The DSM is a socially construction. Diagnoses come and go as society changes. For example, homosexuality was removed as a mental illness in 1987 after gay rights activists protested. The total removal of homosexuality from the DSM was the result of a vote. Recently, sexual identity disorder(s) were reconfigured to eliminate stigma against trans persons. The reconfiguration came after consultation with transgender advocacy organizations. And a vote. Gender dysphoria continues to be a diagnosis only to facilitate insurance reimbursement for treatment. People who are not unhappy with being trans are not diagnosed as having a disorder, and people who have successfully transitioned from one gender to another no longer have a diagnosis. If the DSM had stable diagnostic categories, then it could be reasonably argued that the DSM is purely scientific. But the diagnostic categories historically have shifted in response to advocacy and political action, demonstrating its essential social nature.