Gender Dysphoria

10 Key excerpts on "Gender Dysphoria"

• 

  eBook - PDF

  Gender and Other Identities: Complex conceptualizations in the new age

  • Margaret F. Bello(Author)
  • 2020(Publication Date)
  • Society Publishing

    (Publisher)

  Because these types of the estimates are based on the number of people who are searching for formal treatment which is consisting of the hormone therapy and/or surgical reassignment, these rates are very likely an underestimate of the actual prevalence. The degree of distress experienced by someone with respect to the GD is very critical, and the individuals do much better if they live in the surrounding that is quite supportive, they are permitted to express or share their gender in the way that is most comfortable to them, and are given knowledge that, if important. There are several types of treatments are available to decrease the sense of the incongruence they feel. 3.4. Gender Dysphoria (SEXUAL IDENTITY DIS -ORDERS) The significance of the word gender came from the Old French word termed as “gendre” (which is now termed as “genre”). The meaning of the word “genre” is, “kind, genus, sort.” Typically, children are as-signed to their gender at the time of birth based on their chromosomes and anatomy. Gender Identity Disorder 65 For most of the children, this gender assigned with respect to their gender identity, an essential sense of identifying the individuality as a male or female. Some children can experience a strangeness or oddness and grow into the transgender adults. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), GD is defined as a “marked incongruence among their experienced or expressed gender and the one they were assigned at the time of birth.” It was formerly known as “Gender Identity Disorder.” Children and adolescents who experience this type of chaos or disorder cannot relate to their gender expression when identifying themselves within the traditional societal binary roles of male or female, which can produce cultural stigmatization. Figure 3.3: Sexual identity disorders – Gender Dysphoria.

  Sign up to read

  Learn more about book
• 

  eBook - ePub

  Complex Disorders in Pediatric Psychiatry

  A Clinician's Guide

  • David I Driver, Shari Thomas(Authors)
  • 2018(Publication Date)
  • Elsevier

    (Publisher)

  We first aim to help providers have a sense of the difference between assigned sex, gender identity, and gender role and how Gender Dysphoria affects children and adolescents. It is important to have a common language to discuss the differences and relationships between sex, gender identity, and gender expression. Biologic sex is defined as the set of anatomic and hormonal differences that have historically defined male and female. These are affected by the individual’s genetic makeup. This is different from an individual’s gender identity, which is an individual’s subjective sense of his/her own gender as male, female, or another gender identification. Gender variance is encompassed within gender identity, as it describes any variability in gender identity or gender role. Gender role is the behaviors and roles learned by an individual as determined by the cultural norms. Gender expression is how an individual presents his/her gender through his/her actions, dress, and demeanor, and how those presentations are based on gender norms.

  Gender Dysphoria is a term created by the Diagnostic and Statistical Manual of Mental Disorders , Fifth Edition (DSM-5 ) to describe the distress that might be present in the context of incongruence between sex assigned at birth and gender identity. There is some controversy around the inclusion of Gender Dysphoria within the diagnostic manuals, as it may inadvertently pathologize gender variance through its inclusion in this manual. Gender variance is a healthy exploration of the gender spectrum. Although we do not believe that gender variance is pathologic, we know that individuals who experience incongruence between biologic sex and gender identity are forced to face intense minority stress, overtly and covertly, and it is unsurprising that transgender adolescents often have alarmingly high rates of mental health issues, including increased suicidal ideation and suicide attempts.1 Minority stress is seen systemically through the chronic violence toward transgender and gender nonconforming individuals, high rates of homelessness, underemployment, and poor medical care for these individuals.

  2 –4

  An individual presenting with Gender Dysphoria might have symptoms that stem from minority stress or might be independent of minority stress; however, the dysphoria is not the result of the individual’s gender identity itself.5

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Sexuality

  A Biopsychosocial Approach

  • Chess Denman(Author)
  • 2017(Publication Date)
  • Red Globe Press

    (Publisher)

