World Library  
Flag as Inappropriate
Email this Article

Gender dysphoria


Gender dysphoria

Gender identity disorder/Gender dysphoria
Classification and external resources
ICD-10 F64.9, F64.8
ICD-9 302.85
MedlinePlus 001527
MeSH D005783

Gender identity disorder (GID) or gender dysphoria is the formal diagnosis used by psychologists and physicians to describe people who experience significant dysphoria (discontent) with the sex they were assigned at birth and/or the gender roles associated with that sex. Evidence suggests that people who identify with a gender different from the one they were assigned at birth may do so not just due to psychological or behavioral causes, but also biological ones related to their genetics, the makeup of their brains, or prenatal exposure to hormones.[1]

Estimates of the prevalence of gender identity disorder range from a lower bound of 1:2000 (or about 0.05%) in the Netherlands and Belgium[2] to 0.5% in Massachusetts[3] to 1.2% in New Zealand.[4] These numbers are based on those who identify as transgender. It is estimated that about 0.005% to 0.014% of natal males and 0.002% to 0.003% of natal females would be diagnosed with gender dysphoria, based on current diagnostic criteria, though this is considered a modest underestimate.[5] Research indicates people who transition in adulthood are up to three times more likely to be male assigned at birth, but that among people transitioning in childhood the sex ratio is close to 1:1.[6]

Gender identity disorder is classified as a medical disorder by the ICD-10 CM[7] and DSM-5 (called gender dysphoria).[8] Many transgender people and researchers support declassification of GID because they say the diagnosis pathologizes gender variance, reinforces the binary model of gender,[9] and can result in stigmatization of transgender individuals.[8] The official classification of gender dysphoria as a disorder in the DSM-5 may help resolve some of these issues, because the term "gender dysphoria" applies only to the discontent experienced by some persons resulting from gender identity issues.[8]

The current medical approach to treatment for persons diagnosed with gender identity disorder is to support the individual in physically modifying the body to better match the psychological gender identity.[10] This approach is based on the concept that their experience is based in a medical problem correctable by various forms of medical intervention.[10][11]


  • Signs and symptoms 1
  • Causes 2
    • Biological causes 2.1
  • Diagnosis 3
  • Management 4
    • Prepubescent children 4.1
    • Psychological treatments 4.2
    • Biological treatments 4.3
  • History 5
  • Society and culture 6
    • Gender as a social construction 6.1
    • GID as a birth defect 6.2
    • Distress as a consequence of stigma 6.3
    • Intimate relationships 6.4
    • Replacement for homosexuality in the DSM 6.5
    • International classification 6.6
    • GID as dysfunctional 6.7
    • Insurance coverage 6.8
  • Legislation 7
  • See also 8
  • References 9
  • Further reading 10
  • External links 11

Signs and symptoms

Symptoms of GID in children include disgust at their own genitalia, social isolation from their peers, anxiety, loneliness and depression.[12] According to the American Psychological Association, transgender children are more likely to experience harassment and violence in school, foster care, residential treatment centers, homeless centers and juvenile justice programs than other children.[13]

Adults with GID are at increased risk for stress, isolation, anxiety, depression, poor self-esteem and suicide.[12] Transgender women are likelier than other persons to smoke cigarettes and abuse alcohol and other drugs. In the United States, transgender women have a higher suicide rate than others, both before and after gender reassignment surgery,[12] and are at heightened risk for certain mental disorders.[14]

In 2014, a researcher found that the brains of adolescents with gender dysphoria react to the sex hormone androstadienone in a measurable way similar to the brain of the gender with which the person identifies.[15]


GID exists when a person suffers discontent due to gender identity causes him or her emotional distress.[12] Researchers disagree about the nature of distress and impairment in people with GID. Some have suggested that people with GID suffer because they are stigmatized and victimized;[16] if the society had less-strict gender divisions, transsexuals would suffer less.[17]

Although the exact etiology of gender dysphoria is unknown, there is evidence of biological and sociocultural influences in its development.

