Gender Identity Disorder
Disease Details
Family Health Simplified
- Description
- Gender Identity Disorder, now commonly referred to as Gender Dysphoria, is characterized by a significant and persistent incongruence between an individual's experienced or expressed gender and their assigned gender at birth, causing distress or impairment in social, occupational, or other important areas of functioning.
- Type
- Gender identity disorder is more commonly referred to now as gender dysphoria. It is a psychological condition rather than a genetic one, so it does not have a type of genetic transmission. Instead, it involves a discrepancy between an individual's experienced or expressed gender and the gender they were assigned at birth. The exact causes are complex and involve a combination of genetic, hormonal, developmental, and environmental factors.
- Signs And Symptoms
- Distress arising from an incongruence between a person's felt gender and assigned sex/gender (usually at birth) is the cardinal symptom of gender dysphoria.No particular sexual orientation indicates gender dysphoria. A 2021 review in Dialogues in Clinical Neuroscience found no relation to sexual orientation, but acknowledged that historically the two were often erroneously conflated. The British National Health Service also stated "gender dysphoria is not related to sexual orientation".Gender dysphoria in those assigned male at birth (AMAB) tends to follow one of two broad trajectories: early-onset or late-onset. Early-onset gender dysphoria is behaviorally visible in childhood but may temporarily subside, leading the person to identify as gay or homosexual for a period of time, followed by recurrence of gender dysphoria. A 2016 review in the Archives of Sexual Behavior states this group is usually sexually attracted to members of their natal sex in adulthood, commonly identifying as heterosexual. Late-onset gender dysphoria does not include visible signs in early childhood, but some report having had wishes to be the opposite sex in childhood that they did not report to others. Likewise, according to the review, transgender people assigned male at birth who experience late-onset gender dysphoria will usually be attracted to women and may identify as lesbians or bisexual, while those with early-onset will usually be attracted to men. The review states a similar pattern occurs in those assigned female at birth (AFAB), with those experiencing early-onset GD being most likely to be attracted to women and those with late-onset being most likely to be attracted to men and identify as gay.Symptoms of GD in children include preferences for opposite sex-typical toys, games, activities, or playmates as well as a great dislike of their own genitalia. Some children may also experience social isolation from their peers, anxiety, loneliness, and depression. In adolescents and adults, symptoms include the desire to be and to be treated as a different gender. Adults with GD are at increased risk for stress, isolation, anxiety, depression, poor self-esteem, and suicide. Transgender people are also at heightened risk for eating disorders and substance abuse. According to the American Psychiatric Association, those who experience gender dysphoria later in life "often report having secretly hidden their gender dysphoric feelings from others when they were younger".
- Prognosis
- Gender identity disorder, now more commonly referred to as gender dysphoria, involves a conflict between a person's physical or assigned gender and the gender with which they identify. The prognosis varies depending on several factors, including access to supportive mental health care, social acceptance, and the availability of appropriate medical treatments such as hormone therapy and gender-affirming surgeries. Individuals who receive comprehensive care and support typically experience significant improvements in mental health and quality of life.
- Onset
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The term "gender identity disorder" has been replaced by "gender dysphoria" in medical and psychological contexts. Gender dysphoria refers to the distress a person experiences due to a mismatch between their gender identity and their sex assigned at birth.
**Onset:** Gender dysphoria can manifest at different stages of life. In some cases, it becomes apparent in early childhood, typically between the ages of 2 and 4. In other cases, it may not become evident until adolescence or adulthood. The intensity and expression of gender dysphoria can vary widely among individuals. - Prevalence
- Gender identity disorder, now more commonly referred to as gender dysphoria, has variable prevalence rates. Studies suggest that around 0.005% to 0.014% of assigned males at birth and 0.002% to 0.003% of assigned females at birth seek gender-affirming treatment or surgery. The actual prevalence might be higher when considering those who do not seek medical interventions.
