Gender diversity set a new paradigm in terms of challenge and study for mental health. The analysis includes everything from basic parameters such as shed prejudices and preconceptions, to question old concepts rooted yet even from the proposed DSM, understanding gender diversity not just in terms of behaviour, choices or sexual conditions but from the integration of this in cognition and social inclusion, and finally understand that the nosological processes become in fact they do not have their origins in the diversity of gender, and that this per se does not constitute a pathology. The main issues addressed are the social marginalization, the problems of co-existence, discrimination, external and internal positioning for their conduct, election or sexual and gender perceptions and ways of adaptation are implemented, in addition to nosological processes current mental health, which are influenced but not because of the above. The population Trans in penitentiary system frequently mental health care for problems such as substance abuse, convivial and adaptive circumstances, being achieved in most cases a specific record of the particular problems and behavioral system that allows the convivencial adaptation, with the limiting variables that negatively influence (discrimination, marginalization, etc). The binary logic in the current psychopathology as well as society and culture in general prevents nosological analyze processes of these patients regardless of their behavior, sexual choice or self-perception of gender. They should consolidate new paradigms of psychopathological analysis to achieve a more comprehensive understanding of the nosological processes in these patients to achieve effective therapeutic targets.