Gender Dysphoria and Transsexualism

Gender dysphoria involves a strong, persistent feeling that an individual’s anatomic sex does not match the individual’s inner sense of self as masculine, feminine, mixed, neutral, or something else (gender identity).

This feeling of mismatch causes the individual significant distress or greatly impairs the individual’s ability to function. Transsexualism is the most extreme form of gender dysphoria.

  • Children focus on activities typically associated with the other sex and have negative feelings about their genitals.
  • Medical professionals base the diagnosis on symptoms indicating a strong preference to be the other sex.
  • Most individuals who feel a strong need to live as the other sex seek treatment – hormone therapy and sometimes irreversible genital surgery – that will make their physical appearance like that of the gender they feel they are.
  • Some individuals who feel that their anatomic sex does not match their gender identity are satisfied by working, living, and dressing in society as a member of the opposite gender, but many of these individuals do not have symptoms that meet the criteria for gender dysphoria.

Gender Dysphoria

Individuals with gender dysphoria believe that they are victims of a biologic accident and that they are cruelly imprisoned in a body incompatible with their inner sense of self as masculine, feminine, or something else (gender identity).

For example, some individuals who are labelled male at birth feel like women trapped in a man’s body, and vice versa.

This feeling of mismatch (called gender incongruity or gender nonconformity) is not considered a disorder unless it causes significant distress or interferes with the individual’s ability to function. The distress is typically a combination of anxiety, depression, and irritability.

Some individuals feel that they are neither masculine or feminine, that they are somewhere in-between, that they are a combination of the two, or that their identity changes. Gender queer is a catchall term that refers to some of these variations of gender identity. Other terms that may be used include non-binary and agender.

How many individuals have gender dysphoria is not known, but it is estimated to occur in:

  • 5 to 14 of 1,000 babies whose birth sex is male; and
  • 2 to 3 of 1,000 babies whose birth sex is female.

Many more individuals identify themselves as transgender than meet the criteria for gender dysphoria.

In transvestism (cross-dressing), individuals (almost always men) become sexually aroused by wearing clothing of the opposite sex, but they do not have an inner sense of actually belonging to that sex.

Transsexualism

For transsexuals, the incompatibility felt between anatomic sex and gender identify is complete, severe, disturbing, and long-standing.

Most transsexuals are biologic males who identify themselves as females, sometimes early in childhood, and regard their genitals and masculine features with repugnance.

However, most children with gender identity problems do not become transsexual adults.

Rarely, transsexuals are individuals who were born with genitals that are not clearly male or female (ambiguous genitals) or who have a genetic abnormality, such as Turner syndrome or Klinefelter syndrome.

However, when children are clearly and consistently considered and reared as either boys or girls, even when genitals are ambiguous, most of them have a clear sense of their gender identity.

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