This occurs usually at birth and, thereby, yields the "natal gender.” Gender—atypicul refers to somatic features or behaviors that are not typical (in a statistical sense) of individuals with the same assigned gender in a given society and historical era; for behavior, gender-noncon- forming is an alternative descriptive term. Gender reassignment denotes an official (and usu- ally legal) change of gender. Gender identity is a category of social identity and refers to an individual’s identification as male, female, or, occasionally, some category other than male or female. Gender dysphoria as a general descriptive term refers to an individual’s affective/ cognitive discontent with the assigned gender but is more specifically defined when used as a diagnostic category. Trunsgender refers to the broad spectrum of individuals who tran- siently or persistently identify with a gender different from their natal gender. Transsexual denotes an individual who seeks, or has undergone, a social transition from male to female or female to male, which in many, but not all, cases also involves a somatic transition by cross-sex hormone treatment and genital surgery (sex reassignment surgery).
Gender dysphoria refers to the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender. Although not all indi- viduals will experience distress as a result of such incongruence, many are distressed if the desired physical interventions by means of hormones and / or surgery are not available.
The current term is more descriptive than the previous DSM-IV term gender identity disor- der and focuses on dysphoria as the clinical problem, not identity per se.
Gender Dysphoria in Children 302.6 (F64.2)
A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration, as manifested by at least six of the following (one of which must be Criterion A1): 1. A strong desire to be of the other gender or an insistence that one is the other gen- der (or some alternative gender different from one's assigned gender).
2. In boys (assigned gender). a strong preference for cross-dressing or simulating fe- male attire; or in girls (assigned gender), a strong preference for wearing only typ- ical masculine clothing and a strong resistance to the wearing of typical feminine clothing.
A strong preference for cross-gender roles in make-believe play or fantasy play.
4. A strong preference for the toys, games, or activities stereotypically used or en- gaged in by the other gender.
5. A strong preference for playmates of the other gender.
6. In boys (assigned gender), a strong rejection of typically masculine toys, games, and activities and a strong avoidance of rough-and-tumble play; or in girls (as- signed gender), a strong rejection of typically feminine toys, games, and activities.
7. A strong dislike of one's sexual anatomy.
8. A strong desire for the primary and/or secondary sex characteristics that match one’s experienced gender.
B. The condition is associated with clinically significant distress or impairment in social, school, or other important areas of functioning.
Specify if:
With a disorder of sex development (e.g., a congenital adrenogenital disorder such as 255.2 [E250] congenital adrenal hyperplasia or 259.50 [E3450] androgen insensi- tivity syndrome).
Coding note: Code the disorder of sex development as well as gender dysphoria.
Gender Dysphoria in Adolescents and Adults 302.85 (F64.1)
A. A marked incongruence between one’s experienced/expressed gender and assigned gender, of at least 6 months’ duration. as manifested by at least two of the following: 1. A marked incongruence between one’s experienced/expressed gender and pri- mary and/or secondary sex characteristics (or in young adolescents. the antici- pated secondary sex characteristics).