Skip to main content Accessibility help
×
×
Home

Disorders of gender identity

  • James Barrett
Summary

Gender identity disorders are not common. The most frequent is dual-role transvestism, but it rarely needs medical attention. The least frequent is transsexualism. Transsexualism is not usually indicative of serious psychopathology. Diagnoses should be made by a gender identity clinic and never by the patient, and a clear change of gender role should precede any hormone treatment. Patients must have lived and thrived entirely in their new gender role for at least 2 years before any genital surgery is undertaken. However, bilateral mastectomy might be considered for females after a year of life in a male role. With these selection criteria, the outcomes of surgery are generally good. In the UK, individuals may legally change their recorded sex, usually after gender reassignment treatment.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Disorders of gender identity
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Disorders of gender identity
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Disorders of gender identity
      Available formats
      ×
Copyright
Corresponding author
James Barrett, Charing Cross National Gender Identity Clinic, 179–183 Fulham Palace Road, London W6 8QZ, UK. Email: james.barrett@wlmht.nhs.uk
Footnotes
Hide All

Declaration of Interest

None.

Footnotes
References
Hide All
Antoni, C (2007) The role of the speech and language therapist. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 139–58. Radcliffe Medical Publishing.
Barrett, J (2007a) Dealing with the differentials. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 352. Radcliffe Medical Publishing.
Barrett, J (2007b) Challenging patients and circumstances. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 5565. Radcliffe Medical Publishing.
Barrett, J (2007c) The real-life experience. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 69134. Radcliffe Medical Publishing.
Barrett, J (2007d) Advice for patients about to undergo gender reassignment surgery. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 221–4. Radcliffe Medical Publishing.
Barrett, J (2007e) Relationships. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 249–51. Radcliffe Medical Publishing.
Bellringer, J (2007) Surgery for born males. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 199224. Radcliffe Medical Publishing.
Blanchard, R, Legault, S, Lindsay, WR (1987) Vaginoplasty outcome in male-to-female transsexuals. Journal of Sex & Marital Therapy 13: 265–75.
Blanchard, R, Steiner, BW, Clemmensen, LH et al (1989) Prediction of regrets in postoperative transsexuals. Canadian Journal of Psychiatry 34: 43–5.
Blanchard, R (1991) Clinical observations and systematic studies of autogynephilia. Journal of Sex & Marital Therapy 17: 235–51.
Blanchard, R (1993a) Partial versus complete autogynephilia and gender dysphoria. Journal of Sex & Marital Therapy 19: 301–7.
Blanchard, R, Collins, PI (1993b) Men with sexual interest in transvestites, transsexuals, and she-males. Journal of Nervous and Mental Disease 181: 570–5.
Blanchard, R (1993c) Varieties of autogynephilia and their relationship to gender dysphoria. Archives of Sexual Behavior 22: 241–51.
Blanchard, R (1993d) The she-male phenomenon and the concept of partial autogynephilia. Journal of Sex & Marital Therapy 19: 6976.
Bodlund, O, Kullgren, G (1996) Transsexualism general outcome and prognostic factors: a five-year follow-up study of nineteen transsexuals in the process of changing sex. Archives of Sexual Behavior 25: 303–16.
Buhrich, N, McConaghy, N (1977) The discrete syndromes of transvestism and transsexualism. Archives of Sexual Behavior 6: 483–95.
Cohen-Kettenis, PT, van Goozen, SH (1997) Sex reassignment of adolescent transsexuals: a follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry 36: 263–71.
Cole, CM, O'Boyle, M, Emory, LE et al (1997) Comorbidity of gender dysphoria and other major psychiatric diagnoses. Archives of Sexual Behavior 26: 1326.