- Epidemiology
- Different studies have arrived at different conclusions about the prevalence of gender dysphoria. The DSM-5 estimates that about 0.005% to 0.014% of people assigned male at birth (5-14 per 100k) and 0.002% to 0.003% of people assigned female at birth (2-3 per 100k) are diagnosable with gender dysphoria.According to Black's Medical Dictionary, gender dysphoria "occurs in one in 30,000 male births and one in 100,000 female births." Studies in European countries in the early 2000s found that about 1 in 12,000 natal male adults (8 per 100k) and 1 in 30,000 (3 per 100k) natal female adults seek out sex reassignment surgery. Studies of hormonal treatment or legal name change find higher prevalence than sex reassignment, with, for example a 2010 Swedish study finding that 1 in 7,750 (13 per 100k) adult natal males and 1 in 13,120 (8 per 100k) adult natal females requested a legal name change to a name of the opposite gender.Studies that measure transgender status by self-identification find even greater prevalence of gender identity different from sex assigned at birth (although some of those who identify as transgender or gender nonconforming may not experience clinically significant distress and so do not have gender dysphoria). A study in New Zealand found that 1 in 3,630 natal males (13 per 100k) and 1 in 22,714 (4 per 100k) natal females have changed their legal gender markers. A survey of Massachusetts adults found that 0.5% (500 per 100k) identify as transgender. A national survey in New Zealand of 8,500 randomly selected secondary school students from 91 randomly selected high schools found 1.2% (1,200 per 100k) of students responded "yes" to the question "Do you think you are transgender?". Outside of a clinical setting, the stability of transgender or non-binary identities is unknown.Research indicates that among people who transition in adulthood, individuals are up to three times more likely to be male assigned at birth. However, among people transitioning in childhood, the sex ratio is closer to 1:1. The prevalence of gender dysphoria in children remains uncertain due to the lack of formal prevalence studies. A 2022 literature review reported that approximately 36% of adolescents assessed in specialized gender clinics were natal males, and 63% were natal females. One study highlighted in the review found no significant change in these proportions from 2014-2016. However, when comparing more recent data with earlier studies, there has been a shift favoring natal females (ratio of 1:3) as opposed to nearly equal proportions in earlier studies (ratios of 0.8–0.9:1).
- Intractability
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The term "gender identity disorder" is now considered outdated and has been replaced by "gender dysphoria" in modern clinical terminology. Gender dysphoria refers to the psychological distress that results from an incongruence between one's experienced or expressed gender and one’s assigned sex at birth.
Gender dysphoria is not considered intractable in the traditional sense because various treatments and interventions can significantly alleviate the distress associated with it. These interventions may include psychotherapy, hormone therapy, and gender-affirming surgeries, tailored to the individual’s needs. The goal of these treatments is to align the individual's physical characteristics with their gender identity and to alleviate psychological distress, leading to an improved quality of life. - Disease Severity
- The term "Gender Identity Disorder" (GID) is outdated and has been replaced by "Gender Dysphoria" in medical terminology. The severity of Gender Dysphoria varies greatly among individuals. It can range from mild discomfort to severe distress and impairment in daily functioning. The severity often depends on the level of incongruence between an individual's experienced gender and their assigned sex, as well as the societal and personal acceptance of their gender identity. Treatment and management plans are usually tailored to the individual's specific needs and may include psychological support, hormone therapy, and/or surgical interventions to align their physical appearance with their gender identity.
- Healthcare Professionals
- Disease Ontology ID - DOID:1234
- Pathophysiology
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Gender identity disorder, now more appropriately referred to as gender dysphoria, is not classified with a defined biological pathophysiology. It is characterized by a marked incongruence between an individual's experienced or expressed gender and the gender assigned at birth, which can lead to significant distress or impairment in social, occupational, or other important areas of functioning.
Research suggests a complex interplay of biological, psychological, and social factors:
1. **Biological Factors:** Some studies indicate possible genetic and neurobiological contributions, including differences in brain structure and function in individuals with gender dysphoria. Hormonal influences during prenatal development may also play a role.
