Gender Identity Disorder

Diagnostic Criteria
A. A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex). In children, the disturbance is manifested by four (or more) of the following:

(1) repeatedly stated desire to be, or insistence that he or she is, the other sex (2) in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing (3) strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex (4) intense desire to participate in the stereotypical games and pastimes of the other sex (5) strong preference for playmates of the other sex. In adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction that he or she has the typical feelings and reactions of the other sex.

B. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex. In children, the disturbance is manifested by any of the following: in boys, assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games, and activities; in girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing. In adolescents and adults, the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.

C. The disturbance is not concurrent with a physical intersex condition.

D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Code based on current age:

302.6 Gender Identity Disorder in Children 302.85 Gender Identity Disorder in Adolescents or Adults

Specify if (for sexually mature individuals): Sexually Attracted to Males, Sexually Attracted to Females, Sexually Attracted to Both, Sexually Attracted to Neither

Reference: Gender Identity Disorder. (2000). In American Psychiatric Association (Ed.), Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th, Text revision ed., pp. 581-582). Arlington, VA.

Gender Incongruence (in Adolescents or Adults) [1]
A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2* or more of the following indicators: [2, 3, 4]

1. a marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics) [13, 16]

2. a strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) [17]

3. a strong desire for the primary and/or secondary sex characteristics of the other gender

4. a strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)

5. a strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)

6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)

Subtypes

With a disorder of sex development

Without a disorder of sex development

[14, 15, 16, 19]

To review the rationale for the changes see: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=482#

Reference: 302.85 Gender Identity Disorder in Adolescents or Adults. (2010). In American Psychiatric Association (Ed.), Proposed Revision, APA DSM-5. Retrieved from http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=482#

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Prevalence
There are no studies which have addressed question. At best guess it could be investigated by interviewing those individuals who have undergone sex reassignment surgery to see how many would qualify for the diagnosis. Also, the number of identified transgendered persons will vary depending upon the acceptance level within the community/culture.

Articles
GenderRoleConflictTheory.pdf‎

Media Links
GED_Presentation2003.pdf‎

Questions and Answers
What are the 3 dominant strategies for working with transgendered persons?

Should the proposed changes to the DSM be adopted? Why or why not?