Biological causes

Genetic variation, hormones, and differences in brain functioning and brain structures provide evidence for the biological etiology of the symptoms associated with GID. Twin studies indicate that GID is 62% heritable, evidencing the genetic influence in its development.[18] In male-to-female transsexuals, GID is associated with variations in an individual's genes that make the individual less sensitive to androgens.[1] Zhou et al. (1995) found that in one area of the brain, male-to-female transsexuals have a typically female structure, and female-to-male transsexuals have a typically male structure.[19] Zhou et al. (1995) had a sample size of only six male-to-female transgender individuals. There may, for example, be some non-transgender heterosexual men with some brain structures that would be expected in a female, as the sample size in Zhou et al. (1995) is too small to exclude such possibilities. In addition, some aspects of trans women's hypothalamus functioning resemble that typical of cisgender women.[20]

Similar brain structure differences have, however, been noted between gay and heterosexual men, and between lesbian and heterosexual women.[21][22] More recent studies have found that circumstance and repeated activities such as meditation modify brain structures in a process called brain plasticity or neuroplasticity. In May 2014, the Proceedings of the National Academy of Sciences reported that for fathers, parenting "rewires the male brain".[23]


The American Psychiatric Association permits a diagnosis of gender dysphoria if the criteria in the Diagnostic and Statistical Manual of Mental Disorders (5th Edition), or DSM-5, are met. The DSM-5 moved this diagnosis out of the sexual disorders category and into a category of its own.[24] The DSM-5 states that at least two of the criteria for gender dysphoria must be experienced for at least six months' duration in adolescents or adults for diagnosis.[25] The diagnosis was renamed from "Gender Identity Disorder" to "Gender Dysphoria", after criticisms that the former term was stigmatizing.[26] Subtyping by sexual orientation was deleted. The diagnosis for children was separated from that for adults. The creation of a specific diagnosis for children reflects the supposedly lesser ability of children to have insight into what they are experiencing, or ability to express it in the event that they have insight.[27]

The International Classification of Diseases (ICD-10) list three diagnostic criteria for "transsexualism" (F64.0):[10] Uncertainty about gender identity which causes anxiety or stress is diagnosed as sexual maturation disorder, according to the ICD-10.[28]


Treatment has typically tried to change the person's identification to match physical characteristics or to alter the body to match the gender identification. Today, treatment is generally driven by the patient's desired outcome. It may include psychological counselling, resulting in lifestyle changes, or physical changes, resulting from medical interventions such as hormonal treatment, genital surgery, electrolysis or laser hair removal, chest/breast surgery, or other cosmetic 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, or counseling a spouse to help him or her adjust to the patient's situation.[29]

Treatment for GID is somewhat controversial because of the irreversibility of physical changes. Guidelines have been established to aid clinicians. The World Professional Association for Transgender Health (WPATH) Standards of Care are used as treatment guidelines for GID by some clinicians. Others use guidelines outlined in Gianna Israel and Donald Tarver's Transgender Care. Guidelines for treatment generally follow a "harm reduction" model.[30][31][32]

Prepubescent children

The question of whether to counsel young children to be happy with their assigned sex or to encourage them to continue to exhibit behaviors that do not match their sex—or to explore a transsexual transition—is controversial. Some clinicians report that a significant proportion of young children diagnosed with gender identity disorder later do not exhibit the dysphoria.[33]

Professionals who treat gender identity disorder in children have begun to refer and prescribe hormones, known as a puberty blocker, to delay the onset of puberty until a child is believed to be old enough to make an informed decision on whether hormonal gender reassignment leading to surgical gender reassignment will be in that person's best interest.[34]

Psychological treatments

Until the 1970s, psychotherapy was the primary treatment for GID, and generally was directed to helping the person adjust to the gender of the physical characteristics present at birth. Psychotherapy is any therapeutic interaction that aims to treat a psychological problem. Though some clinicians still use only psychotherapy to treat GID, it is now typically used in addition to biological interventions as treatment for GID.[35] Psychotherapeutic treatment of GID involves helping the patient to adapt. Attempts to "cure" GID by changing the patient's gender identity to reflect birth characteristics have been ineffective.[36]:1568

