Psychiatric Aspects of Gender Dysphoria

Abstract

Gender dysphoria (GD) refers to the distress resulting from the discrepancy between a person’s gender identity and that person’s assigned gender at birth. The relationship between GD and psychopathology varies depending on the age of onset, and, accordingly, the role of the mental health professional should be considered at different levels: assessment and diagnosis of GD and of co-occurring psychopathologies, addressing to individualized treatment by identifying each person’s specific needs for well-being, and support throughout the gender role change and the whole medical gender-affirming path (puberty blockers, cross-sex hormone therapy, and surgery). The presence of GD within the main classification manuals of mental health disorders is highly controversial. For some, GD should not be diagnosed as a mental illness as the incongruence between gender identity and gender assigned at birth is not pathological in itself. However, some people struggling with their gender identity may need both psychological and medical care due to the distress deriving from GD itself and from social stigma. The present chapter will describe and discuss the main psychiatric aspects related to the care of GD in childhood, adolescence, and adult age in line with international recommendations and guidelines.