Transgender people and their allies have pointed out that distress in gender dysphoria is not an inherent part of being transgender. This sets ...
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Inordertobediagnosedwithgenderdysphoria,accordingtotheneweditionofthementalhealthmanual(DSM-5),onewouldhavetobedistressedbytheincongruitybetweenhisorherbirthgenderandthegenderwithwhichheorsheidentifies.
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Editor'sNote:Withthereleaseofthelatesteditionofthementalhealthmanual,theDiagnosticandStatisticalManualofMentalDisorders(theDSM),LiveSciencetakesacloselookatsomeofthedisordersitdefines.Thisseriesasksthefundamentalquestion:Whatisnormal,andwhatisnot?Thelatesteditionofthementalhealthmanualusedbypsychiatriststodiagnosedisordersrevealsachangeinthinkingongenderidentity.Theperspectivechangeissimilartoadecisionmadein1973,whentheAmericanPsychiatricAssociationeliminatedhomosexualityfromitsdisorders'list.IntheneweditionoftheDiagnosticandStatisticalManualofMentalDisorders(DSM-5),releasedonMay22,thenow-defunctdiagnosisofgenderidentitydisorder(GID)receivesanewname,genderdysphoria,whichreflectsanewemphasis.BothGIDandgenderdysphoriadescribeaconditioninwhichsomeoneisintenselyuncomfortablewiththeirbiologicalgenderandstronglyidentifieswith,andwantstobe,theoppositegender.Someofthesepeoplemayliveastheirdesiredgender,andmayevenseekgenderreassignmentsurgerythatcanallowthemtotrade,forexample,apenisforaclitorisandascrotumforavagina.[5SurprisingFactsAboutGayConversionTherapy]IntheoldDSM-IV,GIDfocusedonthe"identity"issue—namely,theincongruitybetweensomeone’sbirthgenderandthegenderwithwhichheorsheidentifies.Whilethisincongruityisstillcrucialtogenderdysphoria,thedraftersofthenewDSM-5wantedtoemphasizetheimportanceofdistressabouttheincongruityforadiagnosis.(TheDSM-5usesthetermgenderratherthansextoallowforthosebornwithbothmaleandfemalegenitaliatohavethecondition.)Thisshiftreflectsrecognitionthatthedisagreementbetweenbirthgenderandidentitymaynotnecessarilybepathologicalifitdoesnotcausetheindividualdistress,saidRobinRosenberg,aclinicalpsychologistandco-authorofthepsychologytextbook"AbnormalPsychology"(WorthPublishers,2009).Forinstance,manytransgenderpeople—thosewhoidentifywithagenderdifferentthantheonetheywereassignedatbirth—arenotdistressedbytheircross-genderidentificationandshouldnotbediagnosedwithgenderdysphoria,Rosenbergsaid.Transgenderpeopleandtheirallieshavepointedoutthatdistressingenderdysphoriaisnotaninherentpartofbeingtransgender.ThissetsitapartfrommanyotherdisordersintheDSM,becauseifsomeoneisdepressed,forexample,heorsheis,almostbydefinition,distressedaspartofdepression.Incontrast,thedistressthataccompaniesgenderdysphoriaarisesasaresultofaculturethatstigmatizespeoplewhodonotconformtogendernorms,Rosenbergsaid.Inthisregard,thechangeresemblestheeliminationofhomosexualityfromthemanual40yearsago."TheconceptunderlyingeliminatinghomosexualityfromtheDSMwasrecognizingthatyoucanbehomosexualandpsychologicalhealthyorbehomosexualandpsychologicallyscrewedup.Beinghomosexualdidn’thavetobetheissue,"Rosenbergsaid. TheDSM-5alsoseparatesthediagnosisofgenderdysphoriaforchildrenfromthatofadolescentsandadults.Thecharacteristicsofgenderdysphoriavarywithage,andmanychildrenwithgenderdysphoriaoutgrowitastheyage,themanualnotes.Followus@livescience,Facebook&Google+.OriginalarticleonLiveScience.com.
WynneParry
WynnewasareporteratTheStamfordAdvocate.ShehasinternedatDiscovermagazineandhasfreelancedforTheNewYorkTimesandScientificAmerican'swebsite.ShehasamastersinjournalismfromColumbiaUniversityandabachelor'sdegreeinbiologyfromtheUniversityofUtah.
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