Biological treatments

Biological treatments physically alter primary and secondary sex characteristics to reduce the discrepancy between an individual's physical body and gender identity.[37] Biological treatments for GID without any form of psychotherapy is quite uncommon. Researchers have found that if individuals bypass psychotherapy in their GID treatment, they often feel lost and confused when their biological treatments are complete.[38]

Psychotherapy, hormone replacement therapy, and sex reassignment surgery together can be effective treating GID when the WPATH standards of care are followed.[36]:1570 The overall level of satisfaction with both psychological and biological treatments is very high.[35]


The term gender identity disorder is an older term for the condition. Some groups, including the American Psychological Association (APA), use the term gender dysphoria.[39] The APA's Diagnostic and Statistical Manual first described the condition in the third publication ("DSM-III") in 1980.[40]

In April 2011, the UK National Research Ethics Service approved prescribing monthly injection of puberty-blocking drugs to youngsters from 12 years old, in order to enable them to get older before deciding on formal sex change. The Tavistock and Portman NHS Foundation Trust (T&P) in North London has treated such children. Clinic director Dr. Polly Carmichael said, "Certainly, of the children between 12 and 14, there's a number who are keen to take part. I know what's been very hard for their families is knowing that there's something available but it's not available here." The clinic received 127 GID referrals in 2010.[41]

The T&P completed a three-year trial to assess the psychological, social and physical benefits and risks involved for 12- to 14-year-old patients. The trial was deemed such a success that doctors have decided to make the drugs more widely available and to children as young as 9 years of age. As recently as 2009, national guidelines stated that treatment for GID should not start until puberty had finished. Ferring Pharmaceuticals manufactures the drug Triptorelin, marketed under the name Gonapeptyl, at £82 per monthly dose. The treatment is reversible, which means the body will resume its previous state upon discontinuation of drugs. MP Andrew Percy said "I think many people will be horrified at the thought of a nine-year-old being provided with a drug that effectively stops them developing and maturing naturally." MP Mark Pritchard said, "With competing NHS resources, especially for life-saving cancer drugs, there needs to be an immediate investigation into why these drugs are being prescribed to those so young."

Carmichael said,

Now we’ve done the study--and the results thus far have been positive--we’ve decided to continue with it. So we’ve decided to do “stage not age” (as the criterion) because it’s obviously fairer. Twelve is an arbitrary age. If they started puberty aged nine or ten instead of 12, as long as they’re monitored and the bone density doesn’t suffer, then it is right that the aim is to stop the development of secondary sex characteristics.[42]

Society and culture

Individuals with GID may or may not regard their own cross-gender feelings and behaviors as a disorder. Advantages and disadvantages exist to classifying GID as a disorder.[10]

Gender as a social construction

Social "gender" characteristics are created and supported by the expectations of a culture, and are therefore only partially related to biological sex. For example, the association of particular colours with "girl" or "boy" babies begins extremely early in Western European-derived cultures. Other expectations relate to approved and allowable behaviors and emotional expression.

Some cultures have three defined genders: male, female, and effeminate male. For example, in Samoa, the fa'afafine, a group of feminine males, are entirely socially accepted. The fa'afafine do not have any of the stigma or distress typically associated in Western cultures with deviating from a male/female gender role. This suggests the distress so frequently associated with GID in a Western context is not caused by the disorder itself, but by difficulties encountered from social disapproval by one's culture.[43] However, research has found that the anxiety associated with the disorder persists in cultures, Eastern or otherwise, which are more accepting of gender nonconformity.[44]

In Australia, a 2014 High Court of Australia judgment unanimously ruled in favour of a plaintiff named Norrie, who asked to be classified by a third gender category, 'non-specific', after a long court battle with the NSW Registrar of Births, Deaths and Marriages.[45]

GID as a birth defect

The "GID as a birth defect" argument is supported by physiological evidence, such as the presence of typically female patterns of white matter and neuron patterns observed in the brains of male-to-female transsexuals[46][47] and overall longer instances of the androgen receptor gene.[48] (Also see Causes of transsexualism.) However, these markers do not identify every individual who undergoes transition. Using such markers to define transsexualism could falsely exclude some people from treatment.[49]

