Mental healthcare
Transgender people may be eligible for diagnosis of gender identity disorder (GID) "only if [being transgender] causes distress or disability."[55] This distress is referred to as gender dysphoria and may manifest as depression or inability to work and form healthy relationships with others. This diagnosis is often misinterpreted as implying that simply being transgender means a person suffers from GID, which is not the case. This has caused much confusion to transgender people and those who seek to either criticize or affirm them. Transgender people who are comfortable with their gender, whose gender does not directly cause inner frustration or impair their functioning, do not suffer from GID. Moreover, GID is not necessarily permanent, and is often resolved through therapy and/or transitioning. GID does not refer to people who feel oppressed by the negative attitudes and behaviors or others including legal entities in the same way that racist institutions do not create a "race disorder." Neither does GID imply an opinion of immorality; the psychological establishment holds the position that people with any kind of mental or emotional problem should not receive stigma. The solution for GID is whatever will alleviate suffering and restore functionality; this often, but not always, consists of undergoing a gender transition.[54]Therapy is recommended by most mental health professionals for those who suffer from internal conflicts regarding their gender identity or those who feel discomfort in their assigned gender role, especially if they desire to transition. People who experience discord between their gender and the expectations of others or whose gender identity conflicts with their body may benefit by talking through their feelings in depth with someone who will listen attentively. However, research on gender identity is relatively new to psychology and scientific understanding of it and related issues is still in its infancy.[54]
The terms "transsexualism", "dual-role transvestism", "gender identity disorder in adolescents or adults" and "gender identity disorder not otherwise specified" are listed as such in the International Statistical Classification of Diseases (ICD) or the American Diagnostic and Statistical Manual of Mental Disorders (DSM) under codes F64.0, F64.1, 302.85 and 302.6 respectively.[56]
In February 2010, France became the first country in the world to remove transgender identity from the list of mental diseases.[57][58]
The issues around psychological classifications and associated stigma (whether based in paraphilia or not) of cross dressers, transsexual men and women (and for that matter lesbian and gay children who may be difficult to tell apart from trans children early in life) have recently become more complex since it was announced that CAMH colleagues Kenneth Zucker and Ray Blanchard would serve on the DSM-V's Sexual and Gender Identity Disorders Work Group.[59]CAMH aims to 'cure' transgender people of their 'disorder', especially in children. Within the trans community, this has mostly produced shock and outrage with attempts to organize other responses.[60]
One of the reasons there is so much controversy about Kenneth Zucker and Ray Blanchard's work group is that many people believe that gender identity disorders/homosexuality are incurable as they are genetic and/or occur as a result of events occurring before birth (therefore already "solidified" by the time of birth). If this is the case, then trying to 'cure' said condition(s) could lead (and in some individuals already has led[61][62][63]) to increased confusion, more intense dysphoria later in life, and perhaps even suicide (likely due to the fact that the younger the transgender individual, the greater the effect of hormones). While some cases of individuals partaking in these sessions seem to show success, the long term repercussions (if any) of some of these individuals being 'cured' have not yet been observed, due to an indefinite amount of time before negative reactions could possibly occur.
Transgender issues are both new in the scientific field and affect relatively few people, so many mental healthcare providers know little about transgender issues. People seeking help from these professionals often end up educating the professional rather than receiving help.[54] Among those therapists who profess to know about transgender issues, many believe that transitioning from one sex to another – the standard transsexual model – is the best or only solution.[citation needed] This usually works well for those who are transsexual, but is not the solution for other transgender people, particularly genderqueer people who do not identify as exclusively male or female. Instead, therapists can work with their transgender clients to support them in whatever steps they choose to take to transition, or support their decision to not transition, while also addressing their clients' sense of congruence between gender identity and appearance.[6]
Physical healthcare
Medical and surgical procedures exist for transsexual and some transgender people. (Most categories of transgender people as described above are not known for seeking the following treatments.) Hormone replacement therapy for trans men induces beard growth and masculinises skin, hair, voice and fat distribution. Hormone replacement therapy for trans women feminises fat distribution and breasts. Laser hair removal or electrolysis removes excess hair for trans women. Surgical procedures for trans women feminise the voice, skin, face, adam's apple, breasts, waist, buttocks and genitals. Surgical procedures for trans men masculinise the chest and genitals and remove the womb andovaries and fallopian tubes. The acronyms "GRS" and "SRS" refer to genital surgery. The term "sex reassignment therapy" (SRT) is used as an umbrella term for physical procedures required for transition. Use of the term "sex change" has been criticized for its emphasis on surgery, and the term "transition" is preferred.[1][64] Availability of these procedures depends on degree of gender dysphoria, presence or absence of gender identity disorder,[65] and standards of care in the relevant jurisdiction.
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