female, and it’s not changeable,” Fitzgerald, R-Leavenworth, said on the Senate floor. “It’s reality. Inability to deal with that reality, or to recognize that reality, is disoriented, and can be disoriented to the point of insanity.”

“I’m not surprised that those who are confused about their sex have a high rate of suicide,” Fitzgerald added. “Suicide does have a high rate with those who are afflicted with some form of insanity.”

According to experts at the American Psychiatric Association, which publishes the Diagnosis and Statistical Manual of Mental Disorders, or DSM, the accepted standard for classifying and diagnosing mental illnesses, being transgender is no longer considered a mental disorder.

But the APA’s acceptance of the condition is a relatively recent development, said Dr. Jack Drescher, an APA distinguished life fellow who was a member of the working group that wrote the section on sexual and gender identity disorders for the latest version of the manual, commonly known as the DSM-5.

“The DSM-5 came out in 2013, and ‘gender dysphoria’ replaced a previous diagnosis called gender identity disorder, which had been in the DSM since 1980,” Drescher said. “But the phenomenon of people having gender dysphoria has been around for a long time, and people have been providing medical treatment for change in Europe since the 1920s.”

The APA also deleted homosexuality as a mental disorder in 1973.

The manual defines gender dysphoria as “a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify.”

“People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of their assigned gender,” the manual states.

Some have argued that because the condition is still listed in the DSM, it still should be considered a mental disorder. But Drescher said that is a misconception as well.

“Gender dysphoria is a diagnosis in the DSM-5, but it’s unlike any of the other diagnoses in the DSM. I think it’s the only diagnosis where, if you have the diagnosis, we don’t try to change the mind, but the treatment is to change the body.”

Drescher, who is a clinical professor of psychiatry and behavioral sciences at New York Medical College, and a clinical supervisor and adjunct professor at New York University, also said that scientists do not know what causes gender dysphoria, although they do know what kinds of treatments do and don’t help people feel better.

“We don’t know why people feel this way. We just know that when people feel this way fairly strongly enough, efforts to change their minds have never worked, and that’s why the standard of care has been to help people change,” he said.

“Not everybody gets the same amount of services in terms of what they do for transition,” he added. “But pretty much, the national consensus is that most people who get treatment do better after they get the treatment. That is, they feel better when they’re allowed to change.”

Drescher also dismissed the assertion, made by many who supported Wednesday’s legislative resolution, that being transgender, or being homosexual, is a voluntary lifestyle choice rather than an innate characteristic of one’s personality.

“Why would people voluntarily choose to be despised and stigmatized by their neighbors?” he said.

“We say that we don’t know why some people are one way or another when we don’t have the data,” he added. “But I can say it’s not a choice in the sense of whether I choose to live in New York or Kansas, or whether I choose to be an Episcopalian or a Roman Catholic. It’s not that kind of choice. It’s something that is usually very deeply felt, and the reason why people let other people know about it is because hiding it usually feels worse.”