  This must be taken into consideration in managing such patients. The continuum between transvestism and transgendered status, and also the range of strengths of transgendered wishes, make it sensible to see all 232 SEXUALITY these conditions as points along a continuum of dissatisfaction with gender. As a result it is often better to use the term Gender Dysphoria to describe them. Causes of Gender Dysphoria: biological and sociocultural issues Theories about the cause of Gender Dysphoria are difficult to formulate largely because no reliable theory of gender identity has yet been formulated. Patients with intersex conditions have often become debating grounds for considering these issues, but even here controversy reigns. There is, for instance, the now infamous case of John/Joan a genetic male whose penis was mutilated in a botched surgical operation. He was then reared as a girl on the advice of John Money, an expert in the field. John/Joan rebelled against this as a teenager and now lives as a man. This case has been taken as evidence that gender identity depends on sex of rearing and, more recently, as evidence for the primacy of biology (Colapinto 2000). The influence of prenatal androgens does seem to be important but not decisive (Bancroft 1989). Bancroft also suggests that in transgendered men in particular there may be elevated testosterone levels. Pillard and Weinrich (1987, in Devor 1999) have developed a more complicated hormonal theory to try to classify different kinds of gender identity in relation to perina-tal hormonal influences but even this theory leaves much unex-plained. Notwithstanding the current lack of firm evidence, most transgendered people and the great majority of people who work with them are fairly convinced of the view that a biological cause for the condition will be uncovered sooner or later.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Introduction to Psychiatry

  Preclinical Foundations and Clinical Essentials

  • Audrey Walker, Steven Schlozman, Jonathan Alpert(Authors)
  • 2021(Publication Date)
  • Cambridge University Press

    (Publisher)

  Indeed, carrying such a diagnosis may imply gender-diverse people are mentally ill simply due to their identities. DSM-V Psychiatric Diagnoses Related to Gender Identity and Sexual Orientation It is important to keep this history in mind when learning about the diagnostic categories that persist in the current, fifth edition of the DSM. Each of the fol- lowing diagnoses is marked by the presentation of gender or sexual “difference” for a socially determined norm, as well as psychiatric symptoms (e.g., clinically significant distress or impairment in social, occupational, or other important areas of functioning) that subsequently affect one’s life. There are three categories of gender- and sexuality-related diagnoses. Gender Dysphoria The first is Gender Dysphoria, defined by distress experienced by an individual whose gender identity does not match the sex they were assigned at birth. Gender Dysphoria can be understood as a psychiatric conflict between one’s physical/ Psychiatry of Gender Identity and Sexual Orientation 461 legal/social sex and one’s gender identity. Some people who meet the criteria for this diagnosis report significant distress and problems functioning due to this psychiatric conflict. Some people may socially transition, using a self-determined name, pronoun, and/or clothing to present to others in a specifically gendered way. Gender Dysphoria is not the same as gender nonconformity, which refers to engaging in behaviors that do not match socially sanctioned expressions and roles for girls/women and boys/men. Instead, Gender Dysphoria refers to distress or impacted functioning due to a discrepancy between one’s gender identity and assigned sex at birth. Diagnoses related to gender include (1) Gender Dysphoria in children, (2) Gender Dysphoria in adolescents and adults, (3) other specified Gender Dysphoria, and (4) unspecified Gender Dysphoria.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Child Psychopathology

  From Infancy to Adolescence

  • Barry H. Schneider(Author)
  • 2014(Publication Date)
  • Cambridge University Press

    (Publisher)

  In essence, the criteria include a pronounced cross-gender identity associated with prolonged and marked distress. The DSM-5 Commission engaged in a long and tortuous debate about the fate of this category, chronicled by Kamens ( 2010 ). The initial recommendation was that the disorder be renamed “gender incongruence.” The DSM-5 Commission decided to relabel the disorder “Gender Dysphoria.” It is not called a disorder although, indeed, it appears in a manual of disorders. The criterion of marked distress and impairment was added to those that were originally considered. The obvious parallel between this diagnostic label and the defunct condition of ego-dystonic homosexuality that entered and exited the nomenclature a generation ago is uncanny. The changes between the DSM-IV criteria for “gender identity disorder” and the DSM-5 criteria for “Gender Dysphoria” are summarized in Box 24.1. showing gender variance in large Western countries to other comorbid problems such as depression and school refusal may thus be symptoms not of any disorder internal to the child but symptoms of harassment and rejection on the part of the peer groups at school and in the community (Gray, Carter and Levitt, 2012 ; Meyer-Bahlburg 2010 ). Some critics suggest that this principle should be revisited to extricate “disorders” that are essentially the result of social stigma. This issue is not relevant to the inclusion of this disorder in the DSM as established by its developers because, as noted in Chapter 3 , the DSM has become a taxonomy built on symptoms, not causes. Perhaps the most important issue from an ontological standpoint is whether gender variance during childhood leads to maladaptive outcomes later on, even though any such maladaptive outcomes could be largely imposed by societal sanctions. There could indeed be some validity in delineating a cluster of symptoms as a disorder if it can be shown that the symptoms lead to maladaptation later in life.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Supporting Transgender and Gender-Creative Youth

