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Both "Female-to-Male" and "Male-to-Female" sections contained highly-contested, and outdated information that did not relate to the "Experience" of gender identity disorder. They do not belong in a section with that label, if anywhere in this article.
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==Experience==
==Experience==


===Female-to-male===
According to psychologist [[Sandra Leiblum]], the documented experiences of female-to-male people experiencing GID are strikingly similar. Patients report themselves as having been masculine in appearance and/or behaviour at a very early age, often as young as three. As children, they preferred the company of boys and disliked dresses and other girlish clothes. They verbalized early a desire to be male. Leiblum describes how during puberty, many individuals reported having been "disgusted" by the changes to their body and were consistently sexually attracted to females. Many later experiment with lesbian relationships but do not want to be with a woman who is attracted to them as a woman. Many eventually develop a relationship with a female partner who understands herself to be heterosexual and who accepts them as male. Many patients seek to transition to living as a man in adulthood.<ref name=":1">{{Cite book|title = Principles and Practice of Sex Therapy, Fourth Edition|last = Leiblum|first = Sandra|url = http://www.amazon.com/Principles-Practice-Therapy-Fourth-Edition/dp/1593853491|accessdate = 23 August 2013|year = 2006|publisher = The Guilford Press|isbn = 1593853491|pages = 488–9}}</ref>

Sociologist Sally Hines, however, states that while most specialists presume that transition results in a heterosexual orientation for female-to-male people with GID, this is often not the case. Many trans men are gay or otherwise attracted to other men.<ref name=transforming>{{Cite book|title = TransForming Gender: Transgender Practices of Identity, Intimacy, and Care|last = Hines|first =Sally|year = 2007|publisher =The Policy Press|isbn = 9781861349170}}</ref>

===Male-to-female===
Many researchers believe that the vast majority of male-to-female GID patients can be classed as either '''androphilic''' (sexually attracted to men) or '''autogynephilic''' ("love of oneself as a woman"), with the rare exceptions being associated with conditions such as schizophrenia or personality disorder.

According to Leiblum, androphilic male-to-female people were typically viewed as effeminate, pretty and gentle as children, and were frequently harassed for that reason. They avoided rough play. Most liked to dress as girls, but did not find it sexually arousing. They often had a strong bond with their mothers. They were attracted to males. Many came out as gay in adolescence, and some became involved with prostitution or drag queen performance. In young adulthood, many became frustrated with gay relationships because they wanted to be understood as female rather than male.<ref name=":1" />

The [[Blanchard's transsexualism typology|typology of transsexualism]] developed by sexologist [[Ray Blanchard]] says that all male-to-female transgender people who don't fit this androphilic type are ''autogynephiles''. One proponent of the autogynephilia model, [[J. Michael Bailey]], described autogynephilic male-to-female children as wanting to be girls or to cross-dress, but as being viewed by others as similarly masculine to typical boys. According to Bailey, they were never sexually attracted to males. As adults, they often married heterosexual women and worked in male-dominated fields, and privately wore women's clothing and became sexually aroused.<ref>{{Cite book|title = The Man Who Would Be Queen: The Science of Gender-Bending and Transsexualism|url = http://www.amazon.com/Man-Would-Queen-Gender-Bending-Transsexualism/dp/0309084180/ref=sr_1_1?s=books&ie=UTF8&qid=1377580758&sr=1-1&keywords=0309084180|last = Bailey|first = J. Michael|author-link=J. Michael Bailey|publisher = Joseph Henry Press|isbn = 0309084180|year = 2003}}</ref> Fellow theorist Anne Lawrence stated that most were over the age of forty when they began living full-time as a woman.<ref>{{Cite book|title = Men Trapped in Men's Bodies: Narratives of Autogynephilic Transsexualism|url = http://books.google.com/?id=l9WI-cXC4GQC&pg=PA215&dq=gender+dysphoria+autogynephilic+boy#v=onepage&q=gender%20dysphoria%20autogynephilic%20boy&f=false|last = Lawrence|first = Anne|author-link=Anne Lawrence|publisher = Springer|origyear = |isbn = 1461451825|date = 2012-12-09}}</ref> Other researchers have criticized the autogynephilia model as not being an accurate description of male-to-female transgender people. The physician [[Charles Allen Moser]] has said the model fails to account for all the information on the sexual and romantic interests of such people and that it lacks supporting data.<ref name="moser2010">{{Cite journal|author=Moser, Charles|year=2010|month=July|title=Blanchard's Autogynephilia Theory: A Critique|journal=Journal of Homosexuality|pmid=20582803|volume=57|edition=6|issue=6|pages=790–809|doi=10.1080/00918369.2010.486241 |url=http://www.informaworld.com/smpp/content~db=all~content=a923357133~tab=content}}</ref>

