Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction
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Assessment and Treatment of Gender Dysphoria, Paraphilic Disorders, and Sexual Dysfunction
Introduction
Gender dysphoria is an incongruence between expressed and assigned gender. Diagnosis of the health condition involves expressing at least two major symptoms for over six months. A detailed examination of the patients with gender dysphoria is effective in determining the appropriate treatment. Treatment is effective due to the rising number of people reporting gender dysphoria. DSM-5 estimates that gender dysphoria occurs among approximately 0.014% of people assigned male gender and 0.003% of people assigned female gender. Treatment involves medication such as hormone therapy, surgery, and psychotherapeutic options. Practitioners diagnose gender dysphoria and recommend treatment to address the symptoms involving incongruence between expressed and assigned gender.
Diagnostic Criteria for Gender Dysphoria
The DSM-5 explains that gender dysphoria is an incongruence between expressed and assigned gender. The diagnosis is clear if the symptoms last at least 6 months (Zucker, 2017). Practitioners use different symptoms to diagnose the condition. Patients should present at least two of the six symptoms. The symptoms include incongruence between assigned and expressed gender, desire to get rid of the primary gender, a strong desire of the other gender apart from the assigned one, and a strong desire to be with the other gender (Zucker, 2017). Other symptoms include a strong desire to be treated like the other gender and a strong conviction of feelings and reactions of the alternative gender. The DSM-5 code of gender dysphoria is 302.85 (Lindley & Galupo, 2020). Practitioners can diagnose gender disorders among children, adolescents, and adults. For example, children may experience a strong desire to wear clothes of the alternative gender. Practitioners should take precautions of collecting elaborate patient medical and behavioral history since not all patients with gender diversity experience dysphoria (Lindley & Galupo, 2020).
Evidenced-Based Psychotherapy and Psychopharmacologic Treatment
Treatment of gender dysphoria involves a supportive environment and knowledge about treatment to reduce the severity of the symptoms (Chew et al., 2018). The focus of the treatment is to reduce the difference between the assigned and expressed gender. Treatment of the condition depends on the severity of the symptoms (Chew et al., 2018).
Psychotherapeutic treatment of gender dysphoria involves behavior therapy and cognitive behavior therapy. Behavioral treatment involves psychological wellbeing, self-fulfillment, and quality of life (Chew et al., 2018). The objective of behavioral treatment is no to change gender identity but to explore gender concerns. Behavioral treatment helps individuals to be comfortable with their gender expression and improve the quality of relationships (Barbisan et al., 2020). Treatment helps individuals to relate effectively at work, school, and home.
Behavioral treatment can involve individual, family, and group counseling (Barbisan et al., 2020). It helps individuals to accept themselves, build social support, enhance comfort in expressing gender identity, explore healthy gender transition, and make good decisions about medical treatment (Barbisan et al., 2020). Treatment of gender dysphoria involves assessment of drug abuse, sexual health concerns, risk-taking behavior, social support, and mood or mental health problems (Barbisan et al., 2020).
Healthcare workers can recommend cognitive behavior therapy to address gender dysphoria (Zucker, 2017). The objective is to change the thinking patterns about the assigned and expressed gender. Practitioners recommend treatment depending on the symptoms since there is no single treatment for gender dysphoria (Zucker, 2017). Healthcare workers use a combination of treatments to lessen the symptoms of gender dysphoria. The combination is important since there is no single treatment for the health disorder (Lindley & Galupo, 2020).
Medical treatment of gender dysphoria involves hormone therapy and surgery. Patients can take hormones such as feminizing or masculinizing hormones to address the differences between expressed and assigned gender (Lindley & Galupo, 2020). Hormones are used to alter the hormone levels to match the preferred gender identity. Patients should be cautious that some hormones can trigger side effects or discomfort (Chew et al., 2018). Surgery is another medical procedure to address gender dysphoria. Surgical operations focus on changing the physical features such as breasts, chest, genitalia, body contouring, and facial features (Chew et al., 2018). Patients should take precautions since the medical procedures can trigger adverse reactions. For example, the hormones can increase the weight of the patient or alter their feelings.
Conclusion
Gender dysphoria is a health condition that involves the incongruence between expressed and assigned gender. Patients express interest in the characteristics or clothes of the alternative gender. Diagnosis involves the expression of persistent symptoms for at least six months. The symptoms include incongruence between assigned and expressed gender, desire to get rid of the primary gender, a strong desire of the other gender apart from the assigned one, and a strong desire to be with the other gender. Treatment of gender dysphoria involves pharmacological and psychotherapeutic approaches. Pharmacological treatment involves hormones that alter the hormones to achieve the intended goal. Psychotherapeutic treatment involves a supportive environment and knowledge about treatment to reduce the severity of the symptoms. The focus of the treatment is to reduce the difference between the assigned and expressed gender. Practitioners take the precaution while recommending treatment since they can trigger side effects.
References
Barbisan, G. K., Moura, D. H., Lobato, M. I. R., & Da Rocha, N. S. (2020). Interpersonal Psychotherapy for Gender Dysphoria in a Transgender Woman. Archives of Sexual Behavior, 49(2), 787-791.
Chew, D., Anderson, J., Williams, K., May, T., & Pang, K. (2018). Hormonal treatment in young people with gender dysphoria: a systematic review. Pediatrics, 141(4).
Lindley, L., & Galupo, M. P. (2020). Gender dysphoria and minority stress: Support for inclusion of gender dysphoria as a proximal stressor. Psychology of Sexual Orientation and Gender Diversity, 7(3), 265.
Zucker, K. J. (2017). Epidemiology of gender dysphoria and transgender identity. Sexual Health, 14(5), 404-411.