2. **Psychological and Social Factors:** These encompass a variety of elements including early family dynamics, individual experiences of trauma or stress, and broader societal and cultural influences on gender roles and norms.
Despite some insights, more research is needed to fully understand the underlying mechanisms of gender dysphoria. - Carrier Status
- Gender Identity Disorder (now more commonly referred to as Gender Dysphoria) is not a genetic condition, so the concept of "carrier status" does not apply. Gender Dysphoria is characterized by a significant incongruence between an individual's experienced or expressed gender and the gender they were assigned at birth, leading to distress or impairment in social, occupational, or other important areas of functioning.
- Mechanism
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Gender identity disorder, now more commonly referred to as gender dysphoria, does not have well-defined molecular mechanisms, as it involves complex interactions between biological, psychological, and social factors. Current research has explored various potential mechanisms, including:
1. **Genetic Factors**: Studies have indicated that there may be a genetic component, with certain gene variants possibly influencing gender identity. However, no specific genes have been firmly linked to gender dysphoria.
2. **Hormonal Influences**: Prenatal exposure to sex hormones, particularly androgens, might play a role in the development of gender identity. Abnormal levels of these hormones during critical periods of fetal brain development could potentially affect gender identity.
3. **Brain Structure and Function**: Neuroimaging studies have suggested that certain brain structures in transgender individuals may resemble those typically associated with their identified gender, rather than their assigned sex at birth. These differences are observed in areas related to self-perception and body image.
4. **Epigenetics**: Epigenetic changes, which modify gene expression without altering the DNA sequence, could also play a role. These changes can be influenced by environmental factors and may impact the development of gender identity.
Despite these findings, a definitive molecular mechanism for gender dysphoria remains elusive. The condition is likely the result of multiple interacting factors rather than a single cause. - Treatment
- Treatment for a person diagnosed with GD may include psychological counseling, supporting the individual's gender expression, or may involve physical transition resulting from medical interventions such as hormonal treatment, genital surgery, electrolysis or laser hair removal, chest/breast surgery, or other reconstructive surgeries. The goal of treatment may simply be to reduce problems resulting from the person's transgender status, for example, counseling the patient in order to reduce guilt associated with cross-dressing.Guidelines have been established to aid clinicians. The World Professional Association for Transgender Health (WPATH) Standards of Care are used by some clinicians as treatment guidelines. Others use guidelines outlined in Gianna Israel and Donald Tarver's Transgender Care. Guidelines for treatment generally follow a "harm reduction" model.
- Compassionate Use Treatment
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Gender Identity Disorder (GID) is now more commonly referred to as Gender Dysphoria. Compassionate use treatment, also known as expanded access, allows patients with serious or life-threatening conditions to access investigational medical products outside clinical trials when no comparable or satisfactory therapy options are available.
For Gender Dysphoria, compassionate use treatment might include access to hormone therapies or surgical procedures that are still under investigation or not yet widely approved. Off-label treatments refer to approved medications prescribed for non-approved indications. For example, medications like GnRH analogs (used off-label to delay puberty) and hormone replacement therapies (HRT) are common off-label treatments for Gender Dysphoria.
Experimental treatments are those still in the clinical trial phase and not yet approved by regulatory bodies. In the context of Gender Dysphoria, this may include novel hormonal treatments or new surgical techniques designed to improve gender affirmation procedures and outcomes. Access to these treatments typically requires involvement in clinical trials or, in some cases, may be available through compassionate use programs. - Lifestyle Recommendations
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The term "gender_identity_disorder" is considered outdated and is now more appropriately referred to as "gender dysphoria." This shift reflects a more respectful and accurate understanding of the condition, which is characterized by significant distress or impairment related to a strong, persistent feeling of incongruence between one’s experienced or expressed gender and the gender assigned at birth.