Davenport, CW (1986) A follow-up study of 10 feminine boys. Archives of Sexual Behavior 15: 511–7.
Davies, D, Stephenson, AJ (2007) Breasts. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 201–7. Radcliffe Medical Publishing.
Green, R (1978) Sexual identity of 37 children raised by homosexual or transsexual parents. American Journal of Psychiatry 135: 692–7.
Green, R, Blanchard, R (1995) Gender identity disorders. In Comprehensive Textbook of Psychiatry (6th edn) (eds Kaplan, HI, Saddock, BJ) 1153–78. Williams and Wilkins.
Haraldsen, IR, Dahl, AA (2000) Symptom profiles of gender dysphoric patients of transsexual type compared to patients with personality disorders and healthy adults. Acta Psychiatrica Scandinavica 102: 276–81.
Heiman, EM, Cao-Van-Lě, (1975) Transsexualism in Vietnam. Archives of Sexual Behavior 4: 8995.
Kuiper, B, Cohen-Kettenis, P (1988) Sex reassignment surgery: a study of 141 Dutch transsexuals. Archives of Sexual Behavior 17: 439–57.
Landen, M, Walinder, J, Lundstrom, B (1996) Prevalence, incidence and sex ratio of transsexualism. Acta Psychiatrica Scandinavica 93: 221–3.
Landen, M, Walinder, J, Hambert, G et al (1998) Factors predictive of regret in sex reassignment. Acta Psychiatrica Scandinavica 97: 284–9.
Levine, SB (1980) Psychiatric diagnosis of patients requesting sex reassignment surgery. Journal of Sex & Marital Therapy 6: 164–73.
Lindemalm, G, Korlin, D, Uddenberg, N (1987) Prognostic factors vs. outcome in male-to-female transsexualism. A follow-up study of 13 cases. Acta Psychiatrica Scandinavica 75: 268–74.
Lothstein, LM, Levine, SB (1981) Expressive psychotherapy with gender dysphoric patients. Archives of General Psychiatry 38: 924–9.
Mate-Kole, C, Freschi, M, Robin, A (1990) A controlled study of psychological and social change after surgical gender reassignment in selected male transsexuals. British Journal of Psychiatry 157: 261–4.
Miach, PP, Berah, EF, Butcher, JN et al (2000) Utility of the MMPI-2 in assessing gender dysphoric patients. Journal of Personality Assessment 75: 268–79.
Rakic, Z, Starcevic, V, Maric, J et al (1996) The outcome of sex reassignment surgery in Belgrade: 32 patients of both sexes. Archives of Sexual Behavior 25: 515–25.
Ralph, D, Christopher, N (2007) Phalloplasty. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 229–47. Radcliffe Medical Publishing.
Rehman, J, Lazer, S, Benet, AE et al (1999) The reported sex and surgery satisfactions of 28 postoperative male-to-female transsexual patients. Archives of Sexual Behavior 28: 7189.
Sandhu, G (2007) ENT surgery. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 191–7. Radcliffe Medical Publishing.
Seal, LJ (2007) The practical management of hormonal treatment in adults with gender dysphoria. In Transsexual and Other Disorders of Gender Identity: A Practical Guide to Management (ed Barrett, J) 157–90. Radcliffe Medical Publishing.
Shtasel, TF (1979) Behavioral treatment of transsexualism: a case report. Journal of Sex & Marital Therapy 5: 362–7.
Smith, YL, van Goozen, SH, Cohen-Kettenis, PT (2001) Adolescents with gender identity disorder who were accepted or rejected for sex reassignment surgery: a prospective follow-up study. Journal of the American Academy of Child & Adolescent Psychiatry 40: 472–81.
Stein, M, Tiefer, L, Melman, A (1990) Follow-up observations of operated male-to-female transsexuals. Journal of Urology 143: 1188–92.
Tsoi, WF, Kok, LP, Yeo, KL et al (1995) Follow-up study of female transsexuals. Annals of the Academy of Medicine, Singapore 24: 664–7.
van Kesteren, PJ, Asscheman, H, Megens, JA et al (1997) Mortality and morbidity in transsexual subjects treated with cross-sex hormones. Clinical Endocrinology 47: 337–42.
World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders. WHO.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Disorders of gender identity

  • James Barrett
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *