Gender Identity Disorder Defined

To be diagnosis with Gender Identity Disorder (GID) the Diagnostic and Statistical Manual (DSM-IV-TR) says “There are two components of Gender Identity Disorder, both of which must be present too make the diagnosis. There must be evidence of a strong and persistent cross- gender identification, which is the desire to be, or the insistence that one is, of the other sex. There must also be evidence of persistent discomfort about one's assigned sex or sense of inappropriateness in the gender role of that sex. To make the diagnosis, there must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning (American Psychiatric Association [DSM-IV-TR], 2000). There are several diagnosis mentioned in the DSM. Transvestic Fetishism is when heterosexual men cross dress for sexual excitement. These people don't necessarily have childhood cross gender behaviors. Schizophrenia patients may demonstrate Gender Identity Disorder behaviors. The DSM is used by many mental health workers to officially diagnosis a patient, most insurance companies won't pay for treatment if proper diagnosis hasn't been made. Kenneth Zucker PH.D. is a well known psychologist and sexologist, and head of the child and adolescent gender identity clinic at Toronto's Centre for Addiction and Mental Health. Zucker supports GID being listed as a disorder in the DSM. He has also been chosen to by the APA to be chair of the Sexual and Gender Identity Disorder work group in revising the DSM fifth edition. According to Shelley Janiczek Woodson, PH.D. “In fairness, it could be argued that any mental health professional working with and/or studying transgender people has some inherent level of conflict of interest in the revision or elimination of the controversial diagnosis of Gender Identity Disorder. I, for example, am a bisexual psychologist who specializes in transgender issues; I am married to a transgender person. The difference between a psychologist like myself and Dr. Zucker is that I do not have a vested professional and financial interest in recommending the continued pathologizing of transgender people through the DSM system, nor do I have a vested interest in de-pathologizing transgender people for that matter. My professional identity and my financial livelihood do not depend upon the continuation of this diagnosis. For Dr. Zucker, there is a clear conflict of interest, exactly the sort of conflict of interest that the APA claims to have so diligently worked to avoid (Woodson, 2010). Many argue GID and other disorders are kept in the DSM for financial gain to health professionals.
Features of Gender Identity Disorder People with Gender Identity Disorder wish to live as a member of the other sex. This idea gives them the desire to adopt the social role of the other sex or to acquire the physical appearance of the other sex through hormonal or surgical manipulation. People with this disorder are uncomfortable being regarded by others as being their birthed sex. Many attempt to pass in public as the other sex, with cross-dressing and hormonal treatment. Gender identity is based on feeling and not biology.
Gender Identity Disorder in Children Gender identity disorders in children and adolescents are rare and more common in boys. GID involves psychological, biological, family and social issues. "In children, the dissturbance is manifested by any following: in boys, asseration that his penis or testes are disgusting or will disappear or assertion that it would be better not ot have a penis, or aversion toward rough-and-tumble play and rejection of male stereotypical toys, games, and activites.””... in girls, rejection of urinating is a sitting position, assertion that she has or will grow a penis, or assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing”(Burke, 1996, p. 64). Children express their desire to be the other sex through cross dressing, perfering to play with the opposite sex, and playing with opposite sex toys or games. Children with GID tend to isolate themselves from society. Statistics given in our class textbook says children with GID have realtionship problems with family and peers, and also experience harrassment (Kearney and Trull, 2012, p. 339). One major precursor to an adulthood homosexual orientation and a homosexual behavior is gender non-conformity in childhood and adolescence. When parents observe deviance in gender identity development or cross-gender behavior in their child, they often intuitively fear a possible developmental course leading towards homosexual inclinations in their child. Parents are typically concerned and many contact a mental health professional for an evaluation for potential treatment to normalize the psychosexual development. Zucker says that clinicians have an ethical obligation to inform parents of the relationship between GID and homosexuality.
