Gender Identity Disorder

What is Gender Identity Disorder?

Gender Identity Disorder is defined as consistent cross-gender identification of a person that is, when an individual has a desire or insists that she or he is of the opposite sex.  He or she has a strong desire not to conform to the society’s norm of his or her gender role.

The cross-gender identification is exhibited by boys are a preoccupation with girl-related activities. They may have a liking for donning women’s clothing. There is also a strong fascination for common girls’ games and girls’ pastimes which makes them engrossed with female fantasy figures. They avoid rough play and physically challenging events and have little or no interest in engaging in stereotypical boys’ toys.

Girls with Gender Identity Disorder display intense opposing response to parental expectations and pursuits to have them wear dresses or feminine clothing. They find interest in engaging rough and competitive play and act in a manner that is typical of boys’. They also believe that they will grow male sexual organs and they wouldn’t like to have breast or experience menstruation.

There are associated features and disorders of Gender Identity Disorder. Many individuals with this disorder may become socially isolated whether by will or rejected by groups which can lead to low self-esteem. Social relationships will eventually be impaired resulting to distress and depression. Suicide attempt and substance abuse are also common.

Children with Gender Identity Disorder may manifest separation anxiety disorder, generalized anxiety disorder and signs and symptoms of depression.

Adolescents may be particularly at risk for suffering depression and have suicidal ideation and attempts because of failure in attaining their developmental task in this age.

Adult onset may be a continuation of the disorder that had a childhood onset or early adolescence. These adults may explicitly show transvestism and fetishism and they are more overt with their behavior.

Gender Identity Diorder (picture view)

Incidence

Studies reveal that children, adolescents and even adults are affected with this rare kind of disorder. This disorder occurs more often in males than in females, can manifest in the early childhood and just before a person reaches adolescence. In this age group, according to Robert Havighurst, a theorist, must develop acceptance in his or her physical body and keep it healthy, in which those with gender identity disorder fails to acquire. There is also no significant association of the disorder with the person’s social class, ancestry or intelligence. Though there are no data that show prevalence of this disorder, roughly an estimation of 1 out of 30,000 adult men and 1 out of 100,000 adult females seek sex-reassignment procedures.

Causes & Mechanism

The cause of this disorder is idiopathic or unknown, but some theories say that

1. hormonal imbalances that occur during fetal and child development,
2. genetic abnormalities of individuals.
3. environmental factors such as parenting or child rearing
4. mixture of above components cause this disorder

The gender of the baby is decided by chromosomes. Men possess an XY chromosome while women possess an XX chromosome. The Y chromosome has a gene called the testes deciding feature. This gene is responsible for the embryo cells to vary and form man’s sexual organs. The embryo cells with no testes deciding feature will keep on forming the woman’s sexual organs.

The recently formed testes discharge considerable amounts of man’s hormones throughout the third pregnancy month, increasing the male variation even more. This release of hormones happens once more in men during the 2^nd to 12^th week following birth. It is vital to know that there is no equivalent hormonal release seen in women at this time.

This information offers the biological cause for gender identity disorder. Man’s hormonal releases should happen not only in adequate quantities, however, also throughout a brief duration to result in the masculinity of the fetus. If there is a lack in the quantity of androgen, the hormone mainly accountable for masculinity, or the release arrives very soon or very late, the fetus might be partially masculine. There were also cases that babies were born with ambiguous genitalia, which can raise identity issues.

Disturbance of hormonal release may be caused by a medical condition involving the mother’s endocrine system, high level of stress or medications affecting the release and regulation of hormones.

Psychosocial mechanisms can also be considered likely perpetuating or maintaining factors of GID in adolescents. In this stage, they develop homoerotic attraction awareness which result to one’s vulnerability of one’s sense of self of being male or female. It is also in this stage that they have to address to issues about sexual orientation. These adolescents may grow in families in which the cross-gender behavior is tolerated and viewed by parents or guardians as a phase during their sons and daughters’ development.

