Gender identity disorders
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GID: Definition
Gender identity disorder, as identified by psychologists and medical doctors, is a condition with which a person who has been assigned one gender (usually at birth on the basis of their sex, but compare intersexual), but identifies as belonging to another gender, or does not conform with the gender role their respective society prescribes to them. It is a psychiatric term for what is widely known by terms like transsexuality, transgender and (subject to debate, but full-fledged GID is present in at least some cases) transvestism or cross-dressing. Another proposed term for the condition is Benjamin's Syndrome, named for Harry Benjamin, a pioneering researcher in the field of transsexuality.
This feeling is usually reported as "having always been there", although in some cases, it seems to appear in adolescence or even in adulthood, and it has been reported by some as intensifying over time. Since many cultures strongly disapprove of cross-gender behaviour, it often results in significant problems for those affected, and sometimes for their close friends and family members as well. In many cases, discomfort is also reported as stemming from the feeling that one's body is "wrong" or meant to be different.
See also: List of transgender-related topics
GID: Description
[edit] DSM-IV
The current edition of the Diagnostic and Statistical Manual of Mental Disorders has five criteria that must be met before a diagnosis of Gender Identity Disorder (302.85) can be given: [1]
- There must be evidence of a strong and persistent cross-gender identification.
- This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
- There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex.
- The individual must not have a concurrent physical intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia).
- There must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The DSM-IV also provides a code for gender disorders that did not fall into these criteria. This diagnosis of Gender Identity Disorder Not Otherwise Specified (GIDNOS, 302.6) is similar to other "NOS" diagnoses, and can be given for, for example: [2]
- Intersex conditions (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia) and accompanying gender dysphoria
- Transient, stress-related cross-dressing behavior
- Persistent preoccupation with castration or penectomy without a desire to acquire the sex characteristics of the other sex, which is known as skoptic syndrome
For some people, GID in the DSM-IV is comparable to transsexuality, whereas GIDNOS, to them, is more comparable to other transgender conditions that may be seen as disorderly. On the other hand, many transgender people themselves feel quite accurately described by the DSM-IV, and many have none of the symptoms listed above under NOS. Some transsexual and transgender people do not feel like the DSM-IV describes their condition accurately, in any sense.
Transvestic fetishism has its own code, as a paraphilia rather than a gender identity disorder.
[edit] ICD-10
The current edition of the International Statistical Classification of Diseases and Related Health Problems has five different diagnoses for gender identity disorder: transsexualism, Dual-role Transvestism, Gender Identity Disorder of Childhood, Other Gender Identity Disorders, and Gender Identity Disorder, Unspecified. [3]
Transsexualism has the following criteria:
- The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment.
- The transsexual identity has been present persistently for at least two years.
- The disorder is not a symptom of another mental disorder or a chromosomal abnormality.
Dual-role transvestism has the following criteria:
- The individual wears clothes of the opposite sex in order to experience temporary membership in the opposite sex.
- There is no sexual motivation for the cross-dressing.
- The individual has no desire for a permanent change to the opposite sex.
Gender Identity Disorder of Childhood has essentially four criteria, which may be summarised as:
- The individual is persistently and intensely distressed about being a girl/boy, and desires (or claims) to be of the opposite gender.
- The individual is preoccupied with the clothing, roles or anatomy of the opposite sex/gender, or rejects the clothing, roles, or anatomy of his/her birth sex/gender.
- The individual has not yet reached puberty.
- The disorder must have been present for at least 6 months.
The remaining two classifications have no specific criteria and may be used as "catch-all" classifications in a similar way to GIDNOS.
Since, very often, many people (including doctors, judges etc.) assume that the classifications "transsexual" and "transvestite" can apply only to adults, the F64 section of the ICD-10 is often criticised, especially since the "usually" in "usually accompanied by the wish to make his or her body as congruent as possible " is often ignored as well, and wish for sexual reassignment surgery (SRS) is seen as a requirement for the diagnosis of "transsexualism". However, an increasing number of physicians and therapists are treating transsexual people who have no desire for surgery, sometimes known as "non-op" transsexuals.
Many transgender people, however, do not fit into either of these two categories; for example, transgender people who wish to change their social gender completely, but who do not bother with SRS. This can lead to significant problems with things such as procuring medical treatment and legal change of name and/or gender; in some cases, it may make them completely impossible.
GID: Discussion as to the appropriateness if defining GID as a disorder
GID: History of the disorder
- historical sources
- famous clinicans
GID: Epidemiology
- GID: Incidence
- GID: Prevalence
- GID: Morbidity
- GID: Mortality
- GID: Racial distribution
- GID: Age distribution
- GID: Sex distribution
GID: Risk factors
GID: Etiology
GID: Diagnosis & evaluation
GID: Treatment Medicine and psychology have tried to cure gender identity disorder and transgender behaviour/feelings ever since they came to their attention in the mid-19th century. Only occasionally have reports of "cures" been found, and almost all of them lack a follow-up. Also, almost all of those reports can be matched with the stories of transgender people who at one point left a treatment as cured. (Some transgender people were in fact "cured" several times.) It was demonstrated that psychological cures were almost completely ineffective, unless the reason for transgender behaviour could clearly be identified as laying outside of the person showing this behaviour.
Medical treatment for changing a person's sexual characteristics (see Gender reassignment therapy) is not considered a cure for transsexual or transgender feeling or behaviour, but it can help transsexual persons to live in a gender role that is more appropriate for their gender identity. But, while there will likely always be transgender people who will need this kind of medical treatment, many believe that the best help for transgender people is social acceptance in a gender role that fits their identity, regardless of their individual perception of their appropriate gender role or their individual need for medical treatment.
- GID: Outcome studies
- GID: Treatment protocols
- GID: Treatment considerations
- GID: Evidenced based treatment
- GID: Theory based treatment
- GID: Team working considerations
- GID: Followup
GID: For people with this difficulty
- GID: User:how to get help
- GID: User:self help materials
- GID: User:useful reading
- GID: User:useful websites
- GID: User:user feedback on treatment of this condition
GID: For their carers
GID: Academic support materials
- GID: Academic: Lecture slides
- GID: Academic: Lecture notes
- GID: Academic: Lecture handouts
- GID: Academic: Multimedia materials
- GID: Academic: Other academic support materials
- GID: Academic: Anonymous fictional case studies for training
GID: For the practitioner
[edit] External links
- Gender Identity Disorder Criteria - according to the DSM-IV
- Standards of Care for Gender Identity Disorders - published by the Harry Benjamin International Gender Dysphoria Association, includes a description of ICD-10 criteria.
- Health Law Standards of Care for Transsexualism An alternative to the Benjamin Standards of Care proposed by the International Conference on Transgender Law and Employment Policy.
- The Banality of Insensitivity: Portrayals of Transgenderism in Psychopathology - Transsexual psychologist, Madeline H. Wyndzen, discusses how viewing transgenderism as a mental disorder (e.g., GID) leads to systemic biases in the research of sexologists.
- THE LORD CHANCELLOR'S DEPARTMENT Government Policy concerning Transsexual People
- Gender Identity Disorder & Transsexualism - Synopsis of Etiology in Adults provides an alternative to the current classifications of psychiatric disorder and mental illness.
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