Gender Identity Disorder
A condition, sometimes called transsexualism, in which an individual develops a gender identity inconsistent with their anatomical and genetic sex.
Researchers have suggested that both early socialization and prenatal hormones may play an important role in the development of transsexuality. It is estimated that about 1 in 20,000 males and 1 in 50,000 females are transsexuals. Gender identity disorder generally begin to manifest between the ages of two and four, in which a child displays a preference for the clothing and typical activities of the opposite sex and also prefer playmates of the opposite sex. Young boys like to play house (assuming a female role), draw pictures of girls, and play with dolls. Girls with gender identity disorder prefer short hairstyles and boys' clothing, have negative feelings about maturing physically as they approach adolescence, and show little interest in typically female pastimes, preferring the traditionally rougher male modes of play, including contact sports. Cross-gender behavior carries a greater social stigma for boys than girls; girls with gender identity disorder experience less overall social rejection, at least until adolescence. Approximately five times more boys than girls are referred to therapists for the disorder.
Most children outgrow gender identity disorder with time and the influence of their parents and peers. Adolescents with gender identity disorder are prone to low self-esteem, social isolation, and distress, and are especially vulnerable to depression and suicide. Preoccupied with cross-gender wishes, they fail to develop both romantic relationships with the opposite sex and peer relationships with members of their own sex, and their relationships with their parents may suffer as well. Approximately 75 percent of boys with gender identity disorder display a homosexual or bisexual orientation by late adolescence or early adulthood, although without a continuation of the disorder. Most of the remaining 25 percent become heterosexual, also without a continuation of the disorder, and those individuals in whom gender identity disorder persists into adulthood may develop either a homosexual or heterosexual orientation.
The major symptom of gender identity disorder in adults is the desire to live as a member of the opposite sex by adopting its social role, behavior, and physical appearance. Some transsexuals become obsessed with activities that reduce gender-related stress, including cross-dressing (dressing as a member of the opposite sex), which may be practiced either privately or in public. (Transvestism is a condition in which individuals cross-dress primarily for sexual arousal.) Both male and female transsexuals may elect to alter their primary and secondary sexual characteristics by undergoing surgery to make their genitals as much like those of the opposite sex as possible. Sex-change surgery was pioneered in Europe in the early 1930s and had gained international notoriety after the procedure was performed on a former American soldier named George (Christine) Jorgenson in Denmark in 1952.
Public awareness of transsexualism has increased through the publicity surrounding such prominent figures as British travel writer Jan Morris (who wrote about her experiences in her book Conundrum) and American tennis star Renee Richards. As of the mid-1970s, it was estimated that more than 2,500 Americans had undergone sex-change operations, and in Europe 1 in 30,000 males and 1 in 100,000 females sought sex-change surgery. The operation itself is accompanied by hormone treatments that aid in acquiring the secondary sex characteristics of the desired sex. While a number of individuals have gone on to lead happy, productive lives following sex-change operations, others fail to make the transition and continue to suffer from gender identity disorder.
Morrison, James. DSM-IV Made Easy: The Clinician's Guide to Diagnosis. New York: The Guilford Press, 1995