According to APA

1. GENDER DYSPHORIA

2. 2

3. GENDER DYSPHORIA IN CHILDREN
A. A marked incongruence between one’s experienced/ expressed gender and assigned gender, of at least 6 months’ duration, as manifested by at least
six of the following (one of which must be Criterion A1):
1. A strong desire to be of the other gender or an insistence that one is the other gender (or some alternative gender different from one’s assigned
gender).
2. In boys (assigned gender), a strong preference for crossdressing or simulating female attire; or in girls (assigned gender), a strong preference for wearing
only typical masculine clothing and a strong resistance to the wearing of typical feminine clothing.
3. A strong preference for cross-gender roles in make believe play or fantasy play.
4. A strong preference for the toys, games, or activities stereotypically used or engaged in by the other gender.
5. A strong preference for playmates of the other gender.
6. In boys (assigned gender), a strong rejection of typically masculine toys, games, and activities and a strong avoidance of rough-and-tumble play; or in girls
(assigned gender), a strong rejection of typically feminine toys, games, and activities.
7. A strong dislike of one’s sexual anatomy.
8. A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender.
B. The condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning

4. GENDER DYSPHORIA IN ADOLESCENTS /
ADULTS
A. A marked incongruence between one’s experienced/ expressed gender and assigned gender, of at least 6 months’
duration, as manifested by at least two of the following:
1.A marked incongruence between one’s experienced/ expressed gender and primary and/or secondary sex
characteristics (or in young adolescents, the anticipated secondary sex characteristics).
2. A strong desire to be rid of one’s primary and/or secondary sex characteristics because of a marked incongruence with
one’s experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated
secondary sex characteristics).
3. A strong desire for the primary and/or secondary sex characteristics of the other gender.
4. A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender).
5. A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender).
6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender
different from one’s assigned gender).
B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important
areas of functioning

5. • Girls with gender dysphoria typically prefer traditional boys’
clothing and short hair. Fantasy heroes often include powerful
male figures like Batman and Superman. They show little
interest in dolls and increased interest in sports
• The most common adult outcome of boys with gender
dysphoria has been homosexuality rather than transsexualism
(Zucker, 2005)
• However, several later studies of clinic-referred children have
found that 10 to 20 percent of boys with gender dysphoria
were transsexual by age 16 or 18, and about 40 to 60 percent
identified themselves as homosexual or bisexual, a
percentage that may have increased by the time they were
older (Zucker, 2005).

6. TREATMENTS
• Gender dysphoria is typically treated psychodynamically—that is, by examining
inner conflicts
• Specialists attempt both to treat the child’s unhappiness with his or her biological
sex and to ease strained relations with parents and peers. Children with gender
dysphoria often have other general psychological and behavioral problems such as
anxiety and mood disorders that also need therapeutic attention (Zucker et al.,
2002).
• Two related facts about gender dysphoria in children are especially important
clinically. First, as we have noted, most children with gender dysphoria do not
become adults with gender dysphoria. The problem generally remits during
childhood (Wallien & Cohen-Kettenis, 2008). Second, individuals who are still
gender dysphoric into adolescence are likely to remain so into adulthood, and they
are also likely to take medical steps to transform their bodies. The crucial period at
which many children with gender dysphoria desist or persist appears to be ages 10
to 13 (Steensma et al., 2011).

7. TRANSSEXUALISM
• Transsexualism occurs in adults with gender dysphoria who desire to
change their sex, and surgical advances have made this goal, although
expensive, partially feasible.
• Transsexualism represents the extreme on a continuum of transgenderism,
or the degree to which one identifies as the other sex (Cohen-Kettenis &
Pfafflin, 2010).
• Psychotherapy is usually not effective in helping adolescents or adults to
resolve their gender dysphoria.
• The only treatment that has been shown to be effective is surgical sex
reassignment. Initially, transsexuals who want and are awaiting surgery are
given hormone treatment. Biological men are given estrogens to facilitate
breast growth, skin softening, and shrinking of muscles. Biological women
are given testosterone, which suppresses menstruation, increases facial
and body hair, and deepens the voice

8. • Before they are eligible for surgery, transsexuals
typically must live for many months with hormonal
therapy, and they generally must live at least a year
as the gender they wish to become. If they
successfully complete the trial period, they undergo
surgery and continue to take hormones indefinitely. In
male-to-female transsexuals, this entails removal of
the penis and testes and the creation of an artificial
vagina.

9. THANKYOU