Gender Dysphoria In Teenagers
The Mayo Clinic explains that “gender dysphoria is a feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics.” Gender dysphoria is not a mental illness, however the disconnect that occurs between a teenager’s assigned sex at birth and one’s internal sense of self can result in undue pain and distress. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) includes gender dysphoria, solely for the purpose of providing a diagnostic term to enable access to care. Hence, a young person that obtains a diagnosis of gender dysphoria will have access to insurance coverage for gender-affirming care. Gender dysphoria most commonly presents in childhood. However, some young people may not experience it until after puberty or much later. It is important to note that gender dysphoria is not related to a teenager’s sexual orientation.
The DSM-5 includes one overarching diagnosis of gender dysphoria with separate specific criteria for children and for adolescents and adults. The diagnostic criteria provided by the American Psychiatric Association outlines gender dysphoria in adolescents and adults as a marked incongruence between one’s experienced/ expressed gender and their assigned gender, lasting at least 6 months, as manifested by at least two of the following:
- A marked incongruence between one’s experienced/ expressed gender and primary and/ or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics)
- A strong desire to be rid of one’s primary and/ or secondary sex characteristics because of a marked incongruence with one’s experienced/ expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics)
- A strong desire for the primary and/ or secondary sex characteristics of the other gender
- A strong desire to be of the other gender (or some alternative gender different from one’s assigned gender)
- A strong desire to be treated as the other gender (or some alternative gender different from one’s assigned gender)
- A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one’s assigned gender)
While the effects of gender dysphoria will differ from teen to teen, to meet criteria for the diagnosis, the condition must also be associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning.
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