**Lifestyle Recommendations for Gender Dysphoria:**
1. **Seek Professional Support:**
- Consulting a mental health professional experienced in gender issues can provide essential support and guidance.
2. **Support Groups:**
- Joining support groups with others experiencing similar feelings can offer community and understanding.
3. **Physical and Mental Health:**
- Maintaining regular health check-ups and taking care of one's physical and mental health is crucial. Exercise, balanced nutrition, and mindfulness practices can be beneficial.
4. **Gender Expression:**
- Dressing and grooming in ways that align with one's gender identity can significantly reduce distress.
5. **Social Transition:**
- If appropriate and desired, begin socially transitioning by using a preferred name and pronouns in various settings, such as work, school, and among friends and family.
6. **Education and Advocacy:**
- Educating oneself and others about gender dysphoria to foster a supportive environment and advocate for inclusivity can be empowering.
7. **Legal and Medical Transition:**
- Exploring legal changes (e.g., name and gender marker changes on identification documents) and medical options like hormone therapy or surgeries, depending on individual needs and desires.
8. **Self-care:**
- Engaging in activities that bring joy and self-affirmation can improve overall well-being.
9. **Boundaries and Communication:**
- Setting boundaries with individuals who may not be supportive and communicating one's needs and experiences with trusted allies.
Creating a supportive, accepting, and affirming environment, both personally and in broader social circles, plays a vital role in the well-being of individuals with gender dysphoria. - Medication
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Gender identity disorder, now commonly referred to as gender dysphoria, involves a conflict between a person's physical or assigned gender and the gender with which they identify. There is no specific medication for gender dysphoria itself, but several medications can assist in gender transition and alleviate symptoms associated with the condition.
For transgender individuals undergoing transition, hormone replacement therapy (HRT) is often used:
1. **For trans women (Male to Female):** Estrogen and anti-androgens.
2. **For trans men (Female to Male):** Testosterone.
Psychiatric medications may also be prescribed to treat associated conditions like depression or anxiety if present.
It's important for individuals to consult with healthcare providers specializing in transgender health for personalized treatment plans. - Repurposable Drugs
- Gender identity disorder, now more commonly referred to as gender dysphoria, is not typically treated with repurposable drugs as it is not a condition that can be addressed with medication in the same way physical illnesses are. Treatment typically focuses on psychological support, hormone replacement therapy (HRT), and potential surgical interventions. Psychological support can include counseling or therapy to help individuals navigate their gender identity and the associated social issues. Hormone therapy involves the use of hormones such as estrogen or testosterone to help align an individual's physical characteristics with their gender identity. Surgery may also be an option for some individuals.
- Metabolites
- Gender identity disorder, now more commonly referred to as gender dysphoria, is not typically associated with specific metabolites. Gender dysphoria is primarily understood as a psychological condition related to a person's experience and discomfort with their assigned gender at birth. There are no known biochemical markers or metabolites specifically linked to this condition. Treatments usually focus on psychological counseling, hormonal therapy, and sometimes surgical interventions, tailored to the individual's needs.
- Nutraceuticals
- There are no specific nutraceuticals recommended for treating gender identity disorder (now more commonly known as gender dysphoria). Management typically involves psychological support, counseling, and, in some cases, medical interventions such as hormone therapy or surgery. It is important to consult with healthcare professionals for appropriate treatment options.
- Peptides
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Gender identity disorder, now commonly referred to as gender dysphoria, is a condition where there's a conflict between an individual's physical or assigned gender and the gender with which they identify. The treatments for gender dysphoria typically involve psychological counseling, hormone therapies, and sometimes surgical interventions.
Peptides and nucleic acids (NAc) are not directly relevant to the standard treatment protocols for gender dysphoria. Instead, the focus is often on therapies that align an individual's physical appearance with their gender identity, such as hormone replacement therapy (HRT), which might involve hormones like estrogen or testosterone rather than peptides.
If you need more specific information on treatments or related aspects of gender dysphoria, please let me know.