Gender Identity Disorder / Transsexualism

Gender Identity Disorder occurs when a persons anatomical sex and their gender identity conflict. This is also called transsexualism. In this disorder, there is a desire to be rid of one’s own gender appropriate anatomy and to live as a person of the opposite gender. These people often, but not always, cross-dress to be in line with their gender identity. Increasingly, numbers of those with this disorder are choosing surgical interventions.

Gender identity disorder (GID) is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria (discontent with the biological sex they were born with). It is a psychiatric classification and describes the problems related to transexuality, transgender identity, and transvestism. It is the diagnostic classification most commonly applied to transexuals.

The current edition of the Diagnostic and Statistical Manual of Mental Disorders has five criteria that must be met before a diagnosis of gender identity disorder (302.85) can be given:

    1. There must be evidence of a strong and persistent cross-gender identification.
    2. This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
    3. There must also be evidence of persistent discomfort about one’s assigned sex or a sense of inappropriateness in the gender role of that sex.
    4. The individual must not have a concurrent physical intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia).
    5. There must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The DSM-IV also provides a code for gender disorders that did not fall into these criteria. Diagnostic code 302.6 is used for Gender Identity Disorder in Children as well as for Gender Identity Disorder Not Otherwise Specified (GIDNOS). GIDNOS is similar to other “NOS” diagnoses, and can be given for, for example:

    1. Intersex conditions (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia) and accompanying gender dysphoria
    2. Transient, stress-related cross-dressing behavior
    3. Persistent preoccupation with castration or penectomy without a desire to acquire the sex characteristics of the other sex, which is known as skoptic syndrome[4][5]

For some people, GID in the DSM-IV is comparable to transsexuality, whereas GIDNOS, to them, is more comparable to other transgender conditions that may be seen as disorderly. On the other hand, many transgender people themselves feel quite accurately described by the DSM-IV, and many have none of the symptoms listed above under NOS. Some transsexual and transgender people do not feel like the DSM-IV describes their condition accurately, in any sense. Transvestic fetishism has its own code, as a paraphilia rather than a gender identity disorder.