Sally Hines says many accounts of people with GID have ignored the complexities of their lives. Hines interviewed many trans women of varying experiences. One identified as heterosexual (androphilic) and yet had been in a marriage with another woman for 40 years, largely due to the fear of being perceived as a gay man prior to transition. Another was a 31-year-old trans woman who was openly in a lesbian relationship.<ref name=transforming />

===Reactions===
Being transgender is not in itself a mental health disorder. GID exists when a person's gender identity causes him or her emotional distress.<ref name=":2">{{Cite book|title = A Nurse's Guide to Women's Mental Health|last = Davidson|first = Michelle R.|publisher = Springer Publishing Company|year = 2012|isbn = 0826171133|location = |pages = 114}}</ref> Researchers disagree about the nature of distress and impairment in people with GID, with some believing people with GID suffer solely because they are stigmatized and victimized,<ref>{{Cite book|title = The Politics of Pathology and the Making of Gender Identity Disorder|last = Bryant|first = Karl Edward|publisher = ProQuest Dissertations & Theses (PQDT)|year = 2007|isbn = 9780549268161|location = Ann Arbor, Michigan|pages = 222}}</ref> and saying that in societies with less-strict gender divisions, transsexuals suffer less.<ref name=":3">{{Cite book|title = Children with Gender Identity Disorder: A Clinical, Ethical, and Legal Analysis|last = Giordano|first = Simona|publisher = Routledge|year = 2012|isbn = 0415502713|location = New Jersey|pages = 147}}</ref>
Being transgender is not in itself a mental health disorder. GID exists when a person's gender identity causes him or her emotional distress.<ref name=":2">{{Cite book|title = A Nurse's Guide to Women's Mental Health|last = Davidson|first = Michelle R.|publisher = Springer Publishing Company|year = 2012|isbn = 0826171133|location = |pages = 114}}</ref> Researchers disagree about the nature of distress and impairment in people with GID, with some believing people with GID suffer solely because they are stigmatized and victimized,<ref>{{Cite book|title = The Politics of Pathology and the Making of Gender Identity Disorder|last = Bryant|first = Karl Edward|publisher = ProQuest Dissertations & Theses (PQDT)|year = 2007|isbn = 9780549268161|location = Ann Arbor, Michigan|pages = 222}}</ref> and saying that in societies with less-strict gender divisions, transsexuals suffer less.<ref name=":3">{{Cite book|title = Children with Gender Identity Disorder: A Clinical, Ethical, and Legal Analysis|last = Giordano|first = Simona|publisher = Routledge|year = 2012|isbn = 0415502713|location = New Jersey|pages = 147}}</ref>


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Adults with GID are at increased risk for stress, isolation, anxiety, [[Depression (mood)|depression]], poor self-esteem and suicide.<ref name=":4">{{Cite book|title = A Nurse's Guide to Women's Mental Health|last = Davidson|first = Michelle R.|publisher = Springer Publishing Company|year = 2012|isbn = 0826171133|location = |pages = 114}}</ref> Transgender women are likelier than other people 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]],<ref name=":2"/> and are at heightened risk for certain [[mental disorders]].<ref>{{Cite book|title = Mentoring sexual orientation and gender identity minorities in a university setting|last = O'Keefe|first = Carolyn Anne|publisher = ProQuest Dissertations & Theses (PQDT)|year = 2007|isbn = 9780542913112|location = California|pages = xvi}}</ref>
Adults with GID are at increased risk for stress, isolation, anxiety, [[Depression (mood)|depression]], poor self-esteem and suicide.<ref name=":4">{{Cite book|title = A Nurse's Guide to Women's Mental Health|last = Davidson|first = Michelle R.|publisher = Springer Publishing Company|year = 2012|isbn = 0826171133|location = |pages = 114}}</ref> Transgender women are likelier than other people 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]],<ref name=":2"/> and are at heightened risk for certain [[mental disorders]].<ref>{{Cite book|title = Mentoring sexual orientation and gender identity minorities in a university setting|last = O'Keefe|first = Carolyn Anne|publisher = ProQuest Dissertations & Theses (PQDT)|year = 2007|isbn = 9780542913112|location = California|pages = xvi}}</ref>

