Gender Identity

Boys will be boys, or so the saying goes. But what happens when boys want to be girls? Or girls want to be boys? Some people feel that their body does not match who they are on the inside. Some choose to present themselves as the gender they identify with through clothing and cosmetics. Others change their physical appearance through hormones and surgery. This is called gender identity disorder, or GID, also known as gender identity confusion, gender dysphoria, transgenderism and transsexualism The cause of gender identity disorder is still being debated. Theories suggest it is caused by genetic abnormalities, endocrine problems like a testosterone or estrogen imbalance in the womb, social factors like parenting or some combination of issues. Gender identity disorder may manifest in children, adolescents or adults, and appears more frequently in males than in females.Because gender identity disorder is currently considered a psychological disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a mental health professional such as a psychiatrist, psychologist or therapist must make the diagnosis. Gender identity struggles may begin as early as age two to four years, when children begin to exhibit interest in cross-gender activities.Most will outgrow symptoms of gender identity disorder before adolescence. By late adolescence or adulthood, about three quarters of boys with symptoms of gender identity disorder report homosexual or bisexual orientations. Adult gender identity disorder typically manifests in late adolescence or in early to mid-adulthood, although there is no determinant age of onset. Adolescents questioning their gender identity usually report cross-gendered feelings since childhood. Later onset gender identity disorder usually appears gradually, with individuals seeking therapy in early to mid-adulthood. There is no specific test that can be performed to indicate whether or not a person has gender identity disorder. Instead mental health professionals use certain criteria to make a diagnosis. These criteria include: persistent identification with the opposite gender, including cross-dressing and living as the opposite sex; persistent feelings of being in the "wrong" body for at least two years; no presence of a DSD (Disorder of Sex Development) condition; anxiety, unhappiness or other distress in every day social or occupational situations due to cross-gendered identification. In children, the diagnosis must include the presence of at least four of the following symptoms: repeated insistence that he or she is the opposite gender, or desires to be the opposite gender; persistent preference for cross-gender roles during play or persistent fantasies of being the opposite gender; a strong desire to play stereotypically gendered games; a strong preference for friends and playmates of the opposite sex; in boys,an insistence on dressing in stereotypical female clothing; in girls,an insistence on dressing in stereotypical male clothing. Psychological therapy can alter the course of gender identity disorder. Early intervention can lead to less transsexual behavior later in life. The initial focus of the treatment is to help the individual function in his/her biologic sex role as well as possible. Adults who have severe gender identity disorder which has persisted for many years sometimes request reassignment of their sex, or sex-change surgery.