2.6.2 Gender Identity Disorders

Gender Identity Disorders, Including Transsexualism and Transvestism

Gender identity disorder (GID), also known as gender dysphoria, refers to the distress experienced by individuals whose gender identity differs from their biological sex. The condition can manifest as transsexualism or transvestism, which are the two main types of GID. Transsexualism is characterized by a strong and persistent desire to live as the opposite sex, while transvestism refers to the act of wearing clothes traditionally associated with the opposite sex.

Prevalence/Incidence:

Studies suggest that the prevalence of GID is approximately 0.005-0.014% among assigned males and 0.002-0.003% among assigned females (American Psychiatric Association, 2013). However, the actual prevalence may be higher due to underreporting or individuals who do not seek medical attention.

Aetiology:

The exact cause of GID is unknown. Some studies suggest that genetic, hormonal, and environmental factors may play a role in the development of the condition. There is evidence to suggest that exposure to atypical hormone levels during fetal development may contribute to the development of GID.

Gender:

GID affects individuals of all genders, but it is more commonly reported in individuals assigned male at birth. The ratio of male-to-female individuals seeking gender reassignment surgery is approximately 3:1.

Onset:

GID typically manifests in early childhood, with many individuals reporting feeling uncomfortable with their biological sex as young as two or three years old. The onset of the condition can occur at any age, but it is most commonly reported during adolescence or early adulthood.

Presentation:

Individuals with GID may experience significant distress related to their gender identity, which can impact their daily functioning and quality of life. Symptoms may include a strong desire to live as the opposite sex, discomfort with one’s biological sex, anxiety, depression, and suicidal ideation.

Treatment:

The treatment of GID may involve a combination of psychotherapy and medical interventions. Psychotherapy can help individuals explore their gender identity and develop coping strategies for managing distress related to GID. Medical interventions may include hormone therapy and/or gender reassignment surgery, which can help individuals transition to their preferred gender identity.

Studies on individuals with gender identity disorder who have undergone gender reassignment surgery have indicated mixed outcomes regarding suicide and self-harm rates. While many individuals report significant alleviation of gender dysphoria and improved quality of life post-surgery, some studies have noted a heightened risk of suicide and self-harm when compared to the general population. It’s crucial to note that these increased risks may not necessarily be a direct result of the surgery itself, but rather a combination of factors including societal discrimination, stigmatization, and other psychosocial factors. Comprehensive post-operative care and support are vital for this vulnerable population.

Outcome:

The outcome of treatment for GID is generally positive, with many individuals reporting improved quality of life and psychological well-being after transitioning to their preferred gender identity.

Aspect	Information
Prevalence	Approximately 0.005-0.014% among assigned males, 0.002-0.003% among females
Aetiology	Unknown; genetic, hormonal, and environmental factors may contribute
Gender	Affects individuals of all genders, but is more commonly reported in males
Onset	Typically manifests in childhood, but can occur at any age
Presentation	Distress related to gender identity, anxiety, depression, suicidal ideation
Treatment	Psychotherapy, hormone therapy, gender reassignment surgery
Outcome	Generally positive, with improved quality of life and well-being

Reference:

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). doi:10.1176/appi.books.9780890425596.744053.