Parents whose adult children tell them they have GID are often distressed, worrying that their child will be unemployable, destitute, friendless and alone, and also worrying about what other relatives, neighbours and friends will think. Mothers usually adapt and accept the situation more quickly than fathers. For male-to-female people who have always seemed "different," parents, particularly mothers, will often support a change of role to female. Mothers seem more distressed than fathers when female-to-male adult children, who had earlier been assumed to be lesbian, change role to male.<ref name=":6">{{Cite book|title = Transexual and Other Disorders of Gender Identity: A Practical Guide to Management|last = Barrett|first = James|publisher = RADCLIFFE MEDICAL PRESS LTD|year = 2007|isbn = 185775719X|location = |pages = 83}}</ref>


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 autogynephilic GID often suffer once the GID is known or revealed, and researchers say the fate of the relationship seems to depend mainly on the woman's adaptability. Problems often arise, with the woman becoming increasingly angry or dissatisfied, if the partner's time spent in a female role grows, if the partner's libido decreases, or if the partner is angry and emotionally cut-off when in the male role. Women often also worry about social stigma and may be uncomfortable with the bodily feminisation of their partner as the partner moves through transition. The 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.<ref name=":6" />
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 autogynephilic GID often suffer once the GID is known or revealed, and researchers say the fate of the relationship seems to depend mainly on the woman's adaptability. Problems often arise, with the woman becoming increasingly angry or dissatisfied, if the partner's time spent in a female role grows, if the partner's libido decreases, or if the partner is angry and emotionally cut-off when in the male role. Women often also worry about social stigma and may be uncomfortable with the bodily feminisation of their partner as the partner moves through transition. The 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.<ref name=":6" />

Revision as of 21:50, 1 September 2013

Gender dysphoria
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Gender identity disorder (GID), also known as gender dysphoria, is a 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. Affected individuals are commonly referred to as transsexual or transgender. 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 behavioural 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 dysphoria range from a lower bound of 1:2000 in the Netherlands and Belgium[2] to 1:200 in Massachusetts[3] up to as high as 1:160 at Grant High School in Portland, Oregon.[4][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 in children is considered[by whom?] clinically distinct from gender dysphoria that appears in adolescence or adulthood.

Controversy exists as to whether GID is a mental disorder.[7] Gender identity disorder is classified as a medical disorder by the ICD-10 CM[8] and DSM-5 (called Gender Dysphoria).[7] 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 also result in stigmatization of transgender individuals.[7] Treatment for gender dysphoria is also controversial, as changes made are typically irreversible.[10]

The current approach to treatment for people diagnosed with gender identity disorder is to support them in physically modifying their bodies so that they better match their gender identities.[10]

Causes

Main article: Causes of transsexualism

Though 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.[11] 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.[12] In addition, some aspects of trans women's hypothalamus functioning resembles that typical of cisgender women.[13]

Sociocultural causes

David Reimer was a male whose penis was accidentally amputated as an infant, and whose parents decided to raise him as a female. David was never comfortable with this assigned gender, and he transitioned to living as male later in life. He remained unhappy, however, and committed suicide at age of 38.[14]

Experience

Being transgender is not in itself a mental health disorder. GID exists when a person's gender identity causes him or her emotional distress.[15] Researchers disagree about the nature of distress and impairment in people with GID, with some believing people with GID suffer solely because they are stigmatized and victimized,[16] and saying that in societies with less-strict gender divisions, transsexuals suffer less.[17]

