This is Bob.
Bob is biologically defined as a male, which is a gender that has been assigned to
him.
But, growing up, Bob realizes that he does not feel comfortable being recognized as a
male in society.
Also, he doesn’t feel comfortable with his body and the gender roles which are
assigned to him.
After consulting with a psychiatrist, he recognized that he is living with a
condition called Gender Dysphoria.
Let’s learn more about this condition.
Gender dysphoria (which has its own chapter in the fifth edition of the Diagnostic and
Statistical Manual of Mental Disorders, termed DSM5) involves
a conflict between people's physical or assigned gender and the gender with which
they identify.
Let’s first clarify what the terms gender, assigned gender, and gender dysphoria
are.
Gender denotes the public and usually legally recognized lived role.
Biological factors combined with social and psychological factors contribute
to gender development.
Assigned gender refers to a person’s initial assignment as male or female at birth.
It is based on anatomy and other visible physical sex characteristics.
Gender dysphoria is a term which refers to an individual’s discontentment with their
assigned gender.
People with gender dysphoria may be very uncomfortable with the gender they were assigned,
sometimes described as being uncomfortable with their body or with the expected roles
of their assigned gender.
This gender conflict affects people in different ways.
It can change the way a person wants to express their gender through behavior, choice
of dress, and self-image.
Some people may cross-dress, some may want to socially transition,
while others may want to medically transition with sex-change surgery and/or hormone treatment.
If a psychiatrist determines that the patient has at least 2 of the following characteristics
for at least six months, they can diagnose the patient
with gender dysphoria: 1.
A marked incongruence between one’s experienced/expressed gender and primary and/or
secondary sex characteristics 2.
A strong desire to be rid of one’s primary and/or secondary sex characteristics
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 5.
A strong desire to be treated as the other gender
6.
A strong conviction that one has the typical feelings and reactions of the other gender
Treatment options for gender dysphoria include counseling, cross-sex hormones, puberty
suppression, and gender reassignment surgery.
For many children the feelings do not continue into adolescence and adulthood.
While some children express feelings and behaviors relating
to gender dysphoria at 4 years old or younger, many may not express feelings and behaviors
until puberty or much later.
But, in general, a child’s treatment typically involves a multidisciplinary
team of health care professionals, which may include a pediatrician, a psychiatrist,
a pediatric endocrinologist who specializes in hormone
conditions in children, and an advocate.
Treatment may focus primarily on affirming psychological support, understanding feelings
and coping with distress, and giving children a
safe space to articulate their feelings.
It is important to note that Gender dysphoria is not the same as gender nonconformity.
Gender nonconformity is not in itself a mental disorder.
The critical element of gender dysphoria is the
presence of clinically significant distress associated with the condition.
The Sexual and Gender Identity Disorders Work Group was concerned that removing gender
dysphoria as a psychiatric diagnosis from the DSM5 would jeopardize access to care.
Replacing the condition’s former name of gender “disorder”
with “dysphoria” in the diagnostic label is
more appropriate with clinical sexology terminology and it also removes the connotation that
someone is “disordered.”
Ultimately, the changes regarding gender dysphoria in the DSM-5
respect the individuals identified by offering a diagnostic name that is more appropriate
to the symptoms and behaviors they experience without
jeopardizing their access to effective treatment options.
WIth all these support groups and the available treatment options present, Bob can finally
feel content about his emotions and thought processes
and live life how he deserves.