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Lecture 1

PSY240H5 Lecture Notes - Lecture 1: Psychopathology, Physical Examination, Psychosexual Development

Course Code
Norman Farb

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Gender disorder and gender identity
Gender Identity
Three aspects of the development of gender identity are separable:
oGender role
oSexual orientation
oGender identity
In some instances these “variables of gender” do not coincide.
Rare cases where the actual biological variables are disagreeing,
hermaphroditism/intersex occurs, with the reproductive structures being partly
female and partly male.
Gender role define by ones culture interms of ones culture and what is expected of boys
and girls
Gender identity internal experience of knowing if you are a female or male
Tansgender ind have anatomy of ones sex and gender identity of another
Gender Dysphoria
The condition of feeling one's emotional and psychological identity as male or female
to be opposite to one's biological sex.
Strong and persistent cross-gender identification.
If an individual feels like the opposite gender trapped in their present gender, this
experience would be termed gender dysphoria.
Gender dysphoria (GD) denotes distress or discomfort with one’s biological sex or
assigned gender
Transsexualism affected persons express an intense and desire to live and be
recognized as members of the other sex and to make their bodies resemble those of
the other sex through hormonal and surgical treatment
- Most widely recognized and most severe GD is
Transgender/transgenderism: Terms used informally to describe persons who
report or exhibit significant cross-gender identity or behavior, whether or not they
meet full diagnostic criteria for GD
- - If the transgendered individual has sought medical intervention (hormone
therapy, SRS) to change their body to the opposite sex, the term used is
Christine Jorgensen’s sex reassignment in 1952 brought the phenomenon of
transsexualism to public attention in Western countries

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Statistics and Gender Dysphoria
Gender dysphoria is much more common in children than in adults, and is seen
at higher rates with males than with females.
Youth populations have become the fastest growing and most challenging(ed)
Evidence of gender non-conformity often becomes apparent in early childhood,
~2 years of
DSM V and Gender Dysphoria
Newly added as a separate diagnostic class in DSM-5
oRationale: This new diagnostic class reflects a change in gender identity
disorder s (GID) defining features by emphasizing the phenomenon of ʼ
“gender incongruence(conflict)” rather than “cross-gender
Criteria now include two separate sets for children and for adults/adolescents
oRationale: Slight changes in the wording of criteria for children were
necessary given developmental considerations.
Transsexualism is not a DSM-5 diagnosis per se
GD was first recognized as a psychiatric diagnosis in 1980 in DSM-III
Typical Clinical Presentation for the person with GD
Dislike for one’s primary or secondary sex characteristics.
Discomfort with one’s assigned gender or associated gender role
Identification with the other gender
Requests for approval for hormonal and surgical sex reassignment are the most
frequent presenting complaints of adult patients with GD
Adults with GD including paraphilias, sexual dysfunctions, depression, or other
general psychiatric conditions
Less Common Clinical Presentation
Rarely, persons with GD may identify with “some alternative gender”
that corresponds to neither their assigned sex nor the other sex
Subtypes of GD in Male Adults
Adult males with GD or transsexualism whose sexual orientation is characterized
by exclusive attraction to men are called homosexual (or androphilic) gender
dysphoric males, or mtf transsexuals
Because they are homosexual relative to their biologic sex
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