mental health disorders
Gender Incongruence and Gender Dysphoria
Diagnosis of Gender Incongruence Dysphoria
A doctor's evaluation, based on standard psychiatric criteria Most children with gender incongruence or gender dysphoria are not evaluated until they are 6 to 9 years old. During the evaluation for gender incongruence or gender dysphoria (regardless of age), the doctor does the following: Conducts an interview to ask about issues of gender identity and gender expression (present and past). If a child is involved, the doctor also interviews the parents and/or caregivers. Assesses for evidence of gender incongruence or gender dysphoria. Reviews relevant medical and mental health history. For children, the doctor also reviews developmental history. Determines whether there are personal and/or family stressors or risks (for example, substance use, exposure to violence, and poverty). Assesses for other mental health conditions that are often associated with gender dysphoria (for example, depression, anxiety, substance use disorders, tobacco use, suicidality). Doctors diagnose gender dysphoria when people (children or adults) do all of the following: Feel that their anatomic sex does not match their gender identity and have felt that way for 6 months or longer Feel greatly distressed or cannot function normally because of this feeling Some people with gender dysphoria have other symptoms. These are slightly different in children than in adolescents and adults. To be diagnosed with gender dysphoria,childrenmust also have at least 6 of the following symptoms: A strong, persistent desire to be or insistence that they are the other gender (or some other gender) A strong preference for dressing in clothing of the opposite gender and, in girls, resistance to wearing typically feminine clothing A strong preference for pretending to be the opposite gender when playing A strong preference for toys, games, and activities typical of the other gender A strong preference for playmates of the other gender A strong rejection of toys, games, and activities typical of the gender that matches their anatomic sex (for example, boys refuse to play with trucks or footballs) A strong dislike of their anatomy A strong desire for the anatomy or other sex characteristics (such as facial hair) that match their gender identity The child must feel great distress or have trouble functioning in social settings, school, or other important areas. A child who expresses a desire to be a different gender just to benefit from the perks they think are associated with the other gender is not likely to have gender dysphoria. For example, a boy who says he wants to be a girl because he thinks his younger sister receives special treatment is unlikely to have gender dysphoria. Adolescents and adultsmust also have one or more of the following symptoms: A strong desire to be rid of their sex characteristics and, for young adolescents, to prevent the development of secondary sex characteristics (those that occur during puberty) A strong desire for the sex characteristics that match their gender identity A strong desire to be another gender A strong desire to live or be treated as another gender A strong belief that they feel and react like another gender 