DSM-5 Codes on Transgender Individuals

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DSM-5 Codes of Transgender Individual

Summary

Gender roles are set societal norms that dictate the type of behaviours that are considered appropriate, desirable, and acceptable for a person based on their perceived or actual sex. They are centred on opposing conceptions of masculinity and femininity with myriad variations and exceptions. Transgender individuals are people whose gender identity differs from the one assigned at birth. Transgender sexuality is the sexuality of transgender individuals. The number of individuals who identify as transgender was approximately 700,000 by 2011, making 0.3% of total America adults, which is not a fair representation as many fear coming out (Meyer & Northridge, 2010). 

Gwen is a transgender female that was last seen by a therapist a year ago, he used to smoke and was overweight. When he decided to transit to a female, he quitted smoking and worked on losing his weight. The client underwent a depressing moment when he lost his job, underwent crying spell and transition pressures. The client explains his unhappiness living as a man with masculine roles. He joined a support group and later and gave it up after the animosity of what men really do. The therapist identifies Gwen’s ability and history to ignore problems. 

Gwen’s Diagnosis

The DSM-5 code for the case scenario of Gwen is F64.1 since she has gender identity disorder in her adulthood. Gender identity disorder is the formal diagnosis given by physicians and psychologists to describe people who face distress with the gender and sex they were assigned at birth. Evidence has suggested that, individual who identify with a different gender from that assigned at birth do so not due to behavioral or psychological causes, but also due to biological ones that are related to their genes or prenatal exposure to hormones (Eischen, 2007). Diagnostic and Statistical Manual for Mental Disorders (DSM-5) determines how mental disorders are diagnosed and defined and impact how we see people and how they view themselves. DSM aims at avoiding stigma and ensuring clinical care for persons who see themselves and feel to be gender different and replaces gender ‘‘identity disorder’’ diagnostic name to ‘‘gender dysphoria’’. Gender nonconformity is not a mental disorder but the clinical distress associated with the condition (Meyer & Northridge, 2010).

Gwen represented dysphoria by his strong desire to be treated as a female and wanted to get rid of his masculine features. It caused clinical distress that she expresses with crying spells at night, social impairments and occupational dysfunction where he lost her job. As a child, the client had the desire to be a female and this was indicated by behaviours and verbalisation at a tender age. The client was, as a child, disgusted the male genitalia, loneliness, anxiety, depression, and social isolation from peers. As an adult, Gwen was stressed, and depressed and suffered reduced self-esteem, isolation, and had suicide ideas. He also suffered from mental disorders before coming out. This is illustrated by his high weight which would be caused by overeating and lack of exercise.

Family and Social Issues of Transgender

They encounter difficulties virtually in every aspect of life both in coping with their own feelings and substantial hostility from society for not conforming to gender norms. They are mostly denied appropriate mental health and medical care and are thus at risk of adverse health outcomes. Gender identity disorder diagnoses have been criticized for pathologizing transgender realities as mental health with unclear symptoms for transsexuals. Transgender children and youth face violence and stigmatization at schools which may cause them not to reach their education potential. Many face stigmas from parents, guardians, and family and the rejection may lead to suicidal thoughts (Eischen, 2007).

Significant Information on Diagnosis, Assessment and Counselling of Gwen

The DSM-5 diagnoses add to a post-transition specifier for individuals living full time as desired gender. It ensures assessment of individuals going through psychotherapy, hormone therapy, related surgery or counselling in support of their gender transition. As part of removing stigma, the word ‘disorder’ is replaced with ‘dysphoria’. The treatment care for the condition include cross-sex hormones, counselling, gender re-assignment surgery, and legal and social transition to the desired gender (Eischen, 2007). 

The core component of diagnosis is the discrepancy between genders assigned during birth (natal gender) and expressed or experienced gender. The condition manifests itself differently at any given age-group, for example, pre-pubertal girls will prefer boys’ styles, names, hairstyles, role playing, dreams, and fantasies and show little interest in girl toys. Some other features include boys shaving their legs, binding their genitals to hide erections, and girls wearing loose sweaters to hide their breasts. Gender dysphoria associated with sex development disorders is noted at an early age by parents and physicians, and physicians are willing to perform cross-sex hormone treatment (TANAKA, 2007).

Difficulties of Assessing and Diagnosing Transgender

Culture-related diagnostic issues are shown where as individuals are reported from different cultures and countries some come from cultures with instituonalized categories rather than male and female. There are also diagnostic makers where individuals with somatic disorders show correlation of final gender outcome with prenatal androgen degree utilization and production. This correlation may not be robust enough as a biological factor to replace a detailed diagnostic interview evaluation for the dysphonia. The environment can act as a difficulty in diagnosis and some individuals learn from habitual fetischistic imaginations. Temperamental individuals without sex development disorders show a high degree of atipicality and make development and persistence of the disorder in adults and adolescents (Tanaka, 2007).

References

Eischen, D. (2007). Love Against Hate As It Relates to Gays, Lesbians, Bisexuals, and Transgenders As Reflected in the Twenty-first Century. Airleaf.

Meyer, I. & Northridge, M. (2010). The health of sexual minorities. New York: Springer.

Tanaka, M. (2007). Genders, Transgenders and Sexualities in Japan. Social Science Japan Journal, 11(1), 155-158. http://dx.doi.org/10.1093/ssjj/jym050