Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management
There have been several myths and misconceptions about the dichotomous understanding of sex and gender. While sex is biologically determined, gender and gender identity depend on childhood experiences, upbringing, social expectations, beliefs, family environment, and peer interactions and is sociall...
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doaj-48ac0a13c2ce45518add16f74a32a0122021-07-14T09:34:38ZengSAGE PublishingJournal of Psychosexual Health2631-83182631-83262021-04-01310.1177/26318318211017049Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and ManagementVyjayanthi N. Venkataramu0Debanjan Banerjee1 Spectrum Diagnostics and Health Care, Bengaluru, Karnataka, India Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, IndiaThere have been several myths and misconceptions about the dichotomous understanding of sex and gender. While sex is biologically determined, gender and gender identity depend on childhood experiences, upbringing, social expectations, beliefs, family environment, and peer interactions and is socially constructed. Gender dysphoria (GD) is the extreme distress experienced by an individual because of a mismatch between their gender identity and the sex assigned at birth. GD has been an ambiguous category in psychiatry, initially termed as “gender identity disorder” till Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5 ) considered removal of the term “disorder” to reduce the stigma associated. The critical element in GD is “clinically significant distress” that differentiates it from gender nonconformity. Individuals with GD identify themselves as transgender and frequently are victims of coercive social norms, discrimination, and stigma. This leads to delay in expression of distress, psychiatric mismanagement, and high comorbidity of depression, anxiety, post-traumatic stress, self-harm, and suicidality. Though management involves a holistic multidisciplinary approach including psychotherapy, social support, and gender-reassignment treatments (medical/surgical), there has been considerable debate and ambiguity related to the same. With this background, the article critics the understanding of GD, focuses on the WPATH SOC-7 treatment guidelines, and highlights the role of mental health professionals for better care.https://doi.org/10.1177/26318318211017049 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vyjayanthi N. Venkataramu Debanjan Banerjee |
spellingShingle |
Vyjayanthi N. Venkataramu Debanjan Banerjee Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management Journal of Psychosexual Health |
author_facet |
Vyjayanthi N. Venkataramu Debanjan Banerjee |
author_sort |
Vyjayanthi N. Venkataramu |
title |
Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management |
title_short |
Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management |
title_full |
Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management |
title_fullStr |
Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management |
title_full_unstemmed |
Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management |
title_sort |
gender dysphoria in psychiatric practice: understanding the clinical ambiguity and management |
publisher |
SAGE Publishing |
series |
Journal of Psychosexual Health |
issn |
2631-8318 2631-8326 |
publishDate |
2021-04-01 |
description |
There have been several myths and misconceptions about the dichotomous understanding of sex and gender. While sex is biologically determined, gender and gender identity depend on childhood experiences, upbringing, social expectations, beliefs, family environment, and peer interactions and is socially constructed. Gender dysphoria (GD) is the extreme distress experienced by an individual because of a mismatch between their gender identity and the sex assigned at birth. GD has been an ambiguous category in psychiatry, initially termed as “gender identity disorder” till Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5 ) considered removal of the term “disorder” to reduce the stigma associated. The critical element in GD is “clinically significant distress” that differentiates it from gender nonconformity. Individuals with GD identify themselves as transgender and frequently are victims of coercive social norms, discrimination, and stigma. This leads to delay in expression of distress, psychiatric mismanagement, and high comorbidity of depression, anxiety, post-traumatic stress, self-harm, and suicidality. Though management involves a holistic multidisciplinary approach including psychotherapy, social support, and gender-reassignment treatments (medical/surgical), there has been considerable debate and ambiguity related to the same. With this background, the article critics the understanding of GD, focuses on the WPATH SOC-7 treatment guidelines, and highlights the role of mental health professionals for better care. |
url |
https://doi.org/10.1177/26318318211017049 |
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