More Symptoms and Diagnoses of Gender Identity Disorders

Gender identity disorder is currently listed as a psychological disorder in the DSM-IV under Section 302.85 (adults and adolescents) and 302.6 (children). Depending on the individual's age, diagnosis may be termed Gender Identity Disorder of Childhood, Gender Identity Disorder of Adolescence or Adulthood and on condition, Gender Identity Disorder Not Otherwise Specified. The DSM changed its terminology from transsexualism to gender identity disorder in 1994.

Transsexual pageant
Pornchai Kittiwongsakul/AFP/Getty Images
Although the DSM-IV regards transsexualism as a mental disorder, many transsexuals celebrate their identity. Thailand's Miss International Queen competition for transsexuals is as serious a competition as a traditional beauty pageant. ­

GID was first included in the DSM-IV in 1980. In addition to the DSM, other standard medical texts like the American Medical Association Encyclopedia, the Merck Manual, and the World Health Organization's International Classification of Diseases (ICD) all include the disorder.

The ICD also maintains a list of gender identity disorder diagnoses, including:

  • Transsexualism
  • Dual-role Transvestitism
  • Gender Identity Disorder of Childhood
  • Other Gender Identity Disorders
  • Gender Identity Disorder, Unspecified

There is no specific test that can be performed to indicate whether or not a person has gender identity disorder. Instead mental health professionals use certain criteria to make a diagnosis. These criteria include:

  • Persistent identification with the opposite gender, including cross-dressing and living as the opposite sex
  • Persistent feelings of being in the "wrong" body for at least two years
  • No presence of a DSD (Disorder of Sex Development) condition
  • Anxiety, unhappiness or other distress in every day social or occupational situations due to cross-gendered identification [source: Psychology Today]

In children, the diagnosis must include the presence of at least four of the following symptoms:

  • Repeated insistence that he or she is the opposite gender, or desires to be the opposite gender
  • Persistent preference for cross-gender roles during play or persistent fantasies of being the opposite gender
  • A strong desire to play stereotypically gendered games
  • A strong preference for friends and playmates of the opposite sex
  • In boys, an insistence on dressing in stereotypical female clothing
  • In girls, an insistence on dressing in stereotypical male clothing [source: Psychiatric News]

DSD (or intersex) conditions are generally classified as "Not Otherwise Specified" (DSM) or "Unspecified" (ICD).

Is GID really a mental disorder?
The inclusion of gender identity disorders in the DSM-IV and other medical texts is a controversial and debated topic. The movement generally falls into two camps: those who believe GID should be removed from the DSM and those who would like it to remain but with significant changes to the language and criteria.

Some mental health professionals and members of the transgendered community believe classifying gender identity disorder as a mental disorder is judgmental and has no clear pathological basis. They suggest that gender roles should not be viewed with such strict boundaries.

It has been suggested that future versions of the DSM move GID away from sexual and psychological labels and instead describe it as an anxiety disorder: Gender Expression Deprivation Anxiety Disorder.

Next we'll explore available treatment options, complications and diseases related to gender identity disorder.