One example is transgender people receiving a psychiatric diagnosis of gender identity disorder. This disorder is characterized by “intense and persistent self-identification with the opposite sex, combined with persistent discomfort with the assigned sex.” By being diagnosed with a disorder, transgender people are perceived as mentally unstable and therefore excluded from society. This discrimination is evident in cases where transgender students have been excluded from school due to wearing clothing deemed unsuitable for their biological sex. Other cases of transgender discrimination involve “difficulty accessing social services because their gender identity and expression are different from those indicated on their birth certificate, driver's license, passport and other official documents,” as is the case with Avery. Additionally, in cases where transgender people wanted to undergo gender reassignment surgery, they had to accept a diagnosis of mental illness, regardless of their emotional stability and psychological health. They also "reported discrimination and cultural insensitivity in drug treatment programs, including verbal and physical abuse by staff, being forced to dress like their biological sex, and