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Dysphoria is defined as a feeling of extreme general discomfort. In the context of transgender and non-binary individuals, sex or gender dysphoria, or gender incongruence, refers the disconnect between one's sex and their gender identity. Those with dysphoria often seek gender therapy, hormone replacement therapy, surgery, or a combination of the three, in order to treat the condition.

Cisgender individuals may also feel gender dysphoria due to cross-sex hormone usage or accidental exposure. Some hormonal disorders such as Polycystic ovary syndrome (PCOS) or gynecomastia may also cause it, though this does not make them transgender. Some intersex individuals also feel dysphoria, often due to forced genital reassignment after birth. Previous versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) discluded intersex individuals in its definitions; however, the DSM-5 changed its language to, among other things, include them in its definition in 2013.[1]

Diagnosis[]

The DSM-5 criteria for a diagnosis requires at least two symptoms lasting at least six months or longer for adolescents and adults, and at least six symptoms lasting at least six months in children.[2][3]

Symptoms[]

Gender dysphoria manifests itself in a variety of ways, including the following[4][2]:

  • belief of being born of the incorrect sex
  • desire to be seen and treated as another gender
  • desire for primary or secondary sex characteristics not of their sex
  • dislike or disturbance with sexual anatomy
  • desire to remove or alter primary or secondary sex characteristics
  • desire to wear the clothing of another gender

In addition to the above symptoms, some manifestation in children includes:

  • rejection of clothing, toys or activities of their assigned gender
  • preference for cross-gender roles in play
  • preference for playmates of the other gender
  • preference for wearing clothes of the other gender

Treatment[]

These symptoms often cause anxiety, depression, suicidal ideation, and self-harm behaviors in transgender people.[5] Studies have shown medical treatment, i.e. hormone replacement therapy (HRT) and surgeries are effective treatments in relieving dysphoria and its effects.[6][7][8][9][10][11] Very few individuals regret transition; an estimation of post-transition regret and detransition is between 1-2.2%.[12]

History of the term[]

In previous versions of the DSM, the term Gender Identity Disorder (GID) was used as a diagnosis for transgender patients.

In 2011, the World Professional Association for Transgender Health (WPATH) published "Recommendations from the WPATH Consensus Process for Revision of the DSM Diagnosis of Gender Identity Disorders: Implications for Human Rights" in the International Journal of Transgenderism, in an appeal to the Diagnostic and Statistical Manual of Mental Disorders to revise its diagnosis of GID.[13]

A study by the National Institute of Psychiatry Ramón de le Fuente Muñiz published a study in The Lancet in 2016, with the conclusion that transgender identity is not a mental illness, and should be removed from future publications of the International Classification of Diseases (ICD).[14]

In 2013, the DSM-5 revised the diagnosis to gender dysphoria and changed some of the criteria for diagnosis. These changes were made to "better characterize the experiences of affected children, adolescents, and adults."[15]

Sources[]

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