By Dr Ananya Mandal, MD
Gender dysphoria or gender identity disorder (also called transsexualism) is a strong and persistent desire to identify with the opposite gender rather than the given biological or anatomical gender.
The Diagnostic and Statistical Manual for Mental Disorders – IV Text Revision (DSM-IV-TR) says that this desire to belong to the opposite sex “extends beyond a desire for a perceived cultural advantage.” Gender dysphoria however is not a mental illness.
When do the symptoms of gender dysphoria develop?
Children between ages three and four normally develop gender identity. This condition may usually manifest at a young age. (1-4)
Symptoms of gender dysphoria in children
Children with the condition may show some of the following features –
- Insisting that they belong to the other sex
- Calling oneself by a name suitable for the opposite sex and trying to pass off as a child of the opposite sex.
- Persistent fantasies of being the other sex
- Preference for cross-dressing or cross-sex roles in play
- Strong preference for playmates of the other sex
- Disliking or refusing to urinate as per sexual norms.
- Intense desire to participate in stereotypical games, activities and pastimes of the opposite sex
- Distress at the secondary sexual changes during puberty
- Isolation and rejection from peers and rejection from social interactions
Typical symptoms in boys
Boys with gender dysphoria detest their penis or testes and wish their genitals would disappear. They dislike male toys and rough play.
Typical symptoms in girls
Girl children may refuse to urinate in the sitting position and feel they would grow the male genitalia. They may be confident that they would not grow breasts or menstruate.
These girls have a severe dislike for feminine clothing. These may all be a part of normal growing up and many children may outgrow this phase. However, some continue to have these problems in adolescence and adulthood.
Symptoms of gender dysphoria in adolescents and adults
Adolescents and adults may experience –
- Intense desire to be the other sex. Fantasies of belonging to the other sex and attempts to fit in with an opposite sex group.
- Desire to live or be treated as the other sex
- Cross dressing to frequently pass as the other sex
- Feeling and reacting like the other sex. This may be real or may be a perception of the individual with gender dysphoria.
- Continued discomfort with his or her biological sex or sense of inappropriateness in the given gender role. Belief that they have been born as the wrong sex.
- Preoccupation with getting rid of primary and secondary sex characteristics like breasts, facial hair and muscle definition.
Symptoms that are not necessary for gender dysphoria
The features of gender dysphoria may not include concurrent physical intersex condition. This means their genitalia may be normal. In intersex individuals there is presence of ambiguous genitalia.
Other symptoms of gender dysphoria
People with gender dysphoria may develop distress or impairment in social, occupational, or other areas of functioning.
The condition affects self-concept and self-esteem and choice of sexual partners. Gender dysphoria is not the same as homosexualism.
These patients may suffer from anxiety disorders and other psychiatric conditions.
Some sufferers may also experience depression or suicidal feelings. Depression may stem from social isolation and being victims of social prejudice and sexual abuse.
Edited by April Cashin-Garbutt, BA Hons (Cantab)
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