Gender Dysphoria

Gender dysphoria is discomfort or dissatisfaction with one's gender. Gender is the socially constructed dichotomy affiliated with constructs of masculinity and femininity and is primarily assigned based on one's perceived sex at birth. Infants born male are socially expected to become men, females to become women; people who choose to cross these boundaries may be diagnosed with gender dysphoria. Interestingly, those who are born intersexed, or with ambiguous genitalia or sex chromosomes, cannot be diagnosed with gender dysphoria because it is based upon a clear dichotomous structure of both sex and gender.

Gender dysphoria is an umbrella term used to refer to both transvestites and transgendered persons. Transvestic fetishism, also know as TF, TV, or cross-dressing, is medically defined to exist only in males who enjoy dressing in women's clothing. Cross-dressers are likely to be heterosexual, appropriately masculine men who may dress in women's clothing for erotic reasons. There is substantial variation in the extent of cross-dressing that may occur, ranging from women's undergarments to full clothing with the accompaniment of wigs, makeup, perfume, and jewelry. Most transvestites do not wish to change their gender or their sex. As many as 1 in 15 men may enjoy cross-dressing behavior; however, numbers of men who participate in this behavior are difficult to estimate given that many men may feel shame and embarrassment about this behavior and actively seek to keep it secret. Women also dress in men's clothing; however, this is not socially constructed as gender dys-phoric, but is merely regarded as gender variance. This may also have founding in the social reality that men have greater social power and privilege; to dress in women's clothing challenges this social position and, thus, may have become regarded as a psychiatric condition.

Gender identity disorder (GID) is the official psychological diagnosis for transgendered and transsexual persons. Transgendered persons are individuals who enact a gender identity that does not culturally align with their sex; for example a born male who lives as a woman (a transwoman), or a born female who lives as a man (a transman). Transgendered persons who pursue surgical genital or sex reassignment surgery are transsexual. Transsexuals who transition from male to female are frequently denoted as MTF or M2F, and those who transition from female to male are denoted as FTM or F2M. Increasingly however, the denotation of T2F or T2M, to recognize a transgendered identity rather than a sexed identity, is being employed.

Before a person can pursue surgical sex reassignment surgery, he or she must be psychiatrically diagnosed with GID, thus must be “mentally ill” to have surgery, which in turn “cures” the mental illness by aligning the person's body with her or his mental gender construct. The psychiatric diagnosis of GID is problematic because it exists in a world where men and women commonly experience gender variations and behaviors that do not necessarily imply the desire to change their gender or sex. Additionally, it is assumed that one's psychiatric distress is the result of GID, whereas it may be the social response and stigma affiliated with cross-gendered or gender-variant behavior that is causing distress.

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