Providing medical care for Gender Identity Disorder（GID）poses enormous challenges and difficulties. The one obstacle to overcome is building a pluralistic treatment system in collaboration with experts from various fields of medicine as outlined in “Guidelines for Treatment and Diagnosis of GID version 3rd”established by the Japanese Society of Psychiatry and Neurology. Another obstacle includes the multilayered decision tree in deployment of physical as well as psychiatric treatment. Offering continuous supports of the pluralistic treatment system following the multilayered decision tree poses a major obstacle.
 In this report,we examined these obstacles from a perspective of the actually accessible healthcare resources and came up with a proposal of constructing a multicenter collaboration system. As one of concrete example of a solution to these obstacles, we demonstrated our activity of“Kansai GID network.”
 By sustaining these activities, many obstacles posed in the treatment of GID could be overcome. We hope substantial and comprehensive treatment systems for GID shall be promptly established in Japan.