psychiatric disorders
Gender Incongruence and Gender Dysphoria
Gender dysphoria and gender incongruence
 Fifth Edition, Text Revision (DSM-5-TR), and is divided into 2 sets of diagnostic criteria, one for children and one for adolescents and adults ( General references ). If an individual experiences or displays gender incongruity or gender nonconformity, this itself is not considered a disorder. It is considered a normal variant in human gender identity and expression. However, when the perceived mismatch between birth sex and the internal sense of gender identity causes someone significant distress or functional impairment, a clinical diagnosis of gender dysphoria may be appropriate. The diagnosis is defined by the person's distress rather than by the presence of gender incongruity or identity. The distress of gender dysphoria is typically described as a combination of anxiety, depression, irritability, and the pervasive sense of not feeling comfortable in one's body. People with severe gender dysphoria may experience severe, disturbing, and long-standing symptoms. They usually have a strong wish to change their body medically and/or surgically to make their body more closely align with their gender identity. There are insufficient data to determine the precise prevalence of gender incongruence or dysphoria, but studies conducted in large health care systems have reported that 0.02 to 0.1% of patients meet DSM-5-TR criteria for a diagnosis of gender dysphoria. Survey-based studies of individuals in nonclinical settings have reported an even higher proportion of respondents who self-identify as transgender: In adults, the prevalence was captured in 2 distinct groups: Those who consider themselves transgender (0.5 to 0.6%) Those who consider themselves gender-incongruent/diverse (0.6 to1.1%) In children and adolescents, the same patterns in prevalence were noted: Those who consider themselves transgender (1.2 to 2.7%) Those who consider themselves gender-incongruent/-diverse (2.5 to 8.4%) According to some experts, the diagnosis of gender dysphoria is primarily a general medical condition with attendant psychiatric symptoms, akin to disorders of sex development, and not primarily a mental disorder. As a result, gender incongruence and gender dysphoria are no longer listed as mental health conditions in the International Classification of Diseases, 11th Revision, but rather in a new sexual health chapter ( General references ). The World Health Organization made this change, in part, to reduce stigma for an already stigmatized condition ( Irrespective of the viewpoint about the clinical nature of gender incongruence and dysphoria, there is substantial evidence that transgender persons as a population suffer from an increased burden of medical, mental health, and sexual health diagnoses, often associated with barriers to access to care. Not all the mental health disorders in this population are gender dysphoria (for example, concomitant depression, anxiety disorders, substance use disorders), and gender dysphoria is not experienced by all individuals with gender incongruence. When defined symptoms are present and reach a threshold of clinical significance, a diagnosis of gender dysphoria may be present. 