Gender Identity Disorder doesn't mean homosexual Gender Identity Disorder is not the same as homosexual. Sexual orientation is about who you are attracted to. Gay people are attracted to people of the same gender. People who have GID desire to be the opposite gender. Basically having the feeling of brain and body mismatch. In other words a female brain in male body or vice-versa. Chazz Bono says "... most people don't know the differnce between gender and gender identity"(Bono, 2011). When homosexuals cross dress this gives society the impression that they want to be the opposite sex, so this theory is debatable.
Prevention and Treatment A full assessment including a family evaluation is essential in treating the child. Recognizing and accepting GID as a problem can provide relief to the child. Decisions about the extent to which to allow the child to assume a gender gender role can be difficult for the family to deal with. This includes problems of whether to inform others of the child’s disorder and how others in the child’s life, should respond to the child. Therapeutic intervention as early as possible in a child’s life is indicated and an optimistic approach to improving the child’s life and, in some cases, altering secondarily the gender identity development. Sex reassignment surgery should not be a method of treatment for children. This method should be made when the child has reached adulthood and are capable of making the decision for themselves. I have included two case studies on children using two different types of treatment. The case of John/Joan is a primary example of sex reassignment surgery imposed by parents gone wrong. David Reimer was born a male, but do to a urination issue at infancy, is parents decided to change him into a girl. David struggled all is life with this decision made by his parents. Later on in life he decided to change back into a man. Although he was back to his original sex, he was still unhappy and ultimately decided to commit suicide (Colapinto, 2000). Rekers and Mead (1979) reported study of a girl, Becky, who was diagnosed with gender identity disorder by two independent clinical psychologists. She had been referred for therapy at the age of 7 . Becky had been exclusively wearing boys’ pants, frequently with cowboy boots, and she consistently refused to wear dresses and other girls’ garments, and she showed no interest in feminine jewelry. The only time she would use cosmetic articles were the times she repeatedly drew beard on her face to appear as a man. She frequently projected her voice as low as she could to sound like a man, coupled with taking male roles in play and making repeated statements that she wanted to be a boy. She occasionally masturbated in public, rubbing her body up against girls in a “humping” fashion. She did not relate well with girls, and clearly preferred playing with boys. Becky became emotionally attached to the female therapist and seemed eager to please her. After the first three therapy sessions of self-monitoring, this intervention resulted in a consistently high level of feminine play in the absence of masculine play. Eventually, the wrist counter was phased out and treatment generalization occurred without it. Between play sessions in the clinic, the female therapist had brief conversations with her. Early in treatment, Becky overtly stated that she wished she were a boy and that she did not want to deliver a baby when she grew up. She stated, “I look ugly in dresses.” Then as therapy progressed, her statement indicated ambivalence toward the new feminine behaviors she was engaging in; for example, playing with cosmetics in the playroom, she said out loud, “I’m getting this stuff off of me, and I ain’t kidding, I better not smell like a girl,” but then minutes later she asked, “Where’s the makeup? You should have gotten the makeup. Doesn’t a lady wear makeup?” Later in treatment, when her therapist asked her, “Would you like to be a boy?” she replied, “No, because boys can’t have babies.” Becky spontaneously began wearing jewelry and perfume at home. Her mother was encouraged to attend to and to praise Becky’s feminine behaviors. Treatment was terminated after 7 months, and follow-up evaluations indicated durability of the treatment effects of normalizing her gender identity and gender role behaviors (Rekers, 2009).

References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, fourth edition, Text Revision.Washington, D.C. (2000).
Bono, Chaz.(May 2011). Transition: The Story of How I Became a Man.
Burke, Phyllis. (1996). Gender Shock: Exploding the Myths of Male & Female.
Colapinto, John. (2000). As Nature Made Him: The Boy who was Raised as a Girl.
Kearney, Christopher A. and Trull, Timothy J. (2012). Abnormal Psychology and Life: A Dimensional Approach.
Rekers, George A. & Oram, K. B. (2009). Child and adolescent therapy for precursors to adulthood homosexual tendencies.