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Psychiatry [GENDER DYSPHORIA]

Gender Terminology
Gender Assignment happens at birth; the child is either male or
female. Legally speaking this is determined by the external Gender Terms
genitalia. Specifically, the genotype is erroneous - only the Assignment Your genitals at birth
external genitalia determines the assignment. “What you are physically”
Gender Your gender in your mind
Identity “What you are mentally”
Gender Identity is what is in the person’s brain. It’s what they
Transgender Someone who’s identity is more often
believe they are. This can be defined as male, female, or other. incongruent than their assignment
Transsexual Not only identifying, but has socially or
Transgender is a broadly used term to describe patients physically changed to another
temporarily or persistently identifying with a gender different assignment
from what they’ve been assigned. Transvestic Cross-Dressing but
Disorder NOT transgendered
Transsexual is a patient who physically or socially transitioned
from one sex to another. Not required to be transsexual, but when
present essentially confirms the diagnosis is physical transition
via surgery or hormones to become more like the opposite gender.

Transvestic disorder: (“Transvestite”) is a condition of cross-


dressing behavior resulting in sexual excitement, causes distress,
but is usually NOT associated with gender dysphoria.

What’s up with gender vs sex? Gender is identity, while sex is


biology. In life they’re used interchangeably.

Gender Dysphoria
Gender dysphoria is a combination of incongruent identity (by Gender Dysphoria
definition, transgendered) that also causes distress. It can be
characterized by the feeling that they are the opposite sex, the Duration > 6 months AND any one:
desire to change themselves to be the opposite sex, or even 1. Incongruence between experienced gender
wanting to rid themselves of all sex characteristics (“asexual” in (gender identity) and sex characteristics
idiom). It can be defined as easily as believing they have the (assignment)
typical feelings of another gender. 2. Desire to be, be treated as, or have sex
characteristics of another gender
In children, all that may happen are instances of cross-dressing, 3. Wanting to rid self of sex characteristics
assuming stereotyped roles of the opposite gender, or rejecting 4. Beliefs that the patient, the self, has typical
stereotyped roles of the same gender. Children may also just be feelings and reactions of another gender
having fun; cross dressing isn’t necessarily an intentional a. Be cautious with stereotyping here
decision, so be careful. To be sure it isn’t more than just dress-up,
there must be 1) some sort of distress and 2) a duration of activity
> 6 months. Be cautious of the idiomatic use of the words and their
clinical definition. Also very low yield for the test.
Paraphilia
Defined as a condition in which a person’s sexual arousal and Defining Paraphilias
gratification depend on fantasizing about or engaging in sexual Common
behavior that’s atypical or extreme. It’s unfortunate for the people Pedophilia Sexual focus on children.
Often Male adult à female child
who have them; what’s totally normal to the “patient” is viewed
Exhibitionism Exposing genitals to strangers
as unacceptable by society. To separate “kinky” from “disorder”
Voyeurism Observing private activities of unaware
consider a paraphilia to be distinguished as a preoccupation with victims
the object or behavior to the point of being dependent on it for Frotteurism Touching, rubbing or a nonconsenting
sexual gratification. Often, the person is gratified sexually by the person
specific act, which requires intense therapy or incarceration if it Uncommon
violates another’s rights. Fetishism Inanimate objects
Masochism Being humiliated or forced to suffer
Homosexuality Sadism Inflicting humiliation or pain on others
Is NOT considered a disease or disorder. Transvestic Sexually aroused by cross dressing
disorder

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