Defining deviancy downward within medical science has been most commonly associated with efforts to eliminate the stigma of mental illness, if not exactly in any commonly recognizable way of thought, rather just by eliminating any consideration of mental illness as a diagnosis. In other words, thinking you're something you're physically not can no longer be considered evidence of a dissociation with reality.
The New England Journal of Medicine apparently thinks it can be a leading medical journal and political opinion-making journal at the same time, and its hubris prevents it from seeing that similar efforts within other fields and their journals have served only to diminish their former reputation, while revealing how naive were their political inklings. (Blame the university administrator who first thought to call the field "political science.")
This was probably inevitable dating from the moment the medical community accepted, if not embraced, psychiatry as science. And thus, here we are.
Another example of academic tourism and disingenuous journalism bundled all into one boiling pot of questionable moral fibre.