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Gender Identity Disorder

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Gender Identity Disorder

Abstract Gender identity disorder is defined as a sense of one’s self as a female, male, or transgender when one’s gender identity and their biological sex are not the same and causing conflict within the person. The DSM classifies GID as a disorder but that has caused a lot of uproar from the transgender community stating that it is not a disorder but a way of life so to say. They believe that they were simply born in the wrong body, with the wrong body parts in comparison to how they feel. Gender identity disorder was first discovered in ancient Greece. It was an ancient Metamorphosis Greek myth where a woman was raised as a man. After they had grown up, somewhere along the way they had fallen in love with another woman. The two had decided to get married and before the ceremony she had been completely transformed into a man. The two stayed together and lived out the rest of their days as husband and wife. Since the mid-19th century there have been people reporting expressions of discomfort with their biological sex and its related roles. And since then the first person to bring GID ( gender identity disorder) to attention was John William Money in 1957. He referred to it as a specific “psychological condition of gender identity disorder”. It wasn’t until 1980 that this disorder was first introduced to the DSM in its third edition.

There are some gender specific differences in regards to GID. In young boys the disorder is manifested by being overly preoccupied with feminine activities as opposed to being appalled by the thought of girls. They may have a preference to dress in girls clothes and do everything that mommy does from the cooking and cleaning to the laundry. To represent long hair most boys will use and towels, aprons, and scarfs. Normally little boys would not be caught dead playing house but boys with this specific disorder will have an intense desire to play house with the other school girls. While they are playing house the boys will also want to play the role of the mother and will be preoccupied with any other feminine fantasy figures they choose. At a young age boys will have a deep desire to be girlie and keep insisting upon the fact that they one day will grow up to be a woman. Also, urinating in public will become a problem because they will insist on going to the women’s bathroom. Often little boys will try to urinate sitting down like a girl and pretend to not have a penis at all by tucking it between their legs. In very severe or extreme cases, the child might even verbalize that they want to be a girl because they find their own penis and testicles absolutely revolting and may say that they want them removed or just wish to have a vagina instead. For girls it’s relatively the same actions. The girls will have an intense negative reaction to going to events where dressing as a girl is required. Their clothes will be similar to boys’ clothes if they aren’t already. If a little girl has somewhat long hair she will express feelings to get it cut really short like boys. She will also want to be called by a boy’s name or a boy version of her own name. Normally Barbie dolls and princesses are an integral part of being a girl but for girls with this disorder batman and superman are their favorite toys and role models. They will also refuse to partake in any kind of feminine dress up. Just as their boy counterparts these girls will refuse to urinate while sitting. They will insist on trying to do it standing up and she will insist that she will eventually grow a penis. She will not want to grow breasts or want to start her menstruations at all. In extreme case the girls will verbalize that they want to grow up to be men.

There really is no typical age of onset for gender identity disorder. This disorder may seem like a boy is attracted to another boy or a girl is attracted to another as in a homosexual nature. This disease should not be confused with homosexuality even though there are some similarities. The homosexual boys may have the same notions in the sense that they want to play house or dress up and the girls may want to dress as a boy and be called as such. The distinct difference is that the child is acting out when they are required to dress, act, or play with others. Other distinctive features are the verbalization of not wanting the assigned biological body parts they each have. Most commonly gender identity disorder will manifest itself on really young children. In many cases the child might also suppress these desires and not report them to anyone until their teenage years or early adulthood.

The symptoms that are expressed by these individuals affected by GID are manifested by their repeated statements of being unhappy with their assigned biological sex. They are generally so preoccupied with the intense feelings of wanting to be the opposite sex that it will interfere with their ordinary daily activities. For older children approaching adolescence they will not develop the right age-appropriate and same-sex peer relationships. This will often lead to severe isolation and distress and may even refuse to go to school because of other children teasing them or because of the social pressure to dress in the appropriate clothing for that sex. Almost the same effect is true of adults. They will be so preoccupied with cross gender wishes that it will take over their life. It will disrupt their everyday normal activities and their relationships will be much more difficult than normal. The performance at work or school will also most likely be compromised. Unfortunately there a no absolute cardinal symptoms to determine the gender identity disorder besides the verbalizing of the desire to be the opposite sex at a young age, if it is even verbalized at all. To warrant this diagnosis, this disorder must be an ongoing disruption of their everyday life. That means that the symptoms need to be present at all times and always interfering with the normal everyday routine that is expected of that individual. These symptoms should be present from the early childhood years of expressing distress in wearing the wrong clothing all the way up through adolescence and into adult hood to achieve the diagnosis of GID or gender identity disorder although it may also manifest itself much later in life even though that is highly unlikely.

As of right now there are no specific abnormalities of the brain itself but there are differences in brain structure and activation and certain unknown genetic variations. Other factors that contribute to the disorder are intrauterine hormone exposure and childhood psychological factors that are based on the interactions with their parents. Now, there are a few different treatment options to be conducted. The first is hormonal therapy and needs to be conducted in two phases only after puberty has been established. Phase one is giving the male patients an anti-androgen or an LHRH agonist while females are given androgens, progestin’s, and LHRH agonists. Once the desired changes have started to occur or have already occurred after the first phase and as long as their mental health stays stable the second phase can be started. Phase two will produce irreversible changes to the body itself as well as sex changing surgery although the surgery is much more permanent. After these phases and regular visits to their therapist throughout their lifetime will help improve the quality of life of that individual.

As a nurse working with patients with a diagnosis of gender identity disorder the treatment would have to be modified for each individual patient and their own specific needs. If dealing with adolescents they may act out intensely or just lack the motivation to change or alter their desire for cross gender roles. In dealing with adults they will more than likely seek therapy options to cope with their own identity but not to correct it.

This research was a correlation because they were looking for a consistent relationship between two different variables and the researchers themselves have no control over anything in the experiment. The hypothesis is that gender identity disorder is slightly more prevalent in male to female patients than it is in female to male patients. Participants were from western European clinics with statistics of 1:30,000 natal males and 1: 100,000 natal females. The conclusion was that the prevalence of GID may be three to eight more times likely in males to females changes over female to male. My suggestion for the next study would be to identify and obtain consent from a child and their parents that insists on having GID and follow them around through their whole adolescent life up until adulthood. There would have to be intense documentation of each occurrence throughout each occurrence of what happened, the medications taken and tried, different therapies and the interactions with other individuals and individuals that have GID. Also I would track whether or not they had received the sex change surgery and how life has been for them before and after and the adjustments that had to be made to deal with everyday life.

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