[Page 1533]Gender dysphoria refers to a state of psychological distress with one’s primary and/or secondary sex characteristics, sex hormone levels, and/or assigned social gender. The condition is diagnosed in children, adolescents, and adults whose gender identity and/or gender expression are incongruent with the gender they were assigned at birth (hereafter referred to as transsexual, transgender, and gender-nonconforming people) and who experience persistent clinically significant gender-related distress or impairment in functioning for at least 6 months, according to the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). No formal epidemiological studies have been conducted, but estimates of prevalence based on number of individuals seeking treatment at specialty clinics suggest that gender dysphoria is rare in the general population (estimates reported ...