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PSYB32H3 (1,174)
Chapter 14


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University of Toronto Scarborough
Konstantine Zakzanis

Chapter 14Sexual and Gender Identity Disorderssexual and gender identity disordersin DSMIV disorders comprising the paraphilias sexual dysfunctions and gender identity disorderGender Identity Disorder our sense of ourselves as male or female our gender identity is so deeply ingrained from earliest childhood that whatever stress is suffered at one time or another the vast majority of people are certain beyond a doubt of their gender in contrast sexual identity or sexual orientation is the preference we have for the sex of a partner for example a man may be attracted to mena matter of sexual orientation without believing he is a womana matter of gender identityCharacteristics of Gender Identity Disordergender identity disorder GIDa disorder in which there is a deeply felt incongruence between anatomic sex and the sensed gender transsexualism and gender identity disorder of childhood are examples transsexualismthe state of being a transsexual a transsexual is a person who believes heshe is opposite in sex to hisher own biological endowment sexreassignment surgery is frequently desired people with transsexualism have an aversion to samesex clothing and activities the evidence of their anatomynormal genitals and the usually secondary sex characteristics such as beard growth for men and developed breasts for womendoesnt persuade them that theyre what others see them to be Levine stated that the majority of GID cases are diagnosed as GIDNOS gender identity disorder not otherwise specified that is the person has symptoms that meet much of the description of GID but there are some unique features that dont fit the precise criteria for GID although transvestites often dress in clothing typical of the opposite sex they do not identify themselves as of the opposite sex when GID begins in childhood it is associated with crossgender behaviors such as dressing in opposite sex clothes preferring opposite sex playmates and engaging in play that would usually be considered more typical of the opposite sex eg a boy playing with Barbie dolls GID is associated with a developmental lag in achieving a sense of gender constancy or stability ie acceptance that one is a boy or girl for life GID in a child is usually recognized by parents when the child is between 24 years old it was found that GID is about 66 times more frequent in boys than in girls it was concluded that social factors partly account for the difference in referral rates crossgender behavior is less tolerated when exhibited by boys and a higher threshold has to be met in order for a girl to be referred most children with GID do not grow up to be disordered in adulthood even without professional intervention however many become gay excluded from GID are people with schizophrenia who on very rare occasions claim to be of the other sex as well as hermaphrodites socalled intersexed individuals who have both male and female reproductive organs a male with GID experiences his sexual interest in men as a conventional heterosexual preference since he considers himself a woman crossdressing is less of a problem for women with GID because contemporary fashions allow women to wear clothing similar to that worn by men people with GID often experience anxiety and depression not surprising given their psychological predicament and the negative attitudes most people have toward them GID in childhood is linked with separation anxiety disorder the prevalence rates for GID are slight 130000 for men and 1100000 to 150000 in womenCauses of Gender Identity Disorder researchers concluded that children who experience a sense of inappropriateness in the culturallyprescribed gender role of their sex but who do not experience discomfort with their biological sex should notbe considered to have GID because of flaws in the DSMIVTR definition of mental disorder and limitations of the current research base there is simply not enough evidence to make any conclusive statement regarding children who experience discomfort with their biological sex these same researchers said that GID in children should be removed from the DSM they said that viewing GID as a mental disorder my contribute to a labeling process that stigmatizes those children with GID who go on to develop homosexuality evidence indicates that gender identity is influence by hormones other research shows that human and other primate offspring of mothers who have taken sex hormones during pregnancy frequently behave like members of the opposite sex an have anatomical abnormalities many perhaps most young children engage in crossgender behavior now and then in some homes such behavior may receive too much attention and reinforcement from parents and other relatives interviews with the parents of children who show signs of GID often reveal that they didnt discourage and in many instances clearly encouraged crossdressing behavior in their atypical childrenthe childs attractiveness isa factor that may contribute to this pattern of parental behavior boys with GID have been rated as more attractive than control children and girls with GID as less attractive also male patients with GID report having had a distant relationship with their fathers females often report a history of physicalsexual abuseour society has a low tolerance for boys who engage in activities more typical of girls whereas girls can play games and dress in a manner more typical of boys and still conform to acceptable standards of behavior for girls Therapies for Gender Identity Disorder there are 2 types of interventions available to help people with GID one attempts to alter the body to suit the persons psychology the other is designed to alter the psychology to match the persons body Body Alterations a person with GID who enters a program that entails alteration of the body is generally required to undergo 612 months of psychotherapy the therapy typically focuses not only on the anxiety and depression that the person has likely been experiencing but also on available options for altering hisher body some people with GID may choose to have only cosmetic surgery a maletofemale transsexual may have electrolysis to remove facial hair and surgery to reduce the size of the chin and Adams apple many transsexuals also take hormones to bring their bodies physically closer to their beliefs about their gender many people with GID go no further than taking hormones but some take the next step of having sex
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