The statement of “risky practices” and of pathologies about “transsexualism” maintains the context of a standard of health based on a majority said to be “normal”, expurgated of the minority peculiarities and generating targeted but conditional policies delivered from expertises. Their economic justification allows to hide the violence of the ideological dimensions which are in confrontation on both sides of the “healthy” and the “pathological”. Trans are at the center of these conceptions and seem to pay the price. On one side a tolerant vision (fights against discrimination, equal rights), on the other side, a pathologizing vision conditioning the frame of the coverage and making up a “coverage” defined from a psychopathologist conception, protected by a “therapeutic shield” and binary standards of gender.