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Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder. The International Classification of Diseases uses the term gender incongruence instead of gender dysphoria, defined as a marked and persistent mismatch between gender identity and assigned gender, regardless of distress or impairment.
Gender identity is the personal sense of one's own gender. Gender identity can correlate with a person's assigned sex or can differ from it. In most individuals, the various biological determinants of sex are congruent and consistent with the individual's gender identity. Gender expression typically reflects a person's gender identity, but this is not always the case. While a person may express behaviors, attitudes, and appearances consistent with a particular gender role, such expression may not necessarily reflect their gender identity. The term gender identity was coined by psychiatry professor Robert J. Stoller in 1964 and popularized by psychologist John Money.
Transvestic fetishism is a psychiatric diagnosis applied to people who are sexually aroused by the act of cross-dressing and experience significant distress or impairment – socially or occupationally – because of their behavior. It differs from cross-dressing without distress or impairment, and/or for entertainment or other purposes that do not involve sexual arousal. Under the name transvestic disorder, it is categorized as a paraphiliac disorder in the DSM-5.
Richard Green was an American-British sexologist, psychiatrist, lawyer, and author known for his research on homosexuality and transsexualism, specifically gender identity disorder in children. He is known for his behaviorism experiment in which he attempted to prevent male homosexuality and transsexuality by extinguishing feminine behavior in young boys. He later came to favor biological explanations for male homosexuality.
Ray Milton Blanchard III is an American-Canadian sexologist who researches pedophilia, sexual orientation and gender identity. He has found that men with more older brothers are more likely to be gay than men with fewer older brothers, a phenomenon he attributes to the reaction of the mother's immune system to male fetuses. Blanchard has also published research studies on phallometry and several paraphilias, including autoerotic asphyxia. Blanchard also proposed a typology of transsexualism.
Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for distress caused by incongruence between assigned sex and gender identity in some pre-pubescent transgender and gender diverse children.
The American-Canadian sexologist Ray Blanchard proposed a psychological typology of gender dysphoria, transsexualism, and fetishistic transvestism in a series of academic papers through the 1980s and 1990s. Building on the work of earlier researchers, including his colleague Kurt Freund, Blanchard categorized trans women into two groups: homosexual transsexuals who are attracted exclusively to men and are feminine in both behavior and appearance; and autogynephilic transsexuals who experience sexual arousal at the idea of having a female body. Blanchard and his supporters argue that the typology explains differences between the two groups in childhood gender nonconformity, sexual orientation, history of sexual fetishism, and age of transition.
Childhood gender nonconformity (CGN) is a phenomenon in which prepubescent children do not conform to expected gender-related sociological or psychological patterns, or identify with the opposite sex/gender. Typical behavior among those who exhibit the phenomenon includes but is not limited to a propensity to cross-dress, refusal to take part in activities conventionally thought suitable for the gender and the exclusive choice of play-mates of the opposite sex.
Child and adolescent psychiatry is a branch of psychiatry that focuses on the diagnosis, treatment, and prevention of mental disorders in children, adolescents, and their families. It investigates the biopsychosocial factors that influence the development and course of psychiatric disorders and treatment responses to various interventions. Child and adolescent psychiatrists primarily use psychotherapy and/or medication to treat mental disorders in the pediatric population.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders, the taxonomic and diagnostic tool published by the American Psychiatric Association (APA). In 2022, a revised version (DSM-5-TR) was published. In the United States, the DSM serves as the principal authority for psychiatric diagnoses. Treatment recommendations, as well as payment by health care providers, are often determined by DSM classifications, so the appearance of a new version has practical importance. However, some providers instead rely on the International Statistical Classification of Diseases and Related Health Problems (ICD), and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions. The DSM-5 is the only DSM to use an Arabic numeral instead of a Roman numeral in its title, as well as the only living document version of a DSM.