Distress as a consequence of stigma

The DSM-IV-TR diagnostic component of distress is not inherent in the cross-gender identity; rather, it is related to social rejection and discrimination suffered by the individual.[43] Dr. Darryl Hill insists that GID is not a mental disorder, but rather that the diagnostic criteria reflect psychological distress in children that occurs when parents and others have trouble relating to their child's gender variance.[50]

Transgender people have often been harassed, socially excluded, and subjected to discrimination, abuse and violence, including murder.[12][17]

Intimate relationships

Intimate relationships between lesbians and female-to-male people with GID will sometimes endure throughout the transition process, or shift into becoming supportive friendships. Intimate relationships between heterosexual women and male-to-female people with GID often suffer once the GID is known or revealed. Researchers say the fate of the relationship seems to depend mainly on the woman's adaptability. Problems often arise, with the cisgender partner becoming increasingly angry or dissatisfied, if her partner's time spent in a female role grows, if her partner's libido decreases, or if her partner is angry and emotionally cut-off when in the male role. Cisgender women sometimes also worry about social stigma and may be uncomfortable with the bodily feminization of their partner as the partner moves through transition. The cisgender women who are likeliest to accept and accommodate their partner's transition, researchers say, are those with a low sex drive or those who are equally sexually attracted to men and women.[51]

Replacement for homosexuality in the DSM

Some people have complained that the deletion of homosexuality as a mental disorder from the DSM-III and the creation of the GID diagnosis was sleight of hand by psychiatrists, who changed the focus of the diagnosis from the deviant desire (for the same sex) to the subversive identity (or the belief/desire for membership of another sex/gender).[52][53] They complain that both diagnoses suggest that the patient is not a "normal" male or female. By contrast, Kenneth Zucker and Robert Spitzer argue that GID was included in the DSM-III (7 years after homosexuality was removed from the DSM-II) because it "met the generally accepted criteria used by the framers of DSM-III for inclusion."[54]

International classification

In December 2002, the British Lord Chancellor's office published a Government Policy Concerning Transsexual People document that categorically states, "What transsexualism is not ... It is not a mental illness."[55] In May 2009, the government of France declared that a transsexual gender identity will no longer be classified as a psychiatric condition.[56]

In August 31, 2010, Thomas Hammarberg, Commissioner for Human Rights within the Strasbourg-based Council of Europe, an independent institution, opposed the mental disorder classification and the sterilization of transgender persons as a requirement for legal sex change.[57]

The Principle 3 of The Yogyakarta Principles on The Application of International Human Rights Law In Relation to Sexual Orientation and Gender Identity states, "Persons of diverse sexual orientation and gender identities shall enjoy legal capacity in all aspects of life. Each person's self-defined sexual orientation and gender identity is integral to their personality and is one of the most basic aspects of self-determination, dignity and freedom," and the Principle 18 states, "Notwithstanding any classifications to the contrary, a person's sexual orientation and gender identity are not, in and of themselves, medical condition and are not to be treated, cured or suppressed."

GID as dysfunctional

Some researchers, including Dr. Robert Spitzer (retired) and Dr. Paul J. Fink, contend that the behaviors and experiences seen in transsexualism are abnormal and constitute a dysfunction.[50]

Insurance coverage

Because GID is classified as a disorder in the DSM-IV-TR, many insurance companies are willing to cover some of the expenses of sex reassignment therapy. Without the classification of GID as a medical disorder, sex reassignment therapy may be viewed as cosmetic treatment, rather than medically necessary treatment, and may not be covered.[58]

In the United States, transgender people are less likely than others to have health insurance, and often face hostility and insensitivity from healthcare providers.[59]


In California, Assembly Bill (AB) No. 1266, authored by Assemblyman Tom Ammiano (D-San Francisco), was passed in May 2013 by the State Assembly:

