Gender Identity Disorder

Definition

Gender Identity Disorder or GID is defined by persistent feelings of gender discomfort and inappropriateness of anatomic sex. People with GID desire to live as members of the opposite sex and often dress and use mannerisms associated with the other gender. GID is more commonly referred to as transsexualism. It was not until the 1950s that clinicians recognized that there were individuals who felt intensely uncomfortable with their biological sex (Morrison, 1995).

Complications of gender identity disorder include:

• Social isolation, ostracism or ridicule, possibly resulting in low self-esteem or dropping out of school (this is more common in males than females)

• Impairment of social relationships, in particular poor same-sex relationships with peers

• Familial difficulties such as difficulties relating to parents, marital problems

• Anxiety, depression and suicidal behavior, which are common in children, adolescents and adults with the disorder

• Sexually transmitted diseases, especially in males, in whom prostitution is moderately common

• Substance abuse

• Legal problems, including increased criminality, difficulties with legal definitions of `male' and `female'

• Medical problems, including infection, injury or death from self-inflicted body changes and self-prescribed hormones.

Symptoms

General symptoms are described with symptoms for clinical diagnosis following:

Children:

• Express the desire to be the opposite sex

• Have disgust with their own genitals

• Believe that they will grow up to become the opposite sex

• Are rejected by their peer group, feel isolated

• Have depression

• Have anxiety

Adults:

• Desire to live as a person of the opposite sex

• Wish to be rid of their own genitals

• Dress in a way that is typical of the opposite sex

• Have depression

• Feel isolated

• Have anxiety

Either adults or children:

• Withdrawal from social interaction

• Cross-dressing

• Clothing habits are typical of the opposite sex

To be clinically diagnosed with GID:

A person must persistently and strongly identify with opposite gender (aside from desiring perceived cultural advantage of being other gender) in any of the following

• Stated wish to be other gender

• Frequently passing as other gender

• Desiring to live or be treated as other gender

• Belief that patient's feelings and reactions as typical of member of other gender

Must have strong discomfort with own gender and may express any of the following:

• Preoccupation with hormones, surgery, etc. as means to change gender physically

• Patient's belief that he or she was born wrong gender

• Patient does not have physical intersex condition

• Symptoms significantly impair occupational, social or personal functioning.

• In sexually mature patients, the disorder is divided into:

• Sexually attracted to males

• Sexually attracted to females

• Sexually attracted to both males and females

• Sexually attracted to neither males nor females

Children less than adolescent age must have four or more of the following symptoms:

• Reiteration of desire to be other gender

• Preference or insistence to dress in clothing of other gender

• Persistent preference for cross-sex roles in fantasy play or repeatedly fantasizing about being other gender

• Persistent desire to participate in games and pastimes of other gender

• Strong preference to play with children of other gender

Boys may display discomfort with assigned gender in following ways:

• Disgust with own genitals

• Belief that genitals will disappear or that it would be preferable not to have a penis

• Rejection of male activities such as rough and tumble play, games and toys

Girls may display discomfort with assigned gender in following ways:

• Rejection of urinating in seated position

• Desire not to develop breasts or menstruate

• Claims that she will have a penis

• Strong dislike for typical female clothing

(American Psychiatric Association, 1994; Morrison,1995)

Causes

People with gender identity disorder act and present themselves as members of the opposite sex. The disorder affects self-concept, the perception of an ideal partner, and the display of femininity or masculinity through mannerisms, behavior, and dress. These feelings persist for at least 2 years. Theories suggesting causes of this disorder are chromosomal abnormalities, hormonal imbalances, and defects in normal human bonding and child rearing. The disorder may occur in children or adults. It is a rare disorder affecting about 3 of every 100,000 males and 1 of every 100,000 females (Morrison, 1995).

For children, symptoms may be present between the ages of 2 to 4 years of age while presentation of symptoms occurs at start of school. For adults, onset of symptoms is typically in early to mid-adulthood, usually after or concurrent with transvestic fetishism.

Treatment

Individual and family counseling is recommended for children, and individual or couples therapy is recommended for adults. Sex reassignment through surgery and hormonal therapy is an option, but often-severe problems persist after this form of treatment.

A better outcome is associated with the early diagnosis and treatment of this disorder.

Presentation for children is typically at the time they start school. For children, cross-sex behaviors tend to diminish over time and in response to parental or medical intervention and peer pressures. Intervention takes form of social skills training and development of acceptance and comfort in assigned biological gender. Research indicates that by late adolescence, about 75% of males who had a childhood history of gender identity disorder have a homosexual or bisexual orientation, but without features of gender identity disorder while the remaining 25% report a heterosexual orientation, again without features of gender identity disorder. The corresponding figures for sexual orientation in females are not known.

Research indicates the following:

• Individuals with childhood- or adolescent-onset gender identity disorder are more likely to request sex-reassignment surgery and more likely to be satisfied with the results of surgery

• Males with GID who are sexually attracted to males typically have a lifelong history of GID and present for treatment earlier than others

• The course in adults tends to be chronic, with cyclical variations in many cases with spontaneous remissions having been reported

• A majority of well-screened transsexuals who have sex reassignment treatment report positive outcome in terms of well being, happiness, and psychosocial adjustment. Better surgical results predict better postoperative adjustment.

From: Yahoo Health