Transgender people are often harassed, socially excluded, subjected to discrimination, abuse, violence and murder.[15][17] In the United States, transgender people are less likely than others to have health insurance, and often face hostility and insensitivity from healthcare providers.[18]

Symptoms of GID in children include disgust at their own genitalia, social isolation from their peers, anxiety, loneliness and depression.[19]

Adults with GID are at increased risk for stress, isolation, anxiety, depression, poor self-esteem and suicide.[20] Transgender women are likelier than other people 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,[15] and are at heightened risk for certain mental disorders.[21]

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 autogynephilic GID often suffer once the GID is known or revealed, and researchers say the fate of the relationship seems to depend mainly on the woman's adaptability. Problems often arise, with the woman becoming increasingly angry or dissatisfied, if the partner's time spent in a female role grows, if the partner's libido decreases, or if the partner is angry and emotionally cut-off when in the male role. Women often also worry about social stigma and may be uncomfortable with the bodily feminisation of their partner as the partner moves through transition. The 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.[22]

Diagnostic criteria

The American Psychiatric Association permits a diagnosis of gender identity disorder 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.[23] The diagnosis itself was renamed "Gender Identity Disorder" to "Gender Dysphoria," after criticisms that the former term was stigmatizing."[24] Subtyping by sexual orientation was deleted, and 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.[25]

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.[26]

Treatment

Treatment has typically either aimed to change the person's identity to match their body, or the opposite. 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 GID, for example counselling the patient in order to reduce guilt associated with cross-dressing, or counselling a spouse to help him or her adjust to the patient's situation.[27]

Treatment for GID is somewhat controversial, and guidelines have been put in place to aid clinicians in their treatment of transgender individuals. The World Professional Association for Transgender Health (WPATH) Standards of Care, are used as treatment guidelines for GID by some clinicians. Others utilize guidelines outlined in Gianna Israel and Donald Tarver's "Transgender Care". Guidelines for treatment generally follow a "harm reduction" model.[28][29][30]

Prepubescent children

Main article: Gender identity disorder in 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 conform to gender stereotypes—or to explore a transsexual transition—is controversial. Some clinicians report a significant proportion of young children with gender identity disorder no longer have such symptoms later in life.[31] There is an active and growing movement among professionals who treat gender dysphoria in children to refer and prescribe hormones, known as a puberty blocker, to delay the onset of puberty until a child is 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.[32]

Psychological treatments

Main article: Psychotherapy

Until the 1970s, psychotherapy was the primary treatment for GID. 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.[33] Psychotherapy alone used to 'cure' individuals of GID is highly controversial and largely ineffective.[33]

Biological treatments

Main articles: Sex reassignment therapy, Sex reassignment surgery, Hormone replacement therapy (male-to-female), and Hormone replacement therapy (female-to-male)

Biological treatments physically alter primary and secondary sex characteristics to reduce the discrepancy between an individual's physical body and gender identity.[34] Biological treatments for GID without any form of psychotherapy is quite uncommon, but researchers found that when individuals bypass psychotherapy in their GID treatment, they often feel lost and confused when their biological treatments are complete.[35]

The most effective form of treatment for GID is a combination of psychotherapy, hormone replacement therapy, and sex reassignment surgery.[citation needed] The overall level of satisfaction with both psychological and biological treatments is very high.[33]

Controversy

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]

Arguments against GID as a disorder

Gender as a social construction

Gender characteristics are socially constructed and therefore naturally unrelated to biological sex. This perspective often notes that other cultures, particularly historical ones, valued gender roles that would presently suggest homosexuality or transgenderism as normal behavior.[citation needed] Some cultures have three defined genders: male, female, and effeminate male. In Samoa, the fa'afafine, a group of feminine males, are entirely socially accepted. The fa'afafine do not experience any of the stigma or distress typically associated with deviating from a male/female gender role, indicating that the distress that is so frequently associated with GID in a Western context is not caused by the disorder, rather it is a secondary result of social disapproval.[36]

GID as a birth defect

This 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[37][38] and overall longer instances of the androgen receptor gene.[39] (Also see Causes of transsexualism.) One rebuttal to this view is that these markers do not identify every individual who undergoes transition, and that using them to define transsexualism could falsely exclude some people from treatment.[40]

