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Persons who experience significant distress about their anatomic sex or assigned gender can receive a diagnosis of gender dysphoria (GD) in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. The most severe form of GD is transsexualism, a diagnosis applicable to persons who want to live as members of the other sex and undergo treatment to make their bodies resemble the other sex. Historically, treatment of GD was first offered to adults with transsexualism; based on the experience gained, treatment was subsequently offered to adults with less severe forms of GD and to persons in other age groups.

Treatment of GD in adults with transsexualism involves five principal elements: (1) assessment of GD and coexisting mental health issues, (2) psychotherapy, ...

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