Existing law prohibits public schools from discriminating on the basis of specified characteristics, including gender, gender identity, and gender expression, and specifies various statements of legislative intent and the policies of the state in that regard. Existing law requires that participation in a particular physical education activity or sport, if required of pupils of one sex, be available to pupils of each sex. This bill would require that a pupil be permitted to participate in sex-segregated school programs, activities, including athletic teams and competitions, and use facilities consistent with his or her gender identity, irrespective of the gender listed on the pupil's records.[60]
The California Catholic Conference opposed the bill as unnecessary, as laws exist already to fight discrimination against transgender students. A spokeswoman for the conference said that the issue should be handled by school officials.[60]

Petitions were collected to require a referendum on the legislation in question, but the Secretary of State of California, Debra Bowen, issued a decision determining that, due to disqualified signatures, the threshold of votes had not been reached to force the referendum in question.[61] Pacific Justice and Capitol Resource institutes, representing opponents of AB 1266, dispute this, filing a lawsuit, opposed by the State of California, to have the disqualified signatures validated and petitioners' names made public, which the State argues are confidential. Pro-referendum forces claim votes were mishandled due to malfeasance and incompetence in Tulare and Mono counties, respectively.[61]

See also


  1. ^ a b Heylens, G; De Cuypere, G;  
  2. ^ Olyslager, Femke;  
  3. ^ Conron, KJ; Scott, G; Stowell, GS; Landers, S (January 2012), "Transgender Health in Massachusetts: Results from a Household Probability Sample of Adults",  
  4. ^ Clark, Terryann C.; Lucassen, Mathijs F.G.; Bullen, at; Denny, Simon J.; Fleming, Theresa M.; Robinson, Elizabeth M.; Rossen, Fiona V. (January 15, 2014). "The Health and Well-Being of Transgender High School Students: Results From the New Zealand Adolescent Health Survey (Youth'12)".  
  5. ^ Diagnostic and Statistical Manual of Mental Disorders 5.  
  6. ^ Landen, M; Walinder, J; Lundstrom, B (1996). "Prevalence, incidence and sex ratio of transsexualism". Acta Psychiatrica Scandinavica 93 (4): 221–223.  
  7. ^ "Gender identity disorder in adolescence and adulthood". Retrieved July 3, 2011. 
  8. ^ a b c Fraser, L; Karasic, D; Meyer, W; Wylie, K (2010). "Recommendations for Revision of the DSM Diagnosis of Gender Identity Disorder in Adults". International Journal of Transgenderism 12 (2): 80–85.  
  9. ^ Newman, L (1 July 2002). "Sex, Gender and Culture: Issues in the Definition, Assessment and Treatment of Gender Identity Disorder". Clinical Child Psychology and Psychiatry 7 (3): 352–359.  
  10. ^ a b c d "Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7". International Journal of Transgenderism (Routledge Taylor & Francis Group) (13): 165–232. 2011.  
  11. ^ Buehler, Stephanie (2013). What Every Mental Health Professional Needs to Know About Sex. Springer Publishing Company.  
  12. ^ a b c d e Davidson, Michelle R. (2012). A Nurse's Guide to Women's Mental Health. Springer Publishing Company. p. 114.  
  13. ^ Ansara and Peter Hegarty, Y. Gavriel (2011). "Cisgenderism in psychology: pathologising and misgendering children from 1999 to 2008". Psychology & Sexuality (Routledge University Press).  
  14. ^ O'Keefe, CarolynAnne (2007). Mentoring sexual orientation and gender identity minorities in a university setting. California: ProQuest Dissertations & Theses (PQDT). p. xvi.  
  15. ^ Brein jongere in verkeerd lichaam lijkt op dat van andere geslacht., 15 June 2014