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 a result of social rejection and discrimination.[36] 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 have trouble relating to their child's gender variance.[41]

Replacement for homosexuality in the DSM

Some people[42] feel that the deletion of homosexuality as a mental disorder from the DSM-III and the ensuing creation of the GID diagnosis was merely sleight of hand by psychiatrists, who changed the focus of the diagnosis from the deviant desire (of the same sex) to the subversive identity (or the belief/desire for membership of another sex/gender).[43] People who believe this tend to point out that the same idea is found in both diagnoses, that the patient is not a "normal" male or female. Kenneth Zucker and Robert Spitzer[44] 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."

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."[45] In May 2009, the government of France has also declared that a transsexual gender identity will no longer be classified as a psychiatric condition in France.[46]

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.[47]

The Principle 3 of The Yogyakarta Principles on The Application of International Human Rights Law In Relation to Sexual Orientation and Gender Identity states that "Person 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 of this states that "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."

Arguments in favor of GID as a disorder

GID as dysfunctional

Some researchers, including Dr. Robert Spitzer and Dr. Paul J. Fink, contend that the behaviors and experiences seen in transsexualism are abnormal and constitute a dysfunction.[41]

Insurance coverage

Because GID is considered 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 funded.[48]

See also

References

  1. ^ a b Heylens, G; De Cuypere, G; Zucker, K; Schelfaut, C; Elaut, E; Vanden Bossche, H; De Baere, E; T'Sjoen, G (2012). "Gender Identity Disorder in Twins: A Review of the Case Report Literature". The Journal of Sexual Medicine. 8 (3): 751–757. doi:10.1111/j.1743-6109.2011.02567.x.
  2. ^ Olyslager, Femke; Conway, Lynn (2008). "Transseksualiteit komt vaker voor dan u denkt. Een nieuwe kijk op de prevalentie van transseksualiteit in Nederland en België". Tijdschrift voor Genderstudies (in Dutch). 11 (2). Amsterdam: Amsterdam University Press: 39–51. ISSN 1388-3186. Retrieved 27 August 2013. …it is safe to assume that the lower limit for the inherent prevalence of transsexualism in the Netherlands and Flanders is on order of 1:2000 to 1:1000 for male to female transsexuals and on the order of 1:4000 to 1:2000 for female to male transsexuals. {{cite journal}}: Unknown parameter |laysource= ignored (help); Unknown parameter |layurl= ignored (help)
  3. ^ Conron, KJ; Scott, G; Stowell, GS; Landers, S (2012), "Transgender Health in Massachusetts: Results from a Household Probability Sample of Adults", American Journal of Public Health, 102 (1), American Public Health Association: 118–222, doi:10.2105/AJPH.2011.300315, ISSN 1541-0048, OCLC 01642844, retrieved 28 August 2013, Between 2007 and 2009, survey participants aged 18 to 64 years in the Massachusetts Behavioral Risk Factor Surveillance System (MA-BRFSS; N = 28 662) were asked: "Some people describe themselves as transgender when they experience a different gender identity from their sex at birth. For example, a person born into a male body, but who feels female or lives as a woman. Do you consider yourself to be transgender?" […] We restricted the analytic sample to 28176 participants who answered yes or no to the transgender question (excluding n=364, 1.0% weighted who declined to respond. […] Transgender respondents (n=131; 0.5%; 95% confidence interval [CI] = 0.3%, 0.6%) were somewhat younger and more likely to be Hispanic than were nontransgender respondents. {{citation}}: Unknown parameter |month= ignored (help)
