ABSTRACT
With the advent of evidence-based medicine, medical students have come to expect that the solutions for all problems can be found in the guidelines and standards of care for every single disorder. Often, they know a great deal about a condition before they have ever seen a patient. Usually working under time constraints, physicians must make quick decisions, frequently issuing a prescription to one patient, and then quickly attending to the next. What they are rarely taught is the fact that most of our present concepts of diseases, disorders, and cures are not as objective as we are inclined to believe. These concepts have evolved over centuries, even as the turnover of information has exploded during recent decades. They are influenced by philosophical, political, and socioeconomic conditions, as well as by general beliefs about what constitutes health and success in life. A “two-spirited” person in a North American context may be viewed as an especially gifted individual, whereas a transsexual person, in most Western contexts, will be diagnosed with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) diagnosis, e.g. a Gender Identity Disorder (DSM-IV, 303.85).
