P 01 Gender Dysphoria in Adolescents or Adults
Gender Dysphoria (in Adolescents or Adults)**
A. A marked incongruence between one?s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2* or more of the following indicators: [2, 3, 4]**
1. a marked incongruence between one?s experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics) [13, 16]
2. a strong desire to be rid of one?s primary and/or secondary sex characteristics because of a marked incongruence with one?s experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) [17]
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 (or some alternative gender different from one?s assigned gender)
5. a strong desire to be treated as the other gender (or some alternative gender different from one?s assigned gender)
6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one?s assigned gender)
B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning, or with a significantly increased risk of suffering, such as distress or disability**
Subtypes
With a disorder of sex development [14]
Without a disorder of sex development
See also: [15, 16, 19]
Specifier**
Post-transition, i.e., the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is undergoing) at least one cross-sex medical procedure or treatment regimen, namely, regular cross-sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in a natal male, mastectomy, phalloplasty in a natal female).
Note: Three changes have been made since the initial website launch in February 2010: the name of the diagnosis, the addition of the B criterion, and the addition of a specifier. Definitions and criterion under A remain unchanged.
For a detailed analysis of the proposal I recommend reading APA Releases 2nd Proposal to Replace GID in the DSM-5 by Kelley Winters at the GID Reform Weblog, which highlights at least four significant points:
First, it replaces the term Gender Incongruence with Gender Dysphoria, thereby shifting the diagnostic focus on to "distress with the wrong physical sex characteristics or the wrong social gender role rather than difference from expectations of assigned birth-sex" [Via GID Reform Weblog]
Second, it re-introduces the clinical significance criterion "which clarifies that diagnosis requires distress or impairment that meets a clinical threshold".
Third, the addition of a post-transition specifier should enable continued access to hormones "after the distress of gender dysphoria has been relieved by transition".
Fourth and last, the separation of gender diagnoses from sexual dysfunctions and paraphilias seems to be a step forward of sorts, although it should be noted that the problematic and controversial category of Transvestic Disorder remains in the DSM-5 proposal.
[Via Bird of Paradox]
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