  4. ^ Volpert, Emily (21 March 2013), "Unisex Bathrooms", Grant Magazine, Grant High School, archived from the original on 27 August 2013, retrieved 27 August 2013, Grant has 10 students who openly identify as transgender, according to school administrators.
  5. ^ Grant High School in PORTLAND, OR | Student Body, US News & World Report, 2010–2011, archived from the original on 27 August 2013, retrieved 27 August 2013, Total Enrollment: 1,619{{citation}}: CS1 maint: date format (link)
  6. ^ Landen, M; Walinder, J; Lundstrom, B (1996). "Prevalence, incidence and sex ratio of transsexualism". Acta Psychiatrica Scandinavica. 93 (4): 221–223. doi:10.1111/j.1600-0447.1996.tb10638.x. PMID 8712018. On average, the male [to female]:female [to male] ratio in prevalence studies is estimated to be 3:1. However […] the incidence studies have shown a considerably lower male [to female] predominance. In Sweden and England and Wales a sex ratio of 1:1 has been reported. In the most recent incidence data from Sweden there is a slight male [to female] predominance among the group consisting of all applicants for sex reassignment, while in the group of primary [early onset] transsexuals there is no difference in incidence between men and women.
  7. ^ 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. doi:10.1080/15532739.2010.509202.
  8. ^ "Gender identity disorder in adolescence and adulthood". ICD10Data.com. Retrieved 2011-07-03.
  9. ^ Newman, L (1). "Sex, Gender and Culture: Issues in the Definition, Assessment and Treatment of Gender Identity Disorder". Clinical Child Psychology and Psychiatry. 7 (3): 352–359. doi:10.1177/1359104502007003004. {{cite journal}}: Check date values in: |date= and |year= / |date= mismatch (help); Unknown parameter |month= ignored (help)
  10. ^ a b c d "HBIGDA Standards Of Care For Gender Identity Disorders, Sixth Version" (PDF). Standards Of Care For Gender Identity Disorders. Harry Benjamin International Gender Dysphoria Association. 2001-02. {{cite web}}: Check date values in: |date= (help); Cite has empty unknown parameter: |coauthors= (help)
  11. ^ Coolidge, F; Thede, L; Young, S (4). "The Heritability of Gender Identity Disorder in a Child and Adolescent Twin Sample". Behavior Genetics. 32 (4): 251–257. doi:10.1023/A:1019724712983. PMID 12211624. {{cite journal}}: Check date values in: |year=, |date=, and |year= / |date= mismatch (help); Unknown parameter |month= ignored (help)
  12. ^ 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. doi:10.1038/378068a0. PMID 7477289.
  13. ^ 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): 1900–8. doi:10.1093/cercor/bhm216. PMID 18056697.
  14. ^ Colapinto, J (2001). As Nature Made Him: The Boy Who Was Raised as a Girl. Harper Perennial. ISBN 0-06-092959-6. Revised in 2006
  15. ^ a b c Davidson, Michelle R. (2012). A Nurse's Guide to Women's Mental Health. Springer Publishing Company. p. 114. ISBN 0826171133.
  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. ISBN 9780549268161.
  17. ^ a b Giordano, Simona (2012). Children with Gender Identity Disorder: A Clinical, Ethical, and Legal Analysis. New Jersey: Routledge. p. 147. ISBN 0415502713.
  18. ^ Mallon, Gerald P. (2009). Social Work Practice with Transgender and Gender Variant Youth. New Jersey: Routledge. ISBN 0415994829.
  19. ^ Davidson, Michelle R. (2012). A Nurse's Guide to Women's Mental Health. Springer Publishing Company. p. 114. ISBN 0826171133.
  20. ^ Davidson, Michelle R. (2012). A Nurse's Guide to Women's Mental Health. Springer Publishing Company. p. 114. ISBN 0826171133.
  21. ^ O'Keefe, Carolyn Anne (2007). Mentoring sexual orientation and gender identity minorities in a university setting. California: ProQuest Dissertations & Theses (PQDT). pp. xvi. ISBN 9780542913112.
  22. ^ Cite error: The named reference :6 was invoked but never defined (see the help page).
  23. ^ "P 01 Gender Dysphoria in Adolescents or Adults". American Psychiatric Association. Retrieved 2 April 2012.
  24. ^ "Gender Dysphoria in Children". American Psychiatric Association. 4 May 2011. Retrieved 3 July 2011.
