Gender Identity Disorder: Diagnosis and Treatment

There are many well-known phrases that make bigger implications than we realise – such as boys will be boys – but what happens when boys want to be girls, or vice versa? Gender Identity Disorder (GID) can play a huge role in an individual’s sexual health, and overall wellbeing, with people feeling that their body does not match who they are on the inside. Also known as gender identity confusion, gender dysphoria, transgenderism and transsexualism, the condition can cause some people to use clothing and cosmetics to explore this identity, while others may choose to change their appearance with hormones or even surgery.

 

According to noted wellness writer Maria Trimarchi, ‘Mental health professionals believe there are three components that make up our gender identity: our sexual orientation, behaviour and mannerism preferences, and core gender identity (that gut feeling we have about the gender we identify with). In most of us, these three components and our anatomy align as male or female. For some, however, these components don’t all match up. The cause of gender identity disorder is still being debated. Theories suggest it is caused by genetic abnormalities, endocrine problems like a testosterone or oestrogen imbalance in the womb, social factors like parenting or some combination of issues.’ But at what age do parents begin to see symptoms of GID in children?

 

There are five steps to diagnosing GID: diagnostic assessment, psychotherapy, real-life experience, hormone therapy and surgery. Trimarchi explains, ‘The process begins when a person consults a mental health professional, who performs sessions of psychotherapy and formulates a diagnosis. To become a candidate for gender reassignment surgery, a person must first be diagnosed with Gender Identity Disorder (GID) or gender dysphoria. The International Classification of Diseases-10 (ICD-10) lists gender identity disorder as a disorder and the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) lists gender dysphoria.’

 

The reason why diagnosis is important is because there is a wide range of variables that fall under the GID umbrella, and prospective candidates for gender reassignment surgery must work with a mental health professional for the right diagnosis. Once the diagnosis is complete, there are three phases left for patients who wish to undergo surgery:

 

1. Hormone therapy

 

2. Real-Life Experience, or the Real-Life Test

 

3. Surgery to change genitalia and other sex characteristics

 

Trimarchi notes, ‘Not all transgender people need all three phases of therapy; each path to gender reassignment is tailored to the person…Before a patient can begin hormone therapy or breast surgery, a mental health professional must write a letter of recommendation to the physician providing medical treatment. In addition to the letter, the World Professional Association for Transgender Health’s Standards of Care require several eligibility and readiness criteria for hormone therapy.’ To undergo hormone therapy, you must:

 

• Be 18 years of age


• Understand what the medical ability of hormones, as well as their social benefits and risks


• Have either a minimum of three months of psychotherapy or a documented three month real-life experience


• Show stable or improved mental health


• Demonstrate ability to take hormones in a responsible manner

 

Trimarchi details, ‘The Real-Life Experience immerses the individual into life as his or her preferred gender. The candidate is required to maintain full or part-time employment (or attend school full or part-time), legally change his or her first name to one that is gender appropriate and prove that people other than the therapist and doctor know his or her desired gender. After 12 months of continuous and successful hormone therapy and Real-Life Experience, the individual is eligible for genital surgery. Two letters of recommendation, usually one from the mental health professional and one from the hormone-prescribing physician, are required for surgery.’

Categories: diagnosis, gender dysphoria, gender identity, gender reassignment, health professional, Hormone Therapy, identity disorder, life experience, Mental Health, Real Life, treatment

Jargon Busters: Understanding Gender Identity Disorder

How do you know that you’re a woman or a man? Does it just come down to the genitals you have, or did you work out your gender identity on more factors? Gender is not a cut-and-dry sexual health issue; it’s not just a case of penises for boys and vaginas for girls. Rather, there is a number of people for whom the body doesn’t match up with what’s going on in the mind, which is commonly known as gender identity disorder. Usually, struggles with gender identity begin in early childhood, but it can happen at any age. Gender identity disorder can be confusing, both for those whose wellbeing is affected by it, and their friends and family. So, let’s clear up the jargon.

 

1. Transexual: The community of people with gender identity disorder is commonly described as “transsexuals” by medical professionals. This term was coined Dr. Harry Benjamin, one of the pioneering doctors to research and work with gender identity disorders, using the research of Magnus Hirschfeld, of the Institute for Sexual Science, and Alfred Kinsey, of the Kinsey Institute, as his springboard.

 

2. Transgender: “Transgender” is used as a general, non-medical term to describe anyone whose gender identity is different from their physical sex at birth. If you’re transgender, you may wish to live as a different gender than the one you were born with, and may put your physical wellbeing at risk to do so. You may undergo gender reassignment surgery – or a sex change – to transform your body to reflect who you are underneath. However, you might not think your gender wellness merits these types of surgeries, and that’s OK too.

 

3. Transman or Transwoman: If you were born as a biological man but you identify as a woman, you are known as a transwoman, or transgender woman. A biologically born woman who identifies as a man is known as transman, or transgender man.

 

4. Third Gender: You might not want to refer to yourself as male or female, but rather find that your identity lies somewhere along a spectrum. This is sometimes referred to as “third gender”, but some people prefer no label at all.

 

5. Transvestite: You may have head someone who dresses in clothing more typically worn by the opposite sex labelled as a “cross-dresser,” “transvestite,” “drag queen” or “drag king”. However, the important distinction to make here is that these words don’t describe a person’s gender.

 

6. Transition: Instead of sticking to the sex you were assigned with at birth, you may decide to move towards the gender you perceive yourself to be. This shift is described as “transition”. Sex reassignment surgery may be part of your transition, but this isn’t always the case.

 

So how do you know if you have gender identity disorder? Diagnosis involves a consultation with a mental health professional, who performs sessions of psychotherapy and formulates a diagnosis. The DSM-IV breaks gender identity disorders into several types: Gender Identity Disorder of Childhood, Gender Identity Disorder of Adolescence or Adulthood and Gender Identity Disorder Not Otherwise Specified. Additionally, the ICD-10 provides five diagnosis types for GIDs: Transsexualism, Dual-role Transvestism, Gender Identity Disorder of Childhood, Other Gender Identity Disorders and Unspecified Gender Identity Disorder. The ICD-10 states that you are diagnosed as transsexual when you have a desire to live as and be accepted as a member of the opposite sex, along with the desire to transform your body with gender reassignment surgery or hormone therapy. Your gender identity needs to be present for at least two years, and the desire for gender change cannot be a symptom of another disorder or a chromosomal abnormality.

Categories: Disorder, Gender, gender identity, gender reassignment, identity, identity disorder, identity disorders, nbsp, reassignment surgery, transgender, transsexual