Kenneth J. Zucker is an American-Canadian psychologist and sexologist known for the living in your own skin model, a form of conversion therapy aimed at preventing pre-pubertal children from growing up transgender by modifying their gender identity and expression.
Jack Drescher is an American psychiatrist and psychoanalyst known for his work on sexual orientation and gender identity.
Susan W. Coates is an American psychoanalyst, who has worked on gender dysphoria in children and early childhood trauma.
Ira Basil Pauly is an American psychiatrist who was an All American college football player at UCLA, and is known for his influential work on transsexualism.
Stephen Barrett Levine is an American psychiatrist known for his thesis that gender dysphoria and being transgender are often caused by psychological issues that should be treated psycho-analytically as opposed to with gender-affirming care. He co-founded Case Western Reserve University School of Medicine's Gender Identity Clinic in 1974, served as the chair of the World Professional Association for Transgender Health (WPATH) drafting committee for the 5th edition of their Standards of Care (SOC-5) published 1998, and served on the American Psychiatric Association (APA) DSM-IV (1994) Subcommittee on Gender Identity Disorders.
Heino F. L. Meyer-Bahlburg is a German-born psychologist best known for his work on biology of sexual orientation, gender identity, intersexuality, and HIV.
Diane Sharon Fordney is an American physician and sex therapist best known for her work on sexual function and dysfunction. She has also published professionally as Diane S. Fordney-Settlage.
Betty Wilson Steiner-Conduit was a Canadian psychiatrist. Steiner was the first head of the Gender Identity Clinic at the Clarke Institute of Psychiatry. She is known for her work with transgender and intersex people.
Homosexuality was classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) beginning with the first edition, published in 1952 by the American Psychiatric Association (APA). This classification was challenged by gay rights activists during the gay liberation following the 1969 Stonewall riots, and in December 1973, the APA board of trustees voted to declassify homosexuality as a mental disorder. In 1974, the DSM was updated and homosexuality was replaced with a new diagnostic code for individuals distressed by their homosexuality, termed ego-dystonic sexual orientation. Distress over one's sexual orientation remained in the manual, under different names, until the DSM-5 in 2013.
Rapid-onset gender dysphoria (ROGD) is a controversial, scientifically unsupported hypothesis which claims that some adolescents identify as transgender and experience gender dysphoria due to peer influence and social contagion. ROGD is not recognized as a valid mental health diagnosis by any major professional associations. The APA, WPATH and 60 other medical professional organizations have called for its elimination from clinical settings due to a lack of reputable scientific evidence for the concept, major methodological issues in existing research, and its stigmatization of gender-affirming care for transgender youth.
References
- 1 2 Bradley SJ, Blanchard R, Coates SW, Green R, Levine SB, Meyer-Bahlburg HFL, Pauly IB, Zucker KJ (1991). Interim report of the DSM-IV Subcommittee on Gender Identity Disorders. Archives of Sexual Behavior Volume 20, Number 4 / August, 1991
- ↑ Bradley, S. (2010). "Interview with Dr. Susan Bradley. Interview by Normand Carrey". Journal of the Canadian Academy of Child and Adolescent Psychiatry. 19 (1): 51–53. PMC 2809448 . PMID 20119569.
- 1 2 Chung, Kathleen; Rhoads, Sarah; Rolin, Alicia; Sackett-Taylor, Andrew C.; Forcier, Michelle (2020). "Treatment Paradigms for Prepubertal Children". In Forcier, Michelle; Van Schalkwyk, Gerrit; Turban, Jack L. (eds.). Pediatric Gender Identity: Gender-affirming Care for Transgender & Gender Diverse Youth. Springer. p. 177. ISBN 978-3030389086.
- 1 2 Ashley, Florence (2022). Banning Transgender Conversion Practices: A Legal and Policy Analysis. Vancouver, BC: University of British Columbia Press. pp. 4–6. ISBN 978-0774866958.
- ↑ Margaret Wente (8 May 2015) The raging battle over transgender kids The Globe and Mail . Archive
