Editing Gender dysphoria (section)

== Signs and symptoms ==

In the [[DSM-5]], a marked incongruence between a person's felt gender and assigned sex or gender (usually at birth) is the core component of the diagnosis, which requires distress about the incongruence.<ref name="DSM5">{{cite book |author1=American Psychiatry Association |author-link=American Psychiatry Association |url=https://archive.org/details/diagnosticstatis0005unse/page/451 |title=Diagnostic and Statistical Manual of Mental Disorders Fifth Edition Text Revision (DSM-5-TR) |date=2022 |publisher=[[American Psychiatric Publishing]] |isbn=978-0-89042-576-3 |edition=5th TR |location=Washington, DC |pages=511–520}}</ref> In pre-pubertal youth it may manifest as an insistence that they are, or will grow up to be, another gender than the one assigned at birth, an aversion to their assigned gender, or an insistence they have or desire to have different genitalia. They may express aversions to stereotypically gendered activities and desire opposite sex-typical toys, games, activities, or playmates though this may be less prominent in surroundings with fewer stereotypes.<ref name="DSM5"/>

Autistic people are more likely to be gender diverse and in those with gender dysphoria there is an overrepresentation of autistic traits.<ref name="DSM5"/> In prepubertal youth, increasing age is associated with more behavioral and emotional problems due to increasing nonacceptance of gender nonconforming behaviors than others, while children and adolescents in affirming environments show less or no psychological problems. Younger children are also less likely to express extreme and persistent dysphoria about their anatomy.<ref name="DSM5"/>

The [[DSM-5]] states that gender dysphoria tends to be [[Gender dysphoria in children|early-onset]] (starting prior to puberty) or late-onset (starting during or after puberty) in non-intersex individuals. Those with early-onset GD which continues into adolescence mostly identify as heterosexual, being attracted to their assigned gender at birth. In some cases, the GD desists or is denied, during which the youth may identify as lesbian or gay, though some may experience a later resurgence in GD. Some of those with late-onset GD report desire to transition during childhood that was not verbalized and others have no recollections of childhood gender dysphoria.<ref name="DSM5"/> According to the ''American Psychiatric Association'',<ref>{{cite web |last=Turban |first=Jack |author-link=Jack Turban |date=August 2022 |title=What is Gender Dysphoria? |url=https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria |website=[[American Psychiatric Association]] |access-date=October 23, 2023}}</ref> those who experience gender dysphoria later in life "often report having secretly hidden their gender dysphoric feelings from others when they were younger".<ref>{{Cite web|url=https://www.psychiatry.org/patients-families/gender-dysphoria/expert-q-and-a|title=Expert Q&A: Gender Dysphoria|website=www.psychiatry.org}}</ref> No particular sexual orientation indicates gender dysphoria.<ref>{{cite journal |last1=Thompson |first1=Lucy |last2=Sarovic |first2=Darko |journal=[[PLOS Global Public Health]] |title=A PRISMA systematic review of adolescent gender dysphoria literature: 1) Epidemiology |year=2022 |volume=2 |issue=3 |pages=e0000245 |doi=10.1371/journal.pgph.0000245 |pmid=36962334 |pmc=10021877 |s2cid=247379163 |doi-access=free}}</ref><ref name="Kaltiala-Heino" /> A 2021 review in Dialogues in Clinical Neuroscience found no relation to sexual orientation, but acknowledged that historically the two were often erroneously conflated.<ref>{{cite journal |vauthors=Crocq MA |title=How gender dysphoria and incongruence became medical diagnoses - a historical review |journal=[[Dialogues in Clinical Neuroscience]] |volume=23 |issue=1 |pages=44–51 |year=2021 |pmid=35860172 |pmc=9286744 |doi=10.1080/19585969.2022.2042166}}</ref> The British [[National Health Service]] also stated "gender dysphoria is not related to sexual orientation".<ref>{{Cite web |url=https://www.nhs.uk/conditions/gender-dysphoria/ |title=Gender Dysphoria |date=23 October 2017 |archive-url=https://web.archive.org/web/20221022102600/https://www.nhs.uk/conditions/gender-dysphoria/ |archive-date=October 22, 2022 |access-date=October 23, 2022}}</ref>