Definition
The psychological diagnosis gender identity disorder (GID) is used
to describe a male or female that feels a strong identification
with the opposite sex and experiences considerable distress because
of their actual sex.
Description
Gender identity disorder can affect children, adolescents, and
adults. Individuals with gender identity disorder have strong
cross-gender identification. They believe that they are, or should
be, the opposite sex. They are uncomfortable with their sexual role
and organs and may express a desire to alter their bodies. While
not all persons with GID are labeled as transsexuals, there are
those who are determined to undergo sex change procedures or have
done so, and, therefore, are classified as transsexual. They often
attempt to pass socially as the opposite sex. Transsexuals alter
their physical appearance cosmetically and hormonally, and may
eventually undergo a sex-change operation.
Children with gender identity disorder refuse to dress and act in
sex-stereotypical ways. It is important to remember that many
emotionally healthy children experience fantasies about being a
member of the opposite sex. The distinction between these children
and gender identity disordered children is that the latter
experience significant interference in functioning because of their
cross-gender identification. They may become severely depressed,
anxious, or socially withdrawn.
Causes and symptoms
The cause of gender identity disorder is not known. It has been
theorized that a prenatal hormonal imbalance may predispose
individuals to the disorder. Problems in the individual's family
interactions or family dynamics have also been postulated as having
some causal impact.
The Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition (DSM-IV), the diagnostic reference standard for United
States mental health professionals, describes the criteria for
gender identity disorder as an individual's strong and lasting
cross-gender identification and their persistent discomfort with
their biological gender role. This discomfort must cause a
significant amount of distress or impairment in the functioning of
the individual.
DSM-IV specifies that children must display at least four of the
following symptoms of cross-gender identification for a diagnosis
of gender identity disorder:
- a repeatedly stated desire to be, or insistence that he or she
is, the opposite sex
- a preference for cross-dressing
- a strong and lasting preference to play make-believe and
role-playing games as a member of the opposite sex or persistent
fantasies that he or she is the opposite sex
- a strong desire to participate in the stereotypical games of the
opposite sex
- a strong preference for friends and playmates of the opposite
sex
Diagnosis
Gender identity disorder is typically diagnosed by a psychiatrist
or psychologist, who conducts an interview with the patient and
takes a detailed social history. Family members may also be
interviewed during the assessment process. This evaluation usually
takes place in an outpatient setting.
Treatment
Treatment for children with gender identity disorder focuses on
treating secondary problems such as depression and anxiety, and
improving self-esteem. Treatment may also work on instilling
positive identifications with the child's biological gender.
Children typically undergo psychosocial therapy sessions; their
parents may also be referred for family or individual
therapy.
Transsexual adults often request hormone and surgical treatments to
suppress their biological sex characteristics and acquire those of
the opposite sex. A team of health professionals, including the
treating psychologist or psychiatrist, medical doctors, and several
surgical specialists, oversee this transitioning process. Because
of the irreversible nature of the surgery, candidates for
sex-change surgery are evaluated extensively and are often required
to spend a period of time integrating themselves into the
cross-gender role before the procedure begins. Counseling and peer
support are also invaluable to transsexual individuals.
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People should perhaps try understanding them instead of putting
them down? It is afterall a psychological disorder which may or may
not be treatable.