  16. ^ Bryant, Karl Edward (2007). The Politics of Pathology and the Making of Gender Identity Disorder. Ann Arbor, Michigan: ProQuest Dissertations & Theses (PQDT). p. 222.  
  17. ^ a b Giordano, Simona (2012). Children with Gender Identity Disorder: A Clinical, Ethical, and Legal Analysis. New Jersey: Routledge. p. 147.  
  18. ^ Coolidge, F; Thede, L; Young, S (4 April 2002). "The Heritability of Gender Identity Disorder in a Child and Adolescent Twin Sample". Behavior Genetics 32 (4): 251–257.  
  19. ^ Zhou, Jiang-Ning; Hofman, Michel A.; Gooren, Louis J.G.; Swaab, Dick F. (1995). "A sex difference in the human brain and its relation to transsexuality". Nature 378 (6552): 68–70.  
  20. ^ Berglund, H.; Lindström, P.; Dhejne-Helmy, C.; Savic, I. (2007). "Male-to-Female Transsexuals Show Sex-Atypical Hypothalamus Activation When Smelling Odorous Steroids". Cerebral Cortex 18 (8): 1900–1908.  
  21. ^ LeVay S (August 1991). "A difference in hypothalamic structure between heterosexual and homosexual men". Science 253 (5023): 1034–7.  
  22. ^ Byne W, Tobet S, Mattiace LA, et al. (September 2001). "The interstitial nuclei of the human anterior hypothalamus: an investigation of variation with sex, sexual orientation, and HIV status". Horm Behav 40 (2): 86–92.  
  23. ^ Eyal Abraham, Talma Hendler, Irit Shapira-Lichter, Yaniv Kanat-Maymon, Orna Zagoory-Sharon, and Ruth Feldman (May 2014). "Father's brain is sensitive to childcare experiences". Proceedings of the National Academy of Sciences 111 (27): 9792–9797.  
  24. ^ "P 01 Gender Dysphoria in Adolescents or Adults". American Psychiatric Association. Retrieved April 2, 2012. 
  25. ^ "Gender Dysphoria". DSM-5. American Psychiatric Association. Retrieved 20 April 2014. 
  26. ^ "Gender Dysphoria in Children". American Psychiatric Association. May 4, 2011. Retrieved July 3, 2011. 
  27. ^ "P 00 Gender Dysphoria in Children". American Psychiatric Association. Retrieved April 2, 2012. 
  28. ^ Potts, S; Bhugra, D (1995). "Classification of sexual disorders". International Review of Psychiatry 7 (2): 167–174.  
  29. ^ Leiblum, Sandra (2006). Principles and Practice of Sex Therapy, Fourth Edition. The Guilford Press. pp. 488–489.  
  30. ^ COMMITTEE ON ADOLESCENCE (June 24, 2013). "Office-Based Care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth: STI/HIV Testing and Prevention". American Academy of Pediatrics. Retrieved August 27, 2013. However, adolescents with multiple or anonymous partners, having unprotected intercourse, or having substance abuse issues should be tested at shorter intervals. 
  31. ^ " Compendium of Health Prof ession Association LGBT Policy & Position Statements". GLMA. 2013. Retrieved August 27, 2013. 
  32. ^ "APA Policy Statements on Lesbian, Gay, Bisexual, & Transgender Concerns". American Psychological Association. 2011. Retrieved August 27, 2013. BE IT FURTHER RESOLVED that APA recognizes the efficacy,benefit, and necessity of gender transition treatments for appropriately evaluated individuals and calls upon public and private insurers to cover these medically necessary treatments; 
  33. ^ Spiegel, Alix (2008-05-08). "Q&A: Therapists on Gender Identity Issues in Kids". NPR. Retrieved 2008-09-16. 
  34. ^ The Transgendered Child: A Handbook for Families and Professionals (Brill and Pepper, 2008)
  35. ^ a b Gijs, L; Brawaeys, A (2007). "Surgical Treatment of Gender Dysphoria in Adults and Adolescents: Recent Developments, Effectiveness, and Challenges". Annual Review of Sex Research 18 (178–224). 
  36. ^ a b George R. Brown, MD (20 July 2011). "Chapter 165 Sexuality and Sexual Disorders". In Robert S. Porter, MD; et al. The  
  37. ^ Bockting, W; Knudson, G; Goldberg, J (January 2006). "Counselling and Mental Health Care of Transgender Adults and Loved Ones". 