Symptoms and Signs

Symptoms in Children

The following are the common symptoms of gender identity disorder among children:

1. Expressed want to belong to the other sex
2. Calling oneself names used typically by the opposite sex
3. Believes that in time they will grow up to become the opposite sex
4. Experience rejection from peer groups
5. Self-isolation
6. Manifesting behavior seen in the opposite sex
7. Depressed or anxious

Symptoms in Adults

The following are the common symptoms among adults:

1. Wear clothes of the opposite sex or cross-dressing
2. Experience loneliness
3. Depressed or anxious
4. Wish to live as a person of  the opposite sex
5. Desire to be rid off their own sexual organs
6. Self-isolation
7. Extracting oneself from social interactions

Diagnostic Test

Trained mental health practitioners such as psychologists or psychiatrists diagnose this kind of disorder. They follow a set of checklist and perform series of tests in order to confirm the diagnosis.

Medical History and Examination

A complete and thorough medical history and psychological exam are also done to rule out possible origins of associated conditions of Gender Identity Disorder like anxiety and depression.

There are two components of Gender Identity Disorder that both of which must be manifested by a person to make the diagnosis:

1.  An evidence of keen and consistent cross-gender identification, which is the want to belong to the other sex and not merely a desire for any observed social advantages of being the opposite sex.
2.  An evidence of consistent discomfort about one’s present sex or sense of unfitting in the person’s gender.
3.  The diagnosis cannot be made if the person has existing physical medical condition that is to say, affecting the hormonal release in the body (adrenal hyperplasia or conditions).
4.  An evidence of clinically significant affliction in social, emotional, occupational, or other crucial areas of life functioning.

There are special diagnostic considerations for sexually mature individuals such as adolescents and adults regarding sexual orientation or attraction. Studies show that adolescents and adults with a childhood onset of GID are sexually attracted to birth sex while most adolescents with adolescence onset of GID are attracted to the opposite sex.

Treatment

Psychotherapy & Family Therapy

The need for treatment is emphasized with the high rate of mental health problems that go along with this disorder such as depression, anxiety, and possibly substance abuse. These are usually not related with the disorder specifically, but these may arise as a person with GID deals socially. Therefore, Psychotherapy for with this kind of disorder is usually advised to alter the course of the disorder as well as Family Therapy, since environmental factors like parenting may take a role in the development of this disorder. The therapy sessions focus on managing the related concerns of anxiety and depression as well as improving the self-confidence.

Counselling

As for adults, counseling is also recommended in addition to participation in a group that aims to guide them in addressing their concerns with regard to their gender issues.

Group Therapy

However, when GID in adolescence doesn’t respond to interventions made psychosocially, counseling specifically group therapy can help with the disorder. The person affected may seek refuge with the support group that he or she shares the disorder with and helps him or her with the adaptation. This can serve as a vent to release emotions and problems thus preventing complications of Gender Identity Disorder.

Hormonal therapy and surgery

Hormonal therapy and surgery such as Gender Reassignment Surgery to stop their innate gender attributes and to have those of what they desire of the opposite sex can be offered for the adolescent with gender dysphoria. Since this surgical procedure is major and permanent, people who want to undergo this operation must go through a long and extensive evaluation period with their health care providers and identity problems may continue after this treatment.

Prognosis

When diagnosed and treated early can lead into good prognosis particularly for born-female individuals with Gender Identity Disorder preceded by Gender Identity Disorder childhood onset. Most individuals with this disorder get to live up ordinary lives with their new adapted gender role. The success of surgical procedures relates to good Psychological outcome.

On the other hand, with the Gender Identity Disorder preceded by a diagnosis of dual role of transvestism, the prognosis of the disorder is guarded. There are regrets about sex-reassignment surgery surfacing because of lack of social and emotional support.

Complications

If Gender Identity Disorder is not addressed, this can cause

1. poor self-image
2. isolation
3. emotional distress to the person
4. severe depression
5. anxiety which can interfere with an individual’s ability to function and develop,
6. problems in work and relationships
7. problems in school