Gender Dysphoria Flashcards
what criterion MUST be present for a diagnosis of gender dysphoria in children
a STRONG DESIRE to be of the other gender or an INSISTENCE that one if the other gender (or some alternative gender different from one’s assigned gender)
how many symptoms are required, amongst those listed in criterion A for gender dysphoria, to meet criteria for gender dysphoria in children
6 (out of a possible 8)
what is criterion A for gender dysphoria in children
a MARKED INCONGRUENCE between one’s experienced/expressed gender and assigned gender, of at least SIX MONTH duration, as manifested by at least SIX of the following (of which one must be number 1)
- a STRONG DESIRE to be of the other gender or an INSISTENCE that one if the other gender (or some alternative gender different from one’s assigned gender)
- in boys (assigned gender),a. strong preference for CROSS DRESSING or simulating female attire; or in girls (assigned gender), a strong preference for wearing only TYPICAL MASCULINE clothing and a strong resistance to the wearing of typical feminine clothing
- a strong preference for CROSS GENDER ROLES in make believe play or fantasy play
- a strong preference for the TOYS, games, or activities stereotypically used or engaged in by the other gender
- a strong preference for PLAYMATES of the other gender
- in boys (assigned gender), a strong rejection of typically masculine toys, games and activities and a strong avoidance of rough and tumble play; in girls (assigned gender), a strong rejection of typically feminine toys, games and activities
- a strong DISLIKE of ones SEXUAL ANATOMY
- a strong desire for the primary and/or secondary SEX CHARACTERISTICS that match one’s experienced gender
what is criterion B for gender dysphoria in children
the condition is associated with clinically significant distress or impairment in school, social, or other areas
what specifier is there for gender dysphoria in children
with a disorder of sex development (i.e a congenital adrenogenital disorder such as congenital adrenal hyperplasia or androgen insensivitity syndrome)
how many symptoms are listed in criterion A for gender dysphoria in adolescents/adults? how many are required for diagnosis?
6 total listed
2 required
what is criterion A fro gender dysphoria in adolescents/adults
a marked incongruence between one’s experienced/expressed gender and assigned gender, of at least SIX MONTHS duration, as manifested by at least TWO of the following:
- a marked incongruence between ones experienced/expressed gender and primary and/or secondary sex characteristics
- a strong desire to BE RID of one’s primary and/or secondary sex characteristics because of a marked incongruence with one’s experienced/expressed gender
- a strong desire for primary/secondary sex characteristics sex characteristics of the other gender
- a strong desire to of the other gender (or some alternative gender)
- a strong desire to be TREATED AS the other gender
- a STRONG CONVICTION that one has the TYPICAL FEELINGS and reactions of the other gender
what specifiers are available for gender dysphoria in adolescents/adults
- with a disorder of sex development
- posttransition
what does the gender dysphoria in adolescents/adults specifier “posttransition” indicate
the individual has transitioned to FULL TIME LIVING in the desired gender (with or without legalization of gender change) and has undergone or is preparing to undergo at least ONE CROSS SEX MEDICAL PROCEDURE or treatment regimen (namely, regular cross sex hormone treatment or gender reassignment surgery confirming desired gender)
what is the core component of the diagnosis of gender dysphoria
the discrepancy between experienced/expressed gender and assigned/natal gender
+
evidence of DISTRESS about this
list two hormone suppressors /”blockers” of gonadal steroids that may be requested or used without Rx for the suppression of secondary sex characteristics in gender dysphoria
gonadotropin releasing hormone analog (GnRH analog) or spironolactone
how does gender dysphoria affect suicide risk
adolescents and adults with gender dysphoria before gender reassignment are at increased risk for SI, SAs and suicides
after gender reassignment, ADJUSTMENT MAY VARY, and suicide risk may persist
what are prevalence rates for gender dysphoria
natal males–> 0.005%-0.014%
natal females–> 0.002%-0.003%
*likely modest underestimates
what are the sex ratios of the rate of referrals to speciality clinics for gender dysphoria
more natal males than females referred in childhood (2:1-4.5:1)
teens–> about equal
adults–> more natal males than females referred (1:1-6.1:1 range)
in which two countries are more adult natal females referred to specialty clinics for gender dysphoria
poland and japan
for clinic-referred children, the onset of cross-gender behaviours usually occurs at what age
between 2-4 years old
*corresponds to developmental time period in which most typically developing children begin expressing gendered behaviours and interests
in what % of natal males does gender dysphoria persist from childhood into adolescence
2.2-30%
in what % of natal females does gender dysphoria persist from childhood into adolescence
12-50%
do we know why gender dysphoria persists in some kids and not others?
modest correlation with SEVERITY at time of baseline assessment
modest correlation between lower SES and persistence in natal males
UNCLEAR if children “encouraged” or supported to live socially in the desired gender will show higher rates of persistence as such children have not yet been followed longitudinally in a systematic manner
what feature do both natal female and male persons with persistent gender dysphoria share
almost all are sexually attracted to individuals of their natal sex
what is the most common sexual orientation in natal males whose gender dysphoria does NOT persist
majority are sexual attracted to males and often self ID as gay/homosexual
what is the most common sexual orientation in natal females whose gender dysphoria does NOT persist
only about 32-50% are sexually attracted to females and go on to ID as lesbian
what are the two broad trajectories for development of gender dysphoria
early and late onset
what is early onset gender dysphoria
begins in childhood and persists into adolescence and adulthood