Gender Dysphoria

Gender Dysphoria

Distress due to mismatch between one’s assigned (natal) sex and experienced gender identity.

• Not about sexual arousal (unlike transvestic fetishism).

Prevalence:

• 5–14 per 1,000 natal males.

• 2–3 per 1,000 natal females.

DSM-5 Criteria

• Duration ≥6 months.

• Children: ≥6 symptoms (strong desire to be other gender, cross-dressing, preference for opposite toys/roles).

• Adolescents/Adults: ≥2 symptoms (desire for other sex traits, to live as other gender, distress with own sex).

Causes:

• Biological: Prenatal hormone exposure, genetics, brain structure differences.

• Psychological: Gender nonconformity in childhood.

• Social: Family reinforcement and cultural norms.

Treatment of Gender Dysphoria

Psychological Evaluation & Education — Confirm diagnosis, address distress.
2. Hormone Therapy — Partially reversible step.
3. Sex Reassignment Surgery (SRS) — Final step; requires 1–2 years of living in desired gender.

Sex Reassignment Surgery (SRS) SRS Outcomes

• Satisfaction: 75–100%

• Regret: 1–7%

• Suicide attempts: ~2% post-surgery

• Transmen generally adjust better than transwomen.

Children:

• Controversial; options include behavior modification, watchful waiting, or affirmation approach.

• Puberty blockers used to delay irreversible changes.