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Gender identity disorder

Gender identity disorder as identified by psychologists and medical doctors is a condition where a person who has been assigned one gender (usually on the basis of their sex, but compare intersexual) identifies themself with another gender role, or do not conform with the gender role their respective society prescribes to them.

This feeling usually is reported as "having always been there", although in many cases it seems to appear in adolescence or even in adulthood, and 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 example a severe identity crisis. Also, social problems are likely to occur if a society does not accept cross-gender behaviour. In many cases discomfort is also reported as stemming from feeling like one's body is "wrong" or meant to be different.

See also Transgender.

Table of contents

Diagnostic Criteria

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 can be given: [1] (http://www.behavenet.com/capsules/disorders/genderiddis.htm)

  1. There must be evidence of a strong and persistent cross-gender identification.
  2. This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
  3. 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.
  4. The individual must not have a concurrent physical intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia[?]).
  5. 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) is similar to other "NOS" diagnoses, and can be given for, for example: [2] (http://www.behavenet.com/capsules/disorders/nos.htm)

  1. Intersex conditions (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia[?]) and accompanying gender dysphoria
  2. Transient, stress-related cross-dressing behavior
  3. Persistent preoccupation with castration or penectomy without a desire to acquire the sex characteristics of the other sex, which is known as skoptic syndrome[?]

GID in the DSM-IV is comparable to transsexuality, whereas GIDNOS is more comparable to other transgender behaviour that may be seen as disordered. However, transvestic fetishism has its own code, as a paraphilia rather than a gender identity disorder.

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] (http://www.hbigda.org/socv6#03)

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.

Controversy

A lot of transgender people do not regard their cross-gender feelings and behaviours as a disorder. The question what a "normal" gender identity or a "normal" gender role is supposed to be; and sometimes even the existence of a "normal" gender identity or gender role is examined and often rejected by parts of modern gender studies.
Some people see "transgendering" as a means for deconstructing gender. However, not all transgenders do wish to or feel that they are deconstructing gender.
Other transgender people object to the classification of GID as a mental disorder on the grounds that there may be a physical cause, as suggested by recent studies about the brains of transsexuals, also pointing out that the treatment for this disorder consists primarily of physical modifications to bring the body into harmony with one's mental (psychological, emotional) gender identity.
The official politics in many countries still interprets transgender in terms of an undesireable thing that has to be prohibited or a psychiatric disorder, which has to be cured. See Heteronormativity

Treatment

Medicine and psychology have tried to cure gender identity disorder or transgender behaviour or feelings ever since it came to their attention in the middle of the 19th century. Only occasionally reports about "cures" can be found, and almost all of them lack a follow-up[?]. Also, all of those reports can be matched with the stories of transgender people who at one point left a treatment as cured. (Some transgenders were in fact "cured" several times.) It never worked, unless the reason for transgender behaviour could clearly be identified as laying outside of the person showing this behaviour.

Medical treatment for changing a persons sexual characteristics (see Sexual reassignment surgery) is not a cure for transgender feeling or behaviour, but can help transgender persons to live in a gender role that is more appropriate to their gender identity. But while there will most likely always be transgender people who will need this kind of medical treatment, the best help transgender people can get is social acceptance in a gender role that fits their identity.

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