Gender identity disorder
Key points
- Gender identity disorder describes a conflict between a person's physical or apparent gender and that person's self-identification.
- People with gender identity disorder may act and present themselves as members of the opposite sex.
- A history and psychiatric evaluation confirms the persistent desire to be the opposite sex.
- Individual and family counseling is recommended for children, and individual or couples therapy is recommended for adults.
Alternative names
Transsexualism
Definition
Gender identity disorder describes a conflict between a person's physical or apparent gender and that person's self-identification. For instance, a person identified as a boy may actually feel and act like a girl. This is distinct from homosexuality in that homosexuals nearly always identify with their apparent sex or gender.
Identity issues may occur in a variety of scenarios and manifest in different ways. For example, some people with normal genitals and secondary sex characteristics of one gender privately identify more with the other gender. Some may cross-dress, and some may actually seek sex-change surgery. Others are born with ambiguous genitalia, which can raise identity issues.
Causes, incidence, and risk factors
People with gender identity disorder may act and present themselves as members of the opposite sex. The disorder may affect self-concept, choice of sexual partners, and the display of femininity or masculinity through mannerisms, behavior, and dress.
The feeling of being in the body of the "wrong" gender must persist for at least 2 years for this diagnosis to be made. The cause is unknown, but hormonal influences in the womb, genetics, and environmental factors (such as parenting) are suspected to be involved. The disorder may occur in children or adults, and is rare.
Symptoms
Children:
- Express the desire to be the opposite sex
- Have disgust with their own genitals
- Believe that they will grow up to become the opposite sex
- Are rejected by their peer group, feel isolated
- Have depression or anxiety
Adults:
- Desire to live as a person of the opposite sex
- Wish to be rid of their own genitals
- Dress in a way that is typical of the opposite sex
- Have depression or anxiety
- Feel isolated
Either adults or children:
- Withdraw from social interaction
- Cross-dress, show habits typical of the opposite sex
Signs and tests
A history and psychiatric evaluation confirms the persistent desire to be the opposite sex. The person's partner choices may be same-sex or opposite sex.
Written and revised by
Gerald Hurowitz, M.D.
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