Editing Gender dysphoria (section)

== Diagnoses ==
=== DSM-5 ===
The [[American Psychiatric Association]] permits a diagnosis of ''gender dysphoria'' in adolescents or adults if two or more of the following criteria are experienced for at least six months' duration:<ref name="DSM5" />
<!--Note that these are paraphrased from the original to avoid copyright violation.-->
* A significant incongruence between one's experienced or expressed gender and one's [[sexual characteristics]]
* A strong desire to be rid of one's sexual characteristics due to incongruence with one's experienced or expressed gender
* A strong desire for the sexual characteristics of a gender other than one's assigned gender
* A strong desire to be of a gender other than one's assigned gender
* A strong desire to be treated as a gender other than one's assigned gender
* A strong conviction that one has the typical reactions and feelings of a gender other than one's assigned gender
In addition, the condition must be associated with clinically significant distress or impairment.<ref name="DSM5" />

The diagnosis also contains two specifiers:<ref name="DSM5" />
* "With a [[intersex|disorder/difference of sex development]]" should be used for those with [[intersex conditions]], in which case the condition should be coded. 
* "Posttransition" may be used if the patient "has transitioned to full-time living in the experienced gender (with or without legalization of gender change)" and has or will undergo "at least one gender-affirming medical procedure or treatment regimen—namely, regular gender-affirming hormone treatment or gender reassignment surgery".

The DSM-5 stated that "Gender dysphoria as a general descriptive term refers to the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender. However, it is more specifically defined when used as a diagnostic category. It does not refer to distress related to stigma, a distinct although possibly co-occurring source of distress."<ref name="DSM5"/>

Neither the [[DSM-I]] (1952) nor the [[DSM-II]] (1968) contained a diagnosis analogous to gender dysphoria. Gender identity disorder first appeared as a diagnosis in the [[DSM-III]] (1980), where it appeared under "psychosexual disorders" but was used only for the childhood diagnosis. Adolescents and adults received a diagnosis of transsexualism (homosexual, heterosexual, or asexual type). The DSM-III-R (1987) added "Gender Identity Disorder of Adolescence and Adulthood, Non-Transsexual Type" (GIDAANT).<ref>{{cite journal |vauthors=Koh J |title=[The history of the concept of gender identity disorder] |journal=Seishin Shinkeigaku Zasshi = Psychiatria et Neurologia Japonica |volume=114 |issue=6 |pages=673–680 |year=2012 | pmid = 22844818 }}</ref><ref>{{cite journal |vauthors = Pauly IB |year=1993 |title=Terminology and Classification of Gender Identity Disorders |journal=[[Journal of Psychology & Human Sexuality]] |volume=5 |issue=4 |pages=1–14 |doi=10.1300/J056v05n04_01 |s2cid=142954603}}</ref><ref>Drescher, Jack, [[doi:10.1080/19359701003589637|Transsexualism, Gender Identity Disorder and the DSM]], ''[[Journal of Gay & Lesbian Mental Health]]'' 14, no. 2 (2010): 112.</ref>  The DSM-5 moved this diagnosis out of the sexual disorders category and into a category of its own.<ref name="DSM5" /> The diagnosis was renamed from gender identity disorder to gender dysphoria, after criticisms that the former term was stigmatizing.<ref name="DSMVChild">{{cite web |date=May 4, 2011 |title=Gender Dysphoria in Children |url=http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=192 |access-date=July 3, 2011 |publisher=[[American Psychiatric Association]] |archive-date=March 14, 2012 |archive-url=https://web.archive.org/web/20120314204820/http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=192 |url-status=live}}</ref> Subtyping by sexual orientation was deleted. The diagnosis for children was separated from that for adults, as "[[gender dysphoria in children]]". The creation of a specific diagnosis for children reflects the lesser ability of children to have insight into what they are experiencing, or ability to express it if they have insight.<ref>{{cite web |title=P 00 Gender Dysphoria in Children |url=http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=192 |access-date=April 2, 2012 |publisher=[[American Psychiatric Association]] |archive-date=March 14, 2012 |archive-url=https://web.archive.org/web/20120314204820/http://www.dsm5.org/ProposedRevision/Pages/proposedrevision.aspx?rid=192 |url-status=live}}</ref> ''Other specified gender dysphoria'' or ''unspecified gender dysphoria'' can be diagnosed if a person does not meet the criteria for gender dysphoria but still has clinically significant distress or impairment.<ref name="DSM5" /> [[Intersex]] people are no longer excluded from the diagnosis of GD.<ref name="Davy">{{cite journal |vauthors=Davy Z, Toze M |title=What Is Gender Dysphoria? A Critical Systematic Narrative Review |journal=[[Transgender Health (journal)|Transgender Health]] |volume=3 |issue=1 |pages=159–169 |year=2018 |pmid=30426079 |pmc=6225591 |doi=10.1089/trgh.2018.0014 |publisher=Mary Ann Liebert, Inc. Publishers}}</ref>

=== ICD-11 ===
The [[International Classification of Diseases]] ([[ICD-11]]) lists three conditions<!--They are defined as "conditions" by the ICD, not "diseases" or "disorders".--> related to gender identity:<ref name="icd11-gc">{{cite web |title=Gender incongruence (ICD-11) |url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/411470068 |access-date=August 28, 2018 |website=icd.who.int |publisher=[[World Health Organization]] |archive-date=August 1, 2018 |archive-url=https://archive.today/20180801205234/https://icd.who.int/browse11/l-m/en%23/http://id.who.int/icd/entity/294762853#/http://id.who.int/icd/entity/411470068 |url-status=live}}</ref>
* Gender incongruence of adolescence or adulthood ({{ICD11|HA60|90875286}})
* [[Gender incongruence of childhood]] ({{ICD11|HA61|344733949}})
* Gender incongruence, unspecified ({{ICD11|HA6Z}})

ICD-11 defines gender incongruence as "a marked and persistent incongruence between an individual's experienced gender and the assigned sex", with no requirement for significant distress or impairment, and a note that "gender variant behaviour and preferences alone are not a basis for assigning the diagnosis..<ref name="icd11-gc"/><ref name="who"/>

The ICD-10 contained the diagnoses "transsexualism" and "gender identity disorder of children" under the chapter "Mental and behavioral disorders" chapter. The ICD-11 renamed the conditions "gender incongruence of adolescence" or adulthood and "gender incongruence of childhood" and moved them into the chapter "Conditions related to sexual health" to reflect "current knowledge that trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such can cause enormous stigma". The [[World Health Organization]] said its inclusion in the ICD-11 "should ensure transgender people’s access to gender-affirming health care" and health insurance.<ref name="who"/>