  Schools, Families, and Communities in Action, Revised Edition

  • Elizabeth J. Meyer, Annie Pullen Sansfaçon, Elizabeth J. Meyer, Annie Pullen Sansfaçon, Elizabeth Meyer(Authors)
  • 2018(Publication Date)
  • Peter Lang Inc., International Academic Publishers

    (Publisher)

  As Spade (2003) argues, the diagnosis of ‘Gender Identity Disorder’ implicitly creates a dichotomy between abnormal and normal gender development that promotes a ‘fiction of natural gender’ (p. 25). In doing so, it assumes that all forms of gender expression that fall outside this definition are fundamentally deviant (Lev, 2005). Paradoxically, while the ‘Gender Identity Disorder’ criteria risk encapsulating many gender-creative individuals beyond the scope of ‘transsexualism’ (making it impossible to be ‘transsexual’ and mentally ‘healthy’), they simultaneously exclude many they are designed to support (Lev, 2005). For example, there is a diverse range of individuals who wish to pursue body modification surgery or receive hor- monal treatment to ease the distress of Gender Dysphoria. However, as the diag- nosis acts as what Lev (2005) describes as an ‘admission ticket,’ those who do not fulfill the criteria often find that treatment is not available. For instance, as ‘trans- vestism’ is separated from ‘transsexualism’ based on the criterion of wanting to change sex, a previous diagnosis of ‘transvestism’ can result in a refusal for medical treatment (Lev, 2005). Another frequent criticism of ‘Gender Identity Disorder’ (GID) is the dec- laration that mental disorders have subsequent distress for the individual. Several have queried the cause of childhood distress as an internal mental pathology that leads to deteriorated social relationships, arguing for the possibility that the distress is a result of social stigmatization from the diagnostic label. Lev (2005) states, ‘If gender-variant behavior was not stigmatized by labeling these expressions as psychi- atric diagnoses, then transgender and transsexual people might experience signifi- cantly less emotional, legal, or social distress’ (p. 48).

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Mental Health, Diabetes and Endocrinology

  • Anne M. Doherty, Aoife M. Egan, Sean Dinneen(Authors)
  • 2021(Publication Date)
  • RCPsych Publications

    (Publisher)

  In DSM-5, the diagnosis is updated to Gender Dysphoria, which is described as a ‘marked incongruence between one’s experienced/expressed gender and assigned gender of at least 6 months’ duration’ and ‘clinically significant distress or impairment in social, school, or other important areas of functioning’ (3). Therefore, the presence of distress and dysfunction are central to its diagnosis in DSM-5, and its presence in DSM-5 keeps it defined as a mental disorder. In the long anticipated ICD-11, due to be published in 2022, the gender identity disorder of ICD-10 categorised under psychiatric disorders will be replaced by gender incongruence of adolescence and adulthood and will be categorised under Conditions Related to Sexual Health (4). This change occurred in response not just to the evolving research and clinical- based knowledge available, but also on the basis of changes in law, policy and human rights standards, which had made the previous categorisation under mental and behavioural disorders increasingly controversial. In ICD-11, the primary focus will be on the incon- gruence between natal sex and experienced gender, rather than the distress or dysphoria 116 associated with this under DSM-5: in ICD-11, dysphoria may be present but is not a requirement for a diagnosis of gender incongruence. As in the ICD-10, there is a restriction in the diagnosis of gender incongruence of adolescence and adulthood before the onset of puberty. In ICD-11, the diagnostic requirements for gender incongruence of adolescence and adulthood will include the continuous presence for at least several months (a reduction from two years in ICD-10) of at least two of the following features: (1) Strong dislike or discomfort with primary and/or secondary sexual characteristics due to their incongruity with the experienced gender.

  Sign up to read

  Learn more about book
• 

  eBook - ePub

  Perverse Psychology

  The pathologization of sexual violence and transgenderism

  • Jem Tosh(Author)
  • 2014(Publication Date)
  • Routledge

    (Publisher)

