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Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however, medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinically competent, and culturally attuned care to gender-variant patients, including those who identify as transgender or transsexual or meet criteria for the diagnosis of Gender Dysphoria GD as defined by The Diagnostic and Statistical Manual of Mental Disorders 5th edition. The article will also be helpful for other mental health professionals.

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Last week, the American Psychiatric Association APA approved the final text for the fifth version of its manual that provides criteria for mental health disorders. Earlier this year, the APA also released a position statement affirming their support of transgender rightsand the language of the DSM-5 reflects an increased sensitivity to and respect for the transgender community. The fifth version of DSM is important for several reasons.

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Gender dysphoria occurs when a person feels distress between the biological sex assigned at birth and the inner gender identity. The typical treatment for this distress is to transition to the gender they feel fits them at heart. While many transgender people experience dysphoria throughout their lives, transitioning and receiving community acceptance can greatly improve their mental health.

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In his old age, the great gay rights activist Frank Kameny recalled Dec. In a single stroke, the A. It would take another 27 years for the World Health Organization to eliminate homosexuality from its own classification of mental disorders in the International Classification of Diseases, the comprehensive manual of some 55, diagnostic codes that doctors everywhere use for diagnosis and insurance reimbursement.

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Science agrees: being transgender is not a mental illness. When people see or hear the medical diagnosis "gender dysphoria", they assume this means being transgender is a mental illness and that trans people are therefore "crazy" in some way. Gender dysphoria is given as a diagnosis related to how a person feels about the gender they were assigned at birth.

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Let friends in your social network know what you are reading about. Gender incongruence is now classified as a sexual health condition, not a mental illness. A link has been sent to your friend's email address.

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Another activist shared a letter Ansara, et al that she and others submitted to the APA criticizing much of its framing around trans identities and providing possible alternatives. For all members of the LGBT community, there are many issues that impact us in very personal and unique ways, resulting in many seemingly-conflicting points of view that all have validity. It is true that trans identities are still contained within a manual of mental disorders, which alone can be stigmatizing regardless of how the classification is labeled.

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The change, although currently limited to Denmark, represents a new phase in the evolution of views on being transgender. It shifted the emphasis in treatment from fixing a disorder to resolving distress over the mismatch. University of San Francisco human rights scholar Richard Johnson agrees.

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Because gender identity disorder is currently considered a psychological disorder in the Diagnostic and Statistical Manual of Mental Disorders DSM-IVa mental health professional such as a psychiatrist, psychologist or therapist must make the diagnosis. The Standards of Care are intended for professionals, individuals with gender identity disorder and their families, as well as institutions or anyone else seeking to understand current information about the psychological, medical and surgical treatments for GID. In accordance with the Standards of Care, when an individual begins to question and feel persistent dissatisfaction with his or her gender identity, no matter at what age, therapy -- psychological, endocrine or surgical -- should begin.

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