Gender Dysphoria

Definitions Sex-your chromosomal make up as either a boy or a girl, also based on your genitalia. Gender-how you, the public, and the legal system view you (as male or female) Gender Dysphoria-an individual’s discontent with the assigned gender

Definitions Transgender-individuals who identify with a gender that is different than how they were born Transsexual-individuals who seek, or have undergone, a social transition from female to male, or male to female-usually involves hormone therapy and genital surgery

Gender Dysphoria in Children For at least 6 months you must have all of the following: Have a strong desire to be the other gender Wear clothes that belong to the opposite sex Enjoy cross-gender roles and role-play and fantasy play Enjoy toys, games, or activities that “belong” to the opposite sex Prefer playmates of their opposite gender A strong dislike of one’s sexual anatomy A desire for the sex characteristics of the opposite sex

Gender Dysphoria in Adolescents For at least 6 months you must have two of the following: Have a strong desire to be the other gender A strong dislike of one’s sexual anatomy (want to get rid of it) A desire for the sex characteristics of the opposite sex A strong desire to be treated as the opposite gender A strong conviction that one has the typical feelings and reactions of the opposite gender The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning

In Adolescents: Specifiers: With a disorder of sex development? Post-transition? (have they already started living like the other gender)

Development and Course Distress: Children will cry when their parents don’t let them “be” the other gender Children are usually aged 2-4 when diagnosed Doesn’t always persist into adulthood (only up to 30-50%) If it doesn’t persist, a male will usually identify themselves later as androphilic If it doesn’t persist, females will identify themselves as gynephilic 32-50% of the time

Prevalence Males: 0.005% to 0.014% Females: 0.002 to 0.003% More common in males, except in Japan and Poland

Risk Factors: 1. Temperamental: Atypical gender behavior is seen in early preschool age 2. Environmental: Males with gender dysphoria more commonly have older brothers 3. Genetic-Weak genetic contribution Increased androgen in females with the disorder No hormone abnormalities in males found

Culture-Related Issues This disorder has been reported across many countries and cultures

Consequence of Gender Dysphoria Failure to develop same-sex peers leads to loneliness Refusal to attend school because of fear of bullying Relationship difficulties Depression, negative self-concept Discrimination (employment, etc,)

Differential Diagnosis How could you tell if a child has Gender Dysphoria Disorder, or is simply a “tomboy” or “in touch with his feminine side”?