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The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Selected: Gender Dysphoria

Gender dysphoria is a condition in which a person feels stressed due to a mismatch between their gender assigned at birth based on their external genitalia and their sense of their gender. People associated with this gender are generally identified as Trans genders. This starts in childhood but some people may not notice it until puberty or much later. Gender identity differs from gender expression. Gender identity refers to one’s perception about their gender and gender at birth is decided based on genitalia. Gender may be guessed based appearance of the person (dress code as well as physical signs). For example in our society person wearing a female dress is considered feminine and wearing a tuxedo is considered a masculine gender expression. These expectations are dependent on gender and may vary from culture to culture. People who are transgender have different sexual orientations and this is very diverse. Treatment may include supporting the individual’s gender expression, hormone therapy, surgery, or even psychological therapy. They come under vulnerable populations because they get humiliation and discrimination from their early life (Davy & Toze, 2018).

This group is not focused on governing bodies and is discussed in our daily life. They may experience a severe level of discrimination and physical abuse due to their physical difference as compared to others (Shah, et al., 2018). This affects them mentally and psychologically leading to compromised working and social relations (Monteiro & Benny, 2019). They are normal creatures and should be treated in a normal way.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides criteria for the diagnosis of Gender Dysphoria among, children, adolescents, and adults (Ashley, 2019). According to DSM-5, two of the following concerns should be present in adults and adolescents lasting for 6 months at least

  • A marked difference between the experienced and gender determined by the sexual characters must be there
  • A strong desire to get rid of primary or by birth gender because of the different experienced gender
  • A strong desire to have sexual characteristics of others rather than own
  • A wish to become another gender rather than be defined at birth
  • A great desire to be treated as a different gender from the assigned gender

DSM-5 states the criteria to diagnose Gender Dysphoria in children as given below. These A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned gender)

  • A strong desire in boys (assigned gender at birth) a strong attraction towards girls dresses and liking girls toys etc. or for girls (assigned gender at birth) a strong likeness towards wearing boys dressing or strong repulsion to wear female clothes
  • A great likeness for cross-gender roles in actual or fantasy play
  • A strong preference to play with other gender and their toys for example boy  (assigned gender at birth) likes to play with girls and dollhouses
  • Rejection of the usual toys according to their gender-based on sexual characteristics
  • A firm sense of rejection for own anatomy
  • A strong wish to have sexual characteristics attained by another gender

Treatment for dysphoria varies from case to case-specific and is designed according to the needs of the person. The first goal is to address the distress and negative thoughts about assigned gender. Gender identity is not the issue but the unacceptance related to it is the issue. A team consisting of a psychologist, social worker, urologist, andrologist, and surgeon. Counseling is the main step to change their thoughts about their appearance and make them ready for medication or surgical therapy. Hormone therapy may also be provided to develop the characteristics of their desired gender. Surgical procedures like breast implantation, chest reconstruction, vaginoplasty, etc. can be provided in gender affirmation procedures (Hadj-Moussa et al., 2018).

References

Ashley, F. (2019). The misuse of gender dysphoria: Toward greater conceptual clarity in transgender health. Perspectives on Psychological Science, 1(1), 17-22. https://doi.org/10.1177/1745691619872987.

Davy, Z., & Toze, M. (2018). What is gender dysphoria? A critical systematic narrative review. Transgender Health, 3(1), 159-169. https://doi.org/10.1089/trgh.2018.0014.

Hadj-Moussa, M., Ohl, D., & Kuzon Jr, W. (2018). Evaluation and treatment of gender dysphoria to prepare for gender confirmation surgery. Sexual Medicine Reviews, 6(4), 607-617. https://doi.org/10.1016/j.sxmr.2018.03.006.

Monteiro, R., & Benny, J. P. (2019). Quality of life and identity stigma: A qualitative study among Dalit transgenders. New Horizons of Dalit Culture and Literature, 79. https://anubooks.com/wp-content/uploads/2019/05/New-Horizons-of-Dalit-Culture-and-Literature-cOMPLETE.pdf#page=84.

Shah, H., Rashid, F., Atif, I., Hydrie, M., Fawad, M., Muzaffar, H., & Hassan, A. (2018). Challenges faced by marginalized communities such as transgender in Pakistan. The Pan African Medical Journal30(1), 2-8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191260/.

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