Recommendations for Revision of theDSMDiagnosis of Gender Identity Disorder in Adults

The World Professional Association for Transgender Health (WPATH) conducted a consensus process in order to make recommendations for revision of the DSM diagnoses of Gender Identity Disorders. This is a report from the work group proposing new diagnostic criteria for Gender Identity Disorders for adults if the diagnosis were to be retained in the next revision of the DSM. The group recommended changing the diagnosis to one based on distress rather than on identity, on which the current diagnosis is based. Hence, they proposed changing the name of the diagnosis from Gender Identity Disorder to the more accurate and less pathologizing Gender Dysphoria, a name familiar to the field, used before, and describing the condition of distress. They proposed the following criteria for a diagnosis of Gender Dysphoria in Adults: (a) strong and persistent distress with physical sex characteristics or ascribed social gender role that is incongruent with persistent gender identity, and (b) the distress is clinically significant or causes impairment in social, occupational, or other important areas of functioning and this distress or impairment is not solely due to external prejudice or discrimination. There was consensus that a transgender identity is not pathology. Gender variant individuals are not inherently disordered; rather, the distress of gender dysphoria is the psychological problem. Keywords: Transsexualtransgendergender identity disorder DSM 5 Lin Fraser, EdD, is a licensed psychotherapist and gender specialist in private practice in San Francisco. A charter member of the WPATH, she is currently the association's President Elect. During the consensus process, she served as co-chair of the work group charged with proposing revisions for the diagnosis of Gender Identity Disorder in Adults. Dan H. Karasic, MD, specializes in transgender care and the care of HIV-positive people. He is the psychiatrist for the Transgender Life Care Program at Castro Mission Health Center and a longtime member of Bay Area Gender Associates. Walter J. Meyer, III, MD, is the Gladys Kempner and R. Lee Kempner Professor in child psychiatry at the University of Texas Medical Branch in Galveston, Texas. He frequently works with transgender individuals as both a psychiatrist and an endocrinologist. He is a past president of WPATH. Kevan Wylie, MD, is a full-time health service consultant who specializes in helping people with sexual, relationship, and gender-related problems. He was recently appointed Vice President of the World Association for Sexual Health and elected to the board of directors of WPATH. During the consensus process, he served as co-chair of the work group charged with proposing recommendations for revision of the diagnosis of Gender Identity Disorder in Adults.