The document discusses changes to disorders of sex and gender in the DSM-5, including renaming female sexual interest/arousal disorder, requiring all sexual dysfunctions to last 6 months, replacing dyspareunia and vaginismus with genito-pelvic pain/penetration disorder, classifying paraphilic disorders separately from sexual dysfunctions, adding specifiers such as in remission or a controlled environment, distinguishing paraphilias from paraphilic disorders, replacing gender identity disorder with gender dysphoria, and creating separate diagnoses for children versus adolescents/adults regarding gender identity issues.