stating that they are a different gender rather than wish to be a different gender).Professionals who treat gender dysphoria in children sometimes prescribe puberty blockers to delay the onset of puberty until a child is believed to be old enough to make an informed decision on whether hormonal or surgical gender reassignment is in their best interest.A review published in Child and Adolescent Mental Health found that puberty blockers are fully reversible, and that they are associated with such positive outcomes as decreased suicidality in adulthood, improved affect and psychological functioning, and improved social life.A review commissioned by the UK Department of Health found that there was very low certainty of quality of evidence about puberty blocker outcomes in terms of mental health, quality of life and impact on gender dysphoria. The Finnish government commissioned a review of the research evidence for treatment of minors and the Finnish Ministry of Health concluded that there are no research-based health care methods for minors with gender dysphoria. Nevertheless, they recommend the use of puberty blockers for minors on a case-by-case basis, and the American Academy of Pediatrics state that "pubertal suppression in children who identify as TGD [transgender and gender diverse] generally leads to improved psychological functioning in adolescence and young adulthood. ".In the United States, several states have introduced or are considering legislation that would prohibit the use of puberty blockers in the treatment of transgender children.
The creation of a specific diagnosis for children reflects the lesser ability of children to have insight into what they are experiencing, or ability to express it if they have insight. Other specified gender dysphoria or unspecified gender dysphoria can be diagnosed if a person does not meet the criteria for gender dysphoria but still has clinically significant distress or impairment. Intersex people are now included in the diagnosis of GD.The International Classification of Diseases (ICD-10) lists several disorders related to gender identity:
Transsexualism (F64.0): Desire to live and be accepted as a member of the opposite sex, usually accompanied by a desire for surgery and hormonal treatment
Gender identity disorder of childhood (F64.2): Persistent and intense distress about ones assigned gender, manifested prior to puberty
Other gender identity disorders (F64.8)
Gender identity disorder, unspecified (F64.9)
Sexual maturation disorder (F66.0): Uncertainty about ones gender identity or sexual orientation, causing anxiety or distressThe ICD-11, which came into effect on 1 January 2022, significantly revised classification of gender identity-related conditions. Under "conditions related to sexual health", the ICD-11 lists "gender incongruence", which is coded into three conditions:
Gender incongruence of adolescence or adulthood (HA60): replaces F64.0
Gender incongruence of childhood (HA61): replaces F64.2
Gender incongruence, unspecified (HA6Z): replaces F64.9In addition, sexual maturation disorder has been removed, along with dual-role transvestism. ICD-11 defines gender incongruence as "a marked and persistent incongruence between an individuals experienced gender and the assigned sex", with no requirement for significant distress or impairment.