Gender identity Disorder

Strong and persistent identification of the self with another gender. Persistent dissatisfaction with own sex. Desire to participate in stereotyped games and pastimes of opposite sex. Preference for cross-dressing. May insist that they are wrong sex. May occur in children, adolescents and adults. Not concurrent with physical intersex condition. Etiology was thought to involve aberrant psychological conditioning, but gender identity may be more defined by organic causes in the brain than the postnatal environment. Theories suggest that childhood issues may play a role in this disorder, such as the parent-child relationship at an early age and the identification a child is able to make with the parents of the same gender.

A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex). in children, the disturbance is manifested by four (or more) of the following:

repeatedly stated desire to be, or insistence that he or she is, the other sex

in boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing, strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex, intense desire to participate in the stereotypical games and pastimes of the other sex, strong preference for playmates of the other sex

Also in children, in boys, assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough- and-tumble play and rejection of male stereotypical toys, games, and activities; in girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing.

in adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction that he or she has the typical feelings and reactions of the other sex. Preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.

Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex.

The disturbance is not concurrent with a physical intersex condition.

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.  Other disorders may be present with this one, including depression, anxiety, relationship difficulties, and personality disorders, and homosexuality is present in a majority of the cases.

This is one of the sexual disorder which is not easy to treat. Treatment is likely to be long-term with small gains made on underlying issues as treatment progresses. Treatment included long session of sex therapy and behavior therapy. Expert sex therapist have shown some gain in treatment in long term sex therapy sessions but the results are variable and unpredictable with uncertainty of the results.