 Notably, Butler considers the political tension between those trans activists who would oppose the Gender Identity Disorder as pathologizing and paternalistic, and those who insist upon its importance in securing access to medical technologies, recommending the strategic use of the diagnosis. While the latter view underestimates that degree to which such a move further empowers the existing structural arrangement and inflicts damage upon those who undergo the regulations (82–3), the former fail to see how, in practice, movement away from some medical regulation is not going to be possible without also completely undermining access to the technology (90–1). In Butler's view, the institutional mechanisms which permit access through medical regulation and psychological evaluation, allow for a kind of culturally circumscribed access to autonomy, but only at the cost of “undoing” oneself (91). Butler sees this bind of “undoing oneself” in order to “do oneself” as characteristic of the general way in which autonomy is both culturally denied and bestowed (100–1).