GID.info
Gender Identity Disorder Information
 

WHAT IS GID?

Gender Identity Disorder is the CURRENT medical psychological classification for anyone who has behaviors or self-identification that is inconsistent with their apparent physical sex.

One of the hardest concepts for many people to comprehend is that "sex" and "gender" are distinct and seperate. For the majority of humanity individual gender identity and behavior is synchronous with apparent physical sex. A more simplistic way to put it is that "sex is between the legs; gender is between the ears." For the individual with Gender Identity Disorder physical sex and psychological sex (i.e., "gender") are in some degree of conflict. Because this often leads to peripheral psychological disturbances and a general unhappiness with one's life, this condition is sometimes alternatively referred to as "Gender Dysphoria." Dysphoria being the polar opposite of "euphoria."

Despite the inclusion of gender disorders in the Diagnostic and Statistical Manual of Mental Illness (DSM-IV) and it's counterpart International Classification of Diseases (ICD-10), these problems are rather confusingly NOT considered "mental illnesses" by the medical community. It should also be noted that the publisher of the DSM has not explained why gender disorders fail to meet their own definition of "social non-conformity." (This debate will b discussed in more detail under the conflicting views section).

Another thing that is hard for people to grasp is that the following sub-classifications are NOT a progression of intensity from one disorder to another. Some people misunderstand this and think that crossdressing is simply a lesser form of transsexuality, or that someone who crossdresses will eventually want to undergo sex reassignment surgery. This is NOT the case! Transvesticism is a completely different psychological issue from Transsexuality and if they didn't both start with "trans" or both usually involve people wearing clothing normally not associated with their birth sex, they wouldn't and shouldn't be discussed together at all, much less be seen as different intensitites of the same condition.

Some of the specific sub-classifications covered by the general GID terminology are:

Transvesticism (Crossdressing):

From The ICD-10:

Dual-role Transvestism (F64.1) has three criteria:

  1. The individual wears clothes of the opposite sex in order to experience temporary membership in the opposite sex;
  2. There is no sexual motivation for the cross-dressing;
  3. The individual has no desire for a permanent change to the opposite sex.

The DSM-IV places greater emphasis on sexual arousal as a motivation for crossdressing:

302.3 Transvestic Fetishism

  1. Over a period of at least 6 months, in a heterosexual male, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.
  2. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  3. Specify if: With Gender Dysphoria: if the person has persistent discomfort with gender role or identity.

The terms "transvestite" and "crossdresser" (often abbreviated "TV" and "CD" respectively) are often used interchangeably. Although it is not defined as such, in common usage many people associate the term "transvestite" exclusively with the DSM-IV definition for "Transvestic Fetishism", while the term "crossdresser" is more associated with the ICD-10's "Dual-Role Transvesticism" definition. The distinction being whether or not there is a sexual motivation for the crossdressing activity.

Note that the DSM definition says that there is no such thing as a gay or bisexual crossdresser, or a "female crossdresser" for that matter. This exclusion is covered by a "catch-all" classification discussed later.

Transsexualism

Again, from the ICD-10:

Transsexualism (F64.0) has three criteria:

  1. The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment;
  2. The transsexual identity has been present persistently for at least two years;
  3. The disorder is not a symptom of another mental disorder or a chromosomal abnormality.

Diagnostic Criteria for Gender Identity Disorder of Childhood

For girls

  1. The individual shows persistent and intense distress about being a girl and has a stated desire to be a boy (not merely a desire for any perceived cultural advantages to being a boy) or insists that she is a boy.
  2. Either of the following must be present: (1) persistent marked aversion to normative feminine clothing and insistence on wearing stereotypical masculine clothing, eg, boys’ underwear and other accessories; (2) persistent repudiation of female anatomical structures, as evidenced by at least one of the following: an assertion that she has (or will grow) a penis, rejection of urinating in the sitting position, or assertion that she does not want to grow breasts or menstruate.
  3. The girl has not yet reached puberty.
  4. The disorder must have been present for at least 6 months.

For boys

  1. The individual shows persistent and intense distress about being a boy and has a desire to be a girl, or, more rarely, insists that he is a girl.
  2. Either of the following must be present: (1) preoccupation with stereotypic female activities, as shown by a preference for either cross-dressing or simulating female attire or by an intense desire to participate in the games and pastimes of girls and rejection of stereotypical male toys, games, and activities; (2) persistent repudiation of male anatomical structures, as indicated by at least one of the following repeated assertions: that he will grow up to become a woman (not merely in role), that his penis or testes are disgusting or will disappear, or that it would be better not to have a penis or testes.
  3. The boy has not yet reached puberty.
  4. The disorder must have been present for at least 6 months.

The DSM-IV has a rather lengthy list of criteria, which are different for children and adults:

  • A strong 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:
    1. Repeatedly stated desire to be, or insistence that he or she is, the other sex.
    2. In boys, preference for cross-dressing or simulating female attire; In girls, insistence on wearing only stereotypical masculine clothing.
    3. Strong and persistent preferences for cross-sex roles in make believe play or persistent fantasies of being the other sex.
    4. Intense desire to participate in the stereotypical games and pastimes of the other sex.
    5. Strong preference for playmates of the other sex.

    In adolescents and adults, the disturbance is manifested by symptoms such as

    1. a stated desire to be the other sex,
    2. frequent passing as the other sex,
    3. desire to live or be treated as the other sex,
    4. or the conviction that he or she has the typical feelings and reactions of the other sex.
  • Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex. In children, the disturbance is manifested by any of the following:
    • 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 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.
  • The disturbance is not concurrent with physical intersex condition.
  • The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

GIDNOS

And, to accommodate anyone who does not meet the specific sub-classification criteria, the DSM-IV has a "catch-all" classification:

302.6 Gender Identity Disorder Not Otherwise Specified (GIDNOS)

This category is included for coding disorders in gender identity that are not classifiable as a specific Gender Identity Disorder. Examples include but are not limited to:

  • Intersex conditions (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia) and accompanying gender dysphoria
  • Transient, stress-related cross-dressing behavior
  • Persistent preoccupation with castration or penectomy without a desire to acquire the sex characteristics of the other sex

It would also cover a female crossdresser, a drag performer, or ANY person how had an contrasexual identity, behavior, and/or appearance that was not stipulated elsewhere. Again, the use of the GIDNOS classification does not indicate nor imply that anything classified under it is the same as anything else classified under it. It is a catch-all for any psychological issue - and I mean ANYTHING - gender related that does not fit under "transvestite" or "transsexual." The three examples listed above are completely unrelelated except that three such individuals would be experiencing different kinds of gender related dyphoria.

Now that you know what it is, read up on what it is NOT.

Disclaimer:

Please do not use this information to "diagnose" yourself. Although GID is a "condition" that is often described as "self-diagnosed" you should seek the help of a qualified therapist specializing in gender psychology. A good list of therapists is available at Dr. Becky Allison's web site.

For more information on the diagnosis and treatment of Gender Identity Disorders also see the Standards of Care section. A fairly comprehensive "patient information" article is available from eMedicine.