Gender Identity Disorder (Gender Dysphoria)

Gender identity disorder, also referred to as gender dysphoria, can occur in children and adults, in both males and females. When this condition is present, a male individual may have feelings of being a female, and vice versa. These feelings have generally been present since early childhood, though some individuals do not develop the condition until they are adults. Some adults with the condition recall events from childhood in which they displayed mild gender identity disorder symptoms, but they learned how to cope with their feelings and keep the condition under control.

Definition

Gender identity disorder occurs when an individual has a conflict with his or her physical gender and the gender that he or she identifies as. Individuals who are physically male may feel and act as if they are females, and vice-versa. Individuals with this condition present with a strong cross-gender identification.

Symptoms

There are a variety of symptoms associated with gender identity disorder, which tend to be easier to recognize during a person’s childhood. Symptoms of gender dysphoria in children include:

  • Adamantly proclaiming that they are a member of the opposite sex.
  • Repeatedly stating that they wish to be a member of the opposite sex.
  • Simulating the opposite sex attire, such as males wearing or expressing a desire to wear feminine clothes and females wearing or expressing a desire to wear masculine clothing.
  • Persistently fantasizing about being a member of the opposite sex when engaging in fantasy play or role playing.
  • Strong desire to play only with members of the opposite sex.
  • Strong desire to play the stereotypical games that members of the opposite sex play, such as boys wanting to play with toys geared towards girls, and girls wanting to play with toys geared towards boys.
  • Repulsion of their own genitals.

For children to be diagnosed with gender identity disorder, at least four of the signs or symptoms above must be present.

In addition to the symptoms above, young boys may have problems accepting that they have a penis, and may complain that the penis is unattractive. They may try to make the penis disappear by hiding it between their legs. When engaging in fantasy role play, they will take on the role of a female character, most often a mother figure.

In the case of girls, they will sometimes refuse to urinate in a sitting position or may assert that they will eventually grow a penis. They often express resentment and anger when a parent tries to dress them in stereotypical female clothing. They usually prefer short hair and may be asked to be called by a boy’s name.

In teenagers and adults, symptoms include the stated desire to be a member of the opposite sex, or trying to pass as a member of the opposite sex. Many teens with the condition, when asked, will profess that they believe they were born of the wrong sex. For many adolescents, gender identity disorder causes a great deal of distress in social settings.

Causes

A specific cause for gender dysphoria is not completely known, and can be different in each individual. Some individuals with this condition were born with ambiguous genitalia, which can result in questions about which gender they are. Hormones in the womb are suspected to play a large role in the development of this condition. Other possible causes include:

  • Genes
  • Social factors
  • Environmental factors
  • Parenting

Risk Factors

There are a few factors that have been identified as possible risks for developing gender identity disorder. These factors include:

  • Being born with ambiguous genitalia
  • Being born to a mother who had a hormonal imbalance during pregnancy
  • Having a parent with gender identity disorder

Diagnostic Tests

In order to confirm a diagnosis of gender identity disorder, an individual must express feelings of being the wrong gender for a minimum of 2 years. A psychiatric evaluation can be given to confirm the existence of a constant desire to become a member of the opposite sex. The individual should be screened for the presence of any physical intersex conditions that could cause symptoms of gender identity disorder, such as an androgen insensitivity or congenital adrenal hyperplasia.

Treatment Options

Treatment for children is aimed at decreasing stress and creating a supportive home and school environment. Children may have positive results with a combination of individual and family therapy. Adults with the condition often benefit from the same type of therapy, as well as couples therapy for those that are involved in committed relationships. Some adults will benefit from sex reassignment via hormone therapy and surgical procedures, however, many will still present with identity problems.

Considerations

Early diagnosis and proper treatment can significantly reduce the risk of depression, anxiety and emotional stress. It is important to contact your healthcare provider if you or your child exhibit symptoms of gender identity disorder. Left untreated, severe depression can develop, as can suicidal thoughts.

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