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Introduction to being transgender or transsexual.
Gender dysphoria, & gender identity

Part 5:
Definitions of Gender Dysphoria.
Gender Incongruence. Catch 22.
A trans/transgender symbol.
Sex included on birth certificates.

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This is a continuation of Part 4 in a previous essay

Definitions of Gender Dysphoria (formerly called "Gender Identity Disorder):"

The APA's list of symptoms related to Gender Dysphoria in the DSM-IV, an older version of the document published in 1952, was:

A. A strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex).

In children, the disturbance is manifested by four (or more) of the following:

1. Repeatedly stated desire to be, or insistence that he or she is, the other sex.

2. In boys, preference for cross-dressing or simulating female attire; in girls, insistence on wearing only stereotypical masculine clothing.

3. Strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex.

4. Intense desire to participate in the stereotypical games and pastimes of the other sex.

5. Strong preference for playmates of the other sex.

In adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the other sex, frequent passing as the other sex, desire to live or be treated as the other sex, or the conviction that he or she has the typical feelings and reactions of the other sex.

B. Persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex.

In children, the disturbance is manifested by any of the following:

In boys, assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games, and activities;

In girls, rejection of urinating in a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing.

In adolescents and adults, the disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.

C. The disturbance is not concurrent with a physical intersex condition.

D. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. 1

The APA's list of symptoms for Gender Incongruence (in Adolescents or Adults) that were incorporated during 2013 into DISM-V is:

A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2 or more of the following indicators:

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). 1

CitizenLink, a fundamentalist Christian news source, reported the views of Professor George Rekers at the University of South Carolina School of Medicine. He said that the change from GID (Gender Identity Disorder) to Gender Dysphoria is political in nature similar to the removal of "homosexuality" from the DSM in 1972. He said:

"I think they are bowing to activist groups to downplay the actual psychopathology involved by just calling it gender incongruence. They don't want to go back to put homosexuality as the disorder. Now it looks like they're back pedaling on Gender Identity Disorder." 2

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Transsexuals are frequently caught in a multiple Catch 22 situation:

bulletTheir employment is often terminated when they transition from male to female or vice versa. They often experience difficulties in obtaining re-employment.
bullet Not having an income, some become homeless. Some enter the sex trade in order to survive.
bullet The vast majority of private health insurance plans do not cover gender confirmation surgery. Neither do some federal government programs.
bullet Without confirmation surgery, they are often refused access to homeless shelters.

Some support groups for lesbians, gays, bisexuals, and transsexuals are now actively advocating for equal protection for persons of all gender identities. However, many conservatives social and religious groups are strenuously resisting this change. Their most common concern is that cisgender males will pretend to be females, enter women's washrooms, and attack girls. We have never been able to find a case on file in which this has actually happened.

The Transgender symbol:

Nancy R. Nangeroni of Nangeroni Design created this symbol and has made it generally available to the transgender community. It combines the international symbols for make and female with a third symbol representing transgender. She writes:

"The circle is a symbol of wholeness, and represents the wholeness of a society which includes the transgender. The misdirection of a society that ridicules the transgender is implied."

The symbol is used by both transgender persons and those friends and supporters who support sexual equality. 3

2020-DEC-12: New England Journal of Medicine article about sex on birth certificates:

An article in the journal by three doctors argues that birth certificates should not display biological sex in their "legally identifying fields," in order to reduce the "harmul effects" on transgender and intersex individuals. The article is titled: "Failed Assignments – Rethinking Sex Designations on Birth Certificates."

It says:

"We believe that it is now time to update the practice of designating sex on birth certificates, given the particularly harmful effects of such designations on intersex and transgender people ... Designating sex as male or female on birth certificates suggests that sex is simple and binary when, biologically, it is not. Sex is a function of multiple biologic processes with many resultant combinations."

In addition, they suggest that assignments on sports teams be defined by hormone levels and not by biological sex. 4

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. "Gender Identity Disorder, DSM-IV" American Psychiatric Association, at:
  2. "Psychiatrists mull renaming sexual disorder," CitizenLink, 2010-FEB-12, at:
  3. Nancy R. Nangeroni, "About the TG Symbol," GenderTalk, at:
  4. Michael Foust, "Birth Certificates Should Not Include a Baby's Sex, say Doctors in New England Journal of Medicine," Christian Headlines, 2021-JAN-14, at: Birth Certificates Should Not Include a Baby's Sex

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Copyright © 2007 to 2021 by Ontario Consultants on Religious Tolerance
Original posting: 2007-JUN-08
Latest update: 2021-JAN-15
Author: B.A. Robinson

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