  38. ^ Hakeem, Az (2008). "Changing Sex or Changing Minds: Specialist Psychotherapy and Transsexuality". Group Analysis 41 (2): 182–196.  
  39. ^ "Gender Dysphoria Fact Sheet". APA. Retrieved 2 September 2013. 
  40. ^ Koh, J (2012). "The history of the concept of gender identity disorder". Seishin Shinkeigaku Zasshi 114 (6): 673–80.  
  41. ^ "Puberty blocker for children considering sex change", Telegraph (Alleyne) 15 Apr 2011
  42. ^ " "NHS to give sex change drugs to nine-year-olds: Clinic accused of 'playing God' with treatment that stops puberty" (Manning and Adams) 18 May 2014". Mail Online. Retrieved 1 October 2014. 
  43. ^ a b Vasey, P; Bartlett, N (2007). "What Can the Samoan "Fa'afafine" Teach Us about the Western Concept of Gender Identity Disorder in Childhood?". Perspectives in Biology and Medicine 50 (4): 481–490.  
  44. ^ Diagnostic and Statistical Manual of Mental Disorders 5.  
  45. ^ NSW Registrar of Births, Deaths and Marriages v Norrie [2014] HCA 11
  46. ^ "Transsexual differences caught on brain scan - life". New Scientist. January 26, 2011. Retrieved 2011-07-05. 
  47. ^ (2000). "Male-to-female transsexuals have female neuron numbers in the limbic nucleus", The Journal of Clinical Endocrinology & Metabolism, 85(5); retrieved from
  48. ^ Hare, L; Bernard, P; Sánchez, F; Baird, P; Vilain, E; Kennedy, T; Harley, V (2009). "Androgen Receptor Repeat Length PolymorphismAssociated with Male-to-Female Transsexualism". Biological Psychiatry 65 (1): 93–96.  
  49. ^ Allen, Mercedes (November 2008). "Transgender in the Genes?". GayCalgary and Edmonton (61): 50. 
  50. ^ a b "Controversy Continues to Grow Over DSM's GID Diagnosis". Psychiatric News. 
  51. ^ Barrett, James (2007). Transexual and Other Disorders of Gender Identity: A Practical Guide to Management. RADCLIFFE MEDICAL PRESS LTD. p. 83.  
  52. ^ Arlene Istar Lev (2004). Transgender Emergence: Therapeutic Guidelines for Working with Gender-Variant People and Their Families. Haworth Press. p. 172.  
  53. ^  
  54. ^  
  55. ^ "Government Policy concerning Transsexual People". People's rights/Transsexual people. U.K. Department for Constitutional Affairs. 2003. 
  56. ^ "La transsexualité ne sera plus classée comme affectation psychiatrique". Le Monde. May 16, 2009. 
  57. ^ Forced divorce and sterilisation - a reality for many transgender persons,; accessed April 11, 2014.
  58. ^ Ford, Zack. "APA Revises Manual: Being Transgender is No Longer a Mental Disorder". Retrieved April 7, 2013. 
  59. ^ Mallon, Gerald P. (2009). Social Work Practice with Transgender and Gender Variant Youth. New Jersey: Routledge.  
  60. ^ a b , "Assembly approves bill on gender identity in schools"Los Angeles Times by Chris Megerian, May 9, 2013; accessed April 11, 2014.
  61. ^ a b Suit against State of California over AB 1266,, April 2014; accessed April 12, 2014.

Further reading

  • Conway, Lynn (February 5, 2011). "Transsexual Women's Successes: Links and Photos". Retrieved December 2, 2014. 
  • Jacques, Juliet. "A Transgender Journey".  
  • World Professional Association for Transgender Health (2012). Standards of Care for Gender Identity Disorders. Harry Benjamin International Gender Dysphoria Association.  Includes a description of ICD-10 criteria.

External links

  • Health Law Standards of Care for Transsexualism - An alternative to the Benjamin Standards of Care proposed by the International Conference on Transgender Law and Employment Policy.
  • The Lord Chancellor's Department Government Policy concerning Transsexual People
  • Gender Identity Disorder & Transsexualism – Synopsis of Etiology in Adults provides an alternative to the current classifications of psychiatric disorder and mental illness.
  • "I'm Not Les: A Transgender Story" (2012 YouTube documentary)
  • GID Reform Advocates
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.