What is gender dysphoria or gender identity disorder?
Gender identity disorders, gender dysphoria or transsexualism, are those clinical conditions in which a person presents a discrepancy between their anatomical sex, and the psychic and social sexual identity to which they feel they belong. It is known that there is no psychopathological disorder and should not be presented as a mental illness.
At what age can it occur?
It usually begins at the end of the second childhood, which is the stage of child development that goes from 3 years to 6 years, therefore between 5 and 6 years, which is when the child already has a greater cognitive development, begins to interact socially, has playmates and the child can act, more and more, in a reflexive way. The child is no longer always driven by his or her impulses, as was the case in earlier stages. In case of gender dysphoria there will be a strong and persistent desire to identify with the opposite sex rather than with the given biological or anatomical sex.
Are there any diagnostic tests?
The diagnosis is based mainly on the anamnesis and its follow-up, the following facts must concur: A marked and persistent identification with the other sex. Persistent discomfort with one’s own sex or feeling of inadequacy with one’s role. The alteration does not coexist with an intersex or genetic disease and there is clinically significant discomfort or deterioration in social, occupational or other important areas of the individual’s activity, for more than 2 years according to the ICD-10 manual.
How should it be treated?
The treatment consists of changing the sexual characteristics of the patient to those of the sex to which he/she feels he/she belongs. The patient develops the treatment in 3 phases known as therapeutic triad that includes:
- 1. Diagnosis and real life experience.
- 2. Cross hormonal treatment.
- 3. Sexual reassignment surgeries (the latter is not always desired, therefore not always applied).
When is it necessary to see a specialist?
Not all children who present in their childhood characteristics of the opposite gender are transsexual as adults. However, all of them will need social and family support. In Spain the law regulating registry rectification in the mention of the sex of the persons, obliges the person to present a psychiatric diagnosis and to follow a hormonal therapy during a period of at least 2 years. In our experience they come alone as soon as they turn 18 and if they are minors, they present themselves with a parent for consent.
For more information on Transsexuality and its treatment contact a specialist in Endocrinology.