gender identity disorder

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Gender Identity Disorder



The psychological diagnosis gender identity disorder (GID) is used to describe a male or female that feels a strong identification with the opposite sex and experiences considerable distress because of their actual sex.


Gender identity disorder can affect children, adolescents, and adults. Individuals with gender identity disorder have strong cross-gender identification. They believe that they are, or should be, the opposite sex. They are uncomfortable with their sexual role and organs and may express a desire to alter their bodies. While not all persons with GID are labeled as transsexuals, there are those who are determined to undergo sex change procedures or have done so, and, therefore, are classified as transsexual. They often attempt to pass socially as the opposite sex. Transsexuals alter their physical appearance cosmetically and hormonally, and may eventually undergo a sex-change operation.
Children with gender identity disorder refuse to dress and act in sex-stereotypical ways. It is important to remember that many emotionally healthy children experience fantasies about being a member of the opposite sex. The distinction between these children and gender identity disordered children is that the latter experience significant interference in functioning because of their cross-gender identification. They may become severely depressed, anxious, or socially withdrawn.

Causes and symptoms

The cause of gender identity disorder is not known. It has been theorized that a prenatal hormonal imbalance may predispose individuals to the disorder. Problems in the individual's family interactions or family dynamics have also been postulated as having some causal impact.
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the diagnostic reference standard for United States mental health professionals, describes the criteria for gender identity disorder as an individual's strong and lasting cross-gender identification and their persistent discomfort with their biological gender role. This discomfort must cause a significant amount of distress or impairment in the functioning of the individual.
DSM-IV specifies that children must display at least four of the following symptoms of cross-gender identification for a diagnosis of gender identity disorder:
  • a repeatedly stated desire to be, or insistence that he or she is, the opposite sex
  • a preference for cross-dressing
  • a strong and lasting preference to play make-believe and role-playing games as a member of the opposite sex or persistent fantasies that he or she is the opposite sex
  • a strong desire to participate in the stereotypical games of the opposite sex
  • a strong preference for friends and playmates of the opposite sex


Gender identity disorder is typically diagnosed by a psychiatrist or psychologist, who conducts an interview with the patient and takes a detailed social history. Family members may also be interviewed during the assessment process. This evaluation usually takes place in an outpatient setting.


Treatment for children with gender identity disorder focuses on treating secondary problems such as depression and anxiety, and improving self-esteem. Treatment may also work on instilling positive identifications with the child's biological gender. Children typically undergo psychosocial therapy sessions; their parents may also be referred for family or individual therapy.
Transsexual adults often request hormone and surgical treatments to suppress their biological sex characteristics and acquire those of the opposite sex. A team of health professionals, including the treating psychologist or psychiatrist, medical doctors, and several surgical specialists, oversee this transitioning process. Because of the irreversible nature of the surgery, candidates for sex-change surgery are evaluated extensively and are often required to spend a period of time integrating themselves into the cross-gender role before the procedure begins. Counseling and peer support are also invaluable to transsexual individuals.


Long-term follow up studies have shown positive results for many transsexuals who have undergone sex-change surgery. However, significant social, personal, and occupational issues may result from surgical sex changes, and the patient may require psychotherapy or counseling.



American Academy of Child and Adolescent Psychiatry (AACAP). 3615 Wisconsin Ave. NW, Washington, DC 20016. (202) 966-7300.


The National Transgender Guide.

Key terms

Cross-dressing — Dressing in clothing that is stereotypical of the opposite sex.
Gender identity disorder (GID) — A strong and lasting cross-gender identification and persistent discomfort with one's biological gender (sex) role. This discomfort must cause a significant amount of distress or impairment in the functioning of the individual.
Transsexual — A person with gender identity disorder who has an overwhelming desire to change anatomic sex; one who seeks hormonal or surgical treatment to change sex.


sex (def. 1); see also gender identity and gender role.
gender identity disorder a disturbance of gender identification in which the affected person has an overwhelming desire to change their anatomic sex or insists that they are of the opposite sex, with persistent discomfort about their assigned sex or about filling its usual gender role; the disorder may become apparent in childhood or not appear until adolescence or adulthood. Individuals may attempt to live as members of the opposite sex and may seek hormonal and surgical treatment to bring their anatomy into conformity with their belief (see transsexualism). It is not the same as transvestism.

gender identity disorder

a condition characterized by a persistent feeling of discomfort or inappropriateness concerning one's anatomical sex. The disorder typically begins in childhood with gender identity problems and is manifested in adolescence or adulthood as cross-dressing.
A clinical state in which a person has a persistent desire to be of the opposite phenotypic sex—cross-gender identification—and experiences discomfort about his/her assigned sex; this desire may take the form of simple ‘cross-dressing’, or may be of such intensity to compel the person to seek sexual re-assignment

gender identity disorder

Transsexualism A clinical condition in which a person has a persistent desire to be of the opposite phenotypic sex–cross-gender identification, and experiences discomfort about his/her assigned sex; this desire may take the form of simple 'cross-dressing', or may be of such intensity to compel the person to seek sexual reassignment. See Sexual reassignment.

gen·der i·den·ti·ty dis·or·der

(jendĕr i-denti-tē dis-ōrdĕr )
Persistent feeling of identification with the opposite gender and discomfort with one's own sex.
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