www.BeTreatedWell.com
Gender Identity
The concept of Gender Identity Disorder dates back to the 1860's when Karl Ulrichs described a "third sex"
individual as someone with a female soul in male body. Interestingly, Ulrichs and other scientists of that era
viewed third sex individuals (and homosexuals) as natural human deviations that were inborn and not
pathological.
An individual is diagnosed with a Gender Identity Disorder when biological sex does not coincide with core
gender identity, E.g., when someone has a female gender identity in a body with male genitals. Usually
biological sex and core gender identity match, but they are two distinct aspects of who we are as individuals:
one is biological and the other is psychological.
Sex is declared at birth from the appearance of the newborns external genitalia, but biologically sex is comprised
of sex-determining genes, sex chromosomes, sex-determining antigen, the gonads, hormones, and internal
structures, in addition to external genitalia. All of these components of biological sex are inter-related
developmentally from the time of conception along with brain development.
Gender identity is a sense of self as male or female, the result of some combination of complex biological and
social processes. Gender identity, including a transsexual gender identity, is firmly established between the
ages of 12 and 36 months, with the onset of cross gender interests usually evident between the ages of 2 years
and 4 years. Not all gender identity confusion in children results in gender identity disorder in adulthood.
A person with a Gender Identity disorder has strong and persistent cross-gender identification which means the
desire to be, or the insistence that one is, of the other gender. This is not merely a desire for any perceived
social or cultural advantage. In addition, there must be symptoms such as a repeated stated desire to be the
other sex, desire to live or be treated as the other sex, the conviction that he or she has feelings and reactions
typical of the other sex.
In addition, the individual with Gender Identity Disorder has persistent discomfort with the assigned sex or
sense of inappropriateness in the gender role of the assigned sex. This would be manifest in symptoms such as
preoccupation with getting rid of primary and secondary sex characteristics and/or a belief that he or she was
born the wrong sex. Accurate diagnosis of Gender Identity Disorder takes specialized knowledge and training.
Though the use of hormones to induce breast growth and sex reassignment surgery dates back to the 1920’s, it
wasn't until Christine Jorgensen’s 1952 sex change that most Americans became aware of transsexuals and
hormonal and surgical treatments for Gender Identity Disorder. These treatments are not widely available and
are not prescribed on demand.
Since 1979 there have been international guidelines regarding standards of care for those with Gender Identity
Disorder, with requirements regarding diagnosis, psychotherapy, and a real-life experience during which a
clinician must be involved. The World Professional Association for Transgender Health(formerly the Harry
Benjamin International Gender Dysphoria Association) Standards of Care state the goal of “lasting personal
comfort with the gendered self in order to maximize overall psychological well-being and self-fulfillment”. The
Standards of Care clearly state that the goal is not to cure the Gender Identity Disorder.
There is no evidence to support claims that Gender Identity Disorder can be changed. Despite reports to the
contrary, numerous research studies have concluded that surgical reassignment in individuals with Gender
Identity Disorder is successful with improvement in subjective satisfaction, occupational improvement, and
psychological functioning. Though Gender Identity Disorder is rare, everyone can benefit from an accurate
understanding of Gender Identity and sex, two distinct aspects of who we are.
Gender Identity
The concept of Gender Identity Disorder dates back to the 1860's when Karl Ulrichs described a "third sex"
individual as someone with a female soul in male body. Interestingly, Ulrichs and other scientists of that era
viewed third sex individuals (and homosexuals) as natural human deviations that were inborn and not
pathological.
An individual is diagnosed with a Gender Identity Disorder when biological sex does not coincide with core
gender identity, E.g., when someone has a female gender identity in a body with male genitals. Usually
biological sex and core gender identity match, but they are two distinct aspects of who we are as individuals:
one is biological and the other is psychological.
Sex is declared at birth from the appearance of the newborns external genitalia, but biologically sex is comprised
of sex-determining genes, sex chromosomes, sex-determining antigen, the gonads, hormones, and internal
structures, in addition to external genitalia. All of these components of biological sex are inter-related
developmentally from the time of conception along with brain development.
Gender identity is a sense of self as male or female, the result of some combination of complex biological and
social processes. Gender identity, including a transsexual gender identity, is firmly established between the
ages of 12 and 36 months, with the onset of cross gender interests usually evident between the ages of 2 years
and 4 years. Not all gender identity confusion in children results in gender identity disorder in adulthood.
A person with a Gender Identity disorder has strong and persistent cross-gender identification which means the
desire to be, or the insistence that one is, of the other gender. This is not merely a desire for any perceived
social or cultural advantage. In addition, there must be symptoms such as a repeated stated desire to be the
other sex, desire to live or be treated as the other sex, the conviction that he or she has feelings and reactions
typical of the other sex.
In addition, the individual with Gender Identity Disorder has persistent discomfort with the assigned sex or
sense of inappropriateness in the gender role of the assigned sex. This would be manifest in symptoms such as
preoccupation with getting rid of primary and secondary sex characteristics and/or a belief that he or she was
born the wrong sex. Accurate diagnosis of Gender Identity Disorder takes specialized knowledge and training.
Though the use of hormones to induce breast growth and sex reassignment surgery dates back to the 1920’s, it
wasn't until Christine Jorgensen’s 1952 sex change that most Americans became aware of transsexuals and
hormonal and surgical treatments for Gender Identity Disorder. These treatments are not widely available and
are not prescribed on demand.
Since 1979 there have been international guidelines regarding standards of care for those with Gender Identity
Disorder, with requirements regarding diagnosis, psychotherapy, and a real-life experience during which a
clinician must be involved. The World Professional Association for Transgender Health(formerly the Harry
Benjamin International Gender Dysphoria Association) Standards of Care state the goal of “lasting personal
comfort with the gendered self in order to maximize overall psychological well-being and self-fulfillment”. The
Standards of Care clearly state that the goal is not to cure the Gender Identity Disorder.
There is no evidence to support claims that Gender Identity Disorder can be changed. Despite reports to the
contrary, numerous research studies have concluded that surgical reassignment in individuals with Gender
Identity Disorder is successful with improvement in subjective satisfaction, occupational improvement, and
psychological functioning. Though Gender Identity Disorder is rare, everyone can benefit from an accurate
understanding of Gender Identity and sex, two distinct aspects of who we are.
Antonia Caretto, Ph.D., PLLC
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www.BeTreatedWell.com
phone: 248.553.9053
phone: 248.553.9053