Mental health articles

Gender identity disorder

In contrast to transvestism, where men dress as women, but accept their male identity, individuals with gender identity disorder (GID) believe themselves to have been born the wrong sex. DSM-IV-TR defines the disorder as:

a strong and persistent cross-gender identifi cation persistent discomfort with one’s sex, or a sense of inappropriateness in the gender role of that sex clinically signifi cant distress or impairment in social, occupational or other important areas of functioning.

In adolescents and adults, gender identity disorder is manifested by a preoccupation with the belief that they are born ‘the wrong sex’ and a desire for the removal of primary and secondary sex characteristics. Many people with this disorder opt for surgery to change their body to what they consider to be their appropriate sex. They become transsexuals. Others do not take such a radical step, but dress and try to pass themselves of as a member of their desired sex. People with GID are often sexually attracted to people of the same sex, which they interpret as conventional heterosexual preference. There are no prevalence data of the condition within the general population. However, what little evidence there is suggests that people with gender identity disorder are highly likely to experience clinically signifi cant distress at some period in their life. e Most adults with GID report a history of consistent cross-gender behaviour in childhood. Boys may reject the rough-and-tumble play and prefer the company of girls. They frequently dress in women’s clothing and insist they will grow up to be a girl. Some claim their penis and testes are disgusting and hope they will somehow change into female genitalia as they grow older. Girls may reject urinating in the sitting position, and assert that they do not want to grow breasts or menstruate. They may reject typical girls’ clothing. Green and Blanchard reported that these behaviours and attitudes are usually detected before the age of 3 years. These characteristics are not static, however, and many children adopt more gender-appropriate behaviours and identities over time. Wallien and Cohen-Kettenis, for example, followed a cohort of 77 children referred to a clinic as a result of gender dysphoria. At 10 years follow-up, 43 per cent of their sample were no longer gender dysphoric. Of note was that the stronger the cross-gender behaviour, the more likely the child to remain gender dysphoric. Some adults may also spontane ously change their gender identity, although such occurrences are rare. Findings that most individuals experience signifi cant reductions in distress if they change sex through hormonal and surgical means, have led some to argue that GID is not a mental health disorder. Rather, any mental distress experienced is an understandable outcome of a physical disorder – having gender-inappropriate genitalia and body type. According to this argument, DSM-IV and certainly DSM-V should no longer include GID as a psychiatric diagnosis.

Tags: disorder, gender identity disorder, symptoms