  Remaining in an incongruent state is not explicitly outlined as an option by the DSM, as the proposed criteria does not allow for nonpathologized incongruence. However, in Frances’ (2010 b) critical blog post he states, ‘Gender incongruence 3 becomes a mental disorder only when it is causing significant problems’ (para. 14, my emphasis). He therefore creates an opening for a subgroup of nonconformists who are not pathologized (those who are nonconforming but not experiencing any ‘significant problems’) and potentially moves the focus away from incongruence and towards distress. However, the DSM almost moved in the opposite direction, potentially reducing the emphasis of distress further than previous DSM revisions. For example, the second proposed revision released in 2011 stated that the diagnosis could be used when an individual had a risk of suffering that was deemed significant enough to justify psychiatric intervention (APA, 2011b). The necessity for diagnoses to include the distress criteria was a direct result of the debate regarding homosexuality as a mental ‘illness’ (see chapter four), thus this potential change to the ‘Gender Dysphoria’ category was cause for concern. Fortunately, this revision did not make it into the DSM-5. While this removal of distress as a criterion did not occur, neither was there a significant change in the construction of ‘Gender Dysphoria’ as representing pathologized distress related to gender identity, as the name implied. As Winters (2011) observed, the term ‘dysphoria’ means ‘abnormal’ (‘dys’) (Starcevic, 2007) ‘distress’ (‘phoria’), but this is inconsistent with the DSM-5 criteria which placed the focus directly on nonconformity

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  Trans and Non-binary Gender Healthcare for Psychiatrists, Psychologists, and Other Health Professionals

  • Christina Richards, James Barrett(Authors)
  • 2020(Publication Date)
  • RCPsych Publications

    (Publisher)

  Chapter 4 Mental Health Conditions Introduction In the World Health Organization’s historic International classification of diseases version 10 (WHO, ICD 10, 1992), and all earlier versions which considered the matter, Gender Dysphoria was termed ‘Transsexualism’ and classified in the section devoted to disorders of adult personality and behaviour. By the early twenty-first century, this placement came to seem increasingly inappropriate, not least because, notwithstanding prejudice towards trans people leading to depression and anxiety (Robles et al., 2016), the rates of psychopathology are no higher among trans people than among cisgender people (Colizzi, Costa, & Todarello, 2014; Hill et al., 2005; Hoshiai et al., 2010; Simon et al., 2011). Consequently the WHO has stated that the renamed Gender Incongruence is not a mental disorder (WHO, 2019a) and, in the International statistical classification of diseases version 11 (WHO, 2019b) has been moved out of sections related to mental disorders and into the section devoted to Conditions related to sexual health. 1 The retention of any diagnosis at all differs from the debates surrounding the removal of homosexuality from the American Psychiatric Association’s Diagnostic and statis- tical manual (DSM) in 1973 and from the ICD in 1992, in that same-gender attraction does not require any specific intervention and associated diagnosis, whereas under current arrange- ments, trans people seeking hormones or surgeries do. Notwithstanding this pragmatic need for a [non-psychiatric] diagnosis, trans folk do not have a mental illness or disorder simply by virtue of being trans – and accordingly ought not to be treated as if they do. On the other hand, being trans does not magically confer some sort of immunity from all known forms of mental illness or disorder, and it is consequently perfectly possible for someone to be both trans and also, incidentally, to have exactly such an illness or disorder.

  Sign up to read

  Learn more about book
• 

  eBook - PDF

  The Troubled Mind

  A Handbook of Therapeutic Approaches to Psychological Distress

  • Susy Churchill(Author)
  • 2020(Publication Date)
  • Red Globe Press

    (Publisher)

  Cohen and Galynker (2002) reported that paedophiles were likely to have a range of other mental health issues, partic-ularly mood, substance-misuse and impulse-control disorders, together with other paraphilias and personality disorders, especially antisocial and Cluster C. Many had themselves been sexually abused as children. The final disorder in this section listed by DSM is gender identity disorder ( Gender Dysphoria ). Gender identity disorder The essential characteristics of this diagnosis, which can apply to children, adolescents and adults, is a belief that they were born in the wrong sex, a desire to be the other sex, and identification with the stereotyped gender role of the other sex. Our client Stefan would receive this diagnosis. This diagnosis would not be made if the individual is anatomically ‘intersex’ (has undifferentiated genitals). DSM reports that most children with gender identity disorder no longer have the condition by adulthood. About 75% of boys with the diagnosis as children go on to report a homosexual or bisexual orientation, but not Gender Dysphoria . In adult males, this condition may have been persistent since childhood, but may also develop in early to mid-adulthood, often after a period of transvestic fetishism. DSM also quotes figures from European population samples showing that 1 in 30,000 adult males and 1 in 100,000 adult females request gender reassignment surgery. Hormones to prevent puberty may be prescribed when young people with established Gender Dysphoria start showing the early signs of puberty, but this causes considerable controversy. THEORETICAL FORMULATIONS OF SEXUAL PROBLEMS Any discussion of sexuality must begin by recognising how much of what is considered ‘normal’ is culturally determined. For example, in Victorian England a woman would not be considered as suffering if she failed to have orgasms: desiring an orgasm would have been seen as a sign of

  Sign up to read

  Learn more about book