Dysphoria

**Dysphoria** is defined as a feeling of extreme general discomfort. In the context of transgender and non-binary individuals, *sex* or *gender dysphoria,* or *gender incongruence*, refers the disconnect between one's sex and their gender identity. Those with dysphoria often seek gender therapy, hormone replacement therapy, surgery, or a combination of the three, in order to treat the condition.

Cisgender individuals may also feel gender dysphoria due to cross-sex hormone usage or accidental exposure. Some hormonal disorders such as Polycystic ovary syndrome (PCOS) or gynecomastia may also cause it, though this does not make them transgender. Some intersex individuals also feel dysphoria, often due to forced genital reassignment after birth. Previous versions of the *Diagnostic and Statistical Manual of Mental Disorders (DSM)* discluded intersex individuals in its definitions; however, the *DSM-5* changed its language to, among other things, include them in its definition in 2013.

## Diagnosis

The *DSM-5* criteria for a diagnosis requires at least two symptoms lasting at least six months or longer for adolescents and adults, and at least six symptoms lasting at least six months in children.

### Symptoms

Gender dysphoria manifests itself in a variety of ways, including the following:

* belief of being born of the incorrect sex
* desire to be seen and treated as another gender
* desire for primary or secondary sex characteristics not of their sex
* dislike or disturbance with sexual anatomy
* desire to remove or alter primary or secondary sex characteristics
* desire to wear the clothing of another gender

In addition to the above symptoms, some manifestation in children includes:

* rejection of clothing, toys or activities of their assigned gender
* preference for cross-gender roles in play
* preference for playmates of the other gender
* preference for wearing clothes of the other gender

### Treatment

These symptoms often cause anxiety, depression, suicidal ideation, and self-harm behaviors in transgender people. Studies have shown medical treatment, i.e. hormone replacement therapy (HRT) and surgeries are effective treatments in relieving dysphoria and its effects. Very few individuals regret transition; an estimation of post-transition regret and detransition is between 1-2.2%.

## History of the term

In previous versions of the *DSM*, the term *Gender Identity Disorder* (GID) was used as a diagnosis for transgender patients.

In 2011, the World Professional Association for Transgender Health (WPATH) published "Recommendations from the WPATH Consensus Process for Revision of the *DSM* Diagnosis of Gender Identity Disorders: Implications for Human Rights" in the *International Journal of Transgenderism,* in an appeal to the *Diagnostic and Statistical Manual of Mental Disorders* to revise its diagnosis of GID.

A study by the National Institute of Psychiatry Ramón de le Fuente Muñiz published a study in *The Lancet* in 2016, with the conclusion that transgender identity is not a mental illness, and should be removed from future publications of the *International Classification of Diseases* (*ICD*).

In 2013, the *DSM-5* revised the diagnosis to gender dysphoria and changed some of the criteria for diagnosis. These changes were made to "better characterize the experiences of affected children, adolescents, and adults."

## Sources

1. ↑ https://link.springer.com/article/10.1007/s10508-015-0550-0
2. ↑ 2.0 2.1 https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria
3. ↑ American Psychiatry Association (2013). *Diagnostic and Statistical Manual of Mental Disorders (DSM-5)* (5th ed.). Washington, DC and London: American Psychiatric Publishing.
4. ↑ https://psychcentral.com/disorders/gender-dysphoria-symptoms/
5. ↑ https://www.nhs.uk/conditions/gender-dysphoria/symptoms/
6. ↑ https://www.cambridge.org/core/journals/psychological-medicine/article/hormone-therapy-gender-affirmation-surgery-and-their-association-with-recent-suicidal-ideation-and-depression-symptoms-in-transgender-veterans/C0D0CFE0B8D5FAD4B852872DAB25D177
7. ↑ https://www.ncbi.nlm.nih.gov/pubmed/24275005
8. ↑ https://www.ncbi.nlm.nih.gov/pubmed/21364939
9. ↑ https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2265.2009.03625.x
10. ↑ https://link.springer.com/article/10.1007%2Fs10508-005-7926-5
11. ↑ https://web.archive.org/web/20141127023934/https://www.skane.se/Upload/Webbplatser/USIL/Dokument/Sjukhusbibliotek/Johansson,%20Annika.pdf
12. ↑ *https://www.researchgate.net/publication/262734734\_An\_Analysis\_of\_All\_Applications\_for\_Sex\_Reassignment\_Surgery\_in\_Sweden\_1960-2010\_Prevalence\_Incidence\_and\_Regrets*
13. ↑ https://www.tandfonline.com/doi/abs/10.1080/15532739.2011.606193
14. ↑ https://www.ncbi.nlm.nih.gov/pubmed/27474250
15. ↑ https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA\_DSM-5-Gender-Dysphoria.pdf