Gender Dysphoria Flashcards
Gender Discordance
- is one way to describe a discrepancy between assigned (natal) gender and experienced gender
- it’s not considered pathological
- it’s present in individuals who are transgendered, genderfluid (experience themselves as different genders at different times), or otherwise genderqueer and experiencing no functional impairment
- it’s present in individuals with gender dysphoria, a DSM-5 diagnosis which applies to individuals who are experiencing functional impairment
Gender Identity
-an individual’s personal sense of identification as male or female or another gender
Examples: “nonbinary”, “genderqueer”, “genderfluid”, “intergender”
Gender Dysphoria
- Has “A” criteria, related to gender discordance (or incongruence)
- Has criterion B: “the condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning.”
- gender dysphoria in children requires at least 6 out of 8 “A”’ criteria
- in adults: requires at least 2 out of 6 “A” criteria
Specifiers can note “with a disorder of sex development” (e.g. Congenital adrenal hyperplasia or androgen sensitive syndrome)
“A” Criteria In Children: 6/8
1: a strong DESIRE TO BE of the other gender or an INSISTENCE THAT HE OR SHE IS the other gender
2: in boys, a strong preference for cross-dressing or simulating female attire; in girls, a strong preference for wearing only typical masculine CLOTHING and a strong resistance to wearing of typical feminine clothing
3: a strong PREFERENCE for CROSS-GENDER ROLES IN MAKE-BELIEVER or fantasy play
4: a strong PREFERENCE for TOYS, GAMES, OR ACTIVITIES typical of the other gender
5: a strong PREFERENCE for PLAYMATES of the other gender
6: in boys, a strong REJECTION OF typically masculine TOYS, GAMES, ACTIVITIES, and a strong avoidance of rough-and-tumble play; in girls, a strong rejection of tropically feminine toys, games and activities
7: a strong DISLIKE OF ONE’S SEXUAL ANATOMY
8: a strong DESIRE FOR the primary and/or secondary SEX CHARACTERISTICS that match ones experienced gender
“A” Criteria in Adults: 2/6
- A marked INCONGRUENCE between one’s experienced/expressed gender and primary and/or secondary sex characteristics
2: 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
3: a strong DESIRE FOR the primary and/or secondary SEX CHARACTERISTICS OF THE OTHER GENDER
4: a strong DESIRE TO BE OF the other gender
5: a strong DESIRE TO BE TREATED AS the other gender
6: a strong CONVICTION THAT ONE HAS THE TYPICAL FEELINGS AND REACTIONS of the other gender
Outcomes of Gender Dysphoria in Children
-“Persist” (endurance of gender discordance/dysphoria)
-“Desist” (non-endurance or discordance with assigned gender)
With mostly gender-conforming behavior
With prominent non-gender conforming behavior
With other sexual minority identity (e.g. Sexual orientation minority)
Most pre-pubertal children with GD will “desist” (84%?)
Most adolescents with GD seem to “persist” and continue with role transition into adulthood
Biggest Predictor with people presenting with gender dysphoria that end up Persisting
-people that live in the role of their experienced gender
Highest degree of association
Conversion Therapy
For people who are gay/lesbian/transgender to try and reverse that
It’s been banned in Cindy
Potentially harmful to patients
Studies focusing on Anxiety and Depression in the Population
Outcome: found that these individuals who are being supported by their families did not have higher rates of anxiety or depression
Led to the idea that allowing to present as their experienced identity led to normal anxiety and depression rates
This is in marked contrast with previous work with gender-non conforming children who had NOT socially transitioned. These children were found to show “markedly higher rates of anxiety and depression and lower self-worth”
What helps trans/gender dysphoria patients?
- when providers and systems convey the message that everyone has a right to respectfully delivered care
- when providers address patients with preferred modes of address (pronouns, etc.)
- understanding potential for mental health comorbidities and family and social stressors and screening for these
- treat mental health comorbidities: psychotherapy (CTB, supportive), pharmacotherapy
- connect individuals and families with care providers to help them navigate care unique to transgender individuals (e.g. Hormone therapy)
Sexual Functioning
- involves a complex interaction among biological, sociocultural, and psychological factors
- normal sexual functioning allows for the possibility of sexual enjoyment/satisfaction and sexual intimacy
- sexual dysfunction: clinically significant disturbance in a person’s ability to respond sexually or to experience sexual pleasure
- classification of sexual dysfunctions requires knowledge of normal sexual functioning/sexual response cycle
Sexual Response Cycle
Desire: interest, willingness, attraction
Excitement/Arousal: physical reaction build, reinforce desire
Plateau: highly aroused
Orgasm
Resolution
Desire (phase)
Characteristics: reflects motivations, drives, personality; characterized by sexual fantasies and desire for sexual activity
Dysfunction: female sexual interest/arousal disorder
Male hypoactive sexual desire disorder
Excitement (phase)
Characteristics: subjective sense of sexual pleasure and accompanying physiological responses
Dysfunction: E.D.
Female sexual interest/arousal disorder
Orgasm (phase)
Characteristics: peaking of sexual pleasure and release of sexual tension with physiologic responses
Dysfunction: Premature ejaculation, delayed ejaculation, female orgasmic disorder