  25. ^ "P 00 Gender Dysphoria in Children". American Psychiatric Association. Retrieved 2 April 2012.
  26. ^ Potts, S; Bhugra, D (1995). "Classification of sexual disorders". International Review of Psychiatry. 7 (2): 167–174. doi:10.3109/09540269509028323.
  27. ^ Cite error: The named reference :1 was invoked but never defined (see the help page).
  28. ^ COMMITTEE ON ADOLESCENCE (24 June 2013). "Office-Based Care for Lesbian, Gay, Bisexual, Transgender, and Questioning Youth: STI/HIV Testing and Prevention". American Academy of Pediatrics. Retrieved 27 August 2013. However, adolescents with multiple or anonymous partners, having unprotected intercourse, or having substance abuse issues should be tested at shorter intervals.
  29. ^ "www.glma.org Compendium of Health Prof ession Association LGBT Policy & Position Statements" (PDF). GLMA. 2013. Retrieved 27 August 2013.
  30. ^ "APA Policy Statements on Lesbian, Gay, Bisexual, & Transgender Concerns" (PDF). American Psychological Association. 2011. Retrieved 27 August 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;
  31. ^ Spiegel, Alix (2008-05-08). "Q&A: Therapists on Gender Identity Issues in Kids". NPR. Retrieved 2008-09-16. {{cite web}}: Cite has empty unknown parameter: |coauthors= (help)
  32. ^ The Transgendered Child: A handbook for Families and Professionals (Brill and Pepper, 2008)
  33. ^ a b c 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).
  34. ^ Bockting, W; Knudson, G; Goldberg, J (2006). "Counselling and Mental Health Care of Transgender Adults and Loved Ones". {{cite journal}}: Cite journal requires |journal= (help); Unknown parameter |month= ignored (help)
  35. ^ Hakeem, Az (2008). "Changing Sex or Changing Minds: Specialist Psychotherapy and Transsexuality". Group Analysis. 41 (2): 182–196. doi:10.1177/0533316408089883.
  36. ^ 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. doi:10.1353/pbm.2007.0056. PMID 17951883.
  37. ^ "Transsexual differences caught on brain scan - life - 26 January 2011". New Scientist. Retrieved 2011-07-05.
  38. ^ (2000). Male-to-female transsexuals have female neuron numbers in the limbic nucleus. The Journal of Clinical Endocrinology & Metabolism, 85(5), Retrieved from http://jcem.endojournals.org/cgi/content/full/85/5/2034
  39. ^ Hare, L; Bernard, P; Sánchez, F; Baird, P; Vilain, E; Kennedy, T; Harley, V (2009). "Androgen Receptor Repeat Length Polymorphism Associated with Male-to-Female Transsexualism". Biological Psychiatry. 65 (1): 93–6. doi:10.1016/j.biopsych.2008.08.033. PMC 3402034. PMID 18962445.
  40. ^ Allen, Mercedes (2008). "Transgender in the Genes?". GayCalgary and Edmonton (61): 50. {{cite journal}}: Unknown parameter |month= ignored (help)
  41. ^ a b "Controversy Continues to Grow Over DSM's GID Diagnosis". Psychiatric News. 18 July 2003.
  42. ^ Arlene Istar Lev (2004). Transgender Emergence: Therapeutic Guidelines for Working with Gender-Variant People and Their Families. Haworth Press. p. 172. ISBN 978-0-7890-2117-5.
  43. ^ Rudacille, Deborah (February 2005). The Riddle of Gender: Science, Activism, and Transgender Rights. Pantheon. ISBN 978-0-375-42162-4.
  44. ^ Zucker, KJ; Spitzer, RL (2005), "Was the gender identity disorder of childhood diagnosis introduced into DSM-III as a backdoor maneuver to replace homosexuality? A historical note.", Journal of Sex and Marital Therapy, 31 (1): 31–42 {{citation}}: Unknown parameter |month= ignored (help)
  45. ^ "Government Policy concerning Transsexual People". People's rights / Transsexual people. U.K. Department for Constitutional Affairs. 2003.
  46. ^ "La transsexualité ne sera plus classée comme affectation psychiatrique". Le Monde. 16 May 2009.
  47. ^ Forced divorce and sterilisation - a reality for many transgender persons
  48. ^ Ford, Zack. "APA Revises Manual: Being Transgender is No Longer a Mental Disorder". Retrieved 7 April 2013.

Further reading

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