Individuals diagnosed with Gender Identity Disorder (GID) have a strong and persistent desire to be the opposite of the sex they are assigned. They sometimes may insist that they are of the other sex and complain of being uncomfortable about being their assigned sex. This strong and persistent desire causes significant distress or impairment in social, occupational and familial functions. The onset of cross-gender mannerisms may begin as early as 2 years old. Many children will go through a “phase” of confused identity and will then proceed to normal adulthood. Others may continue to have a strong desire to become the other sex and may even undergo sex-reassignment surgery as adolescents or adults.


Symptoms / Diagnoses


An individual with GID has a strong and persistent cross-gender identification, which as not merely a desire for any perceived cultural advantages of being the other sex.


In children, the disturbance is manifested by four (or more) of the following:

  • Repeatedly stated desire to be, or insistence that he or she is, the other sex
  • In boys, preference for cross-dressing or simulating female attire in girls, insistence on wearing only stereotypically masculine clothing
  • Strong and persistent preferences for cross-sex roles in make–believe play or persistent fantasies or being the other sex
  • Intense desire to participate in the stereotypical games and pastimes of the other sex
  • Strong preference for playmates of the other sex


In adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the other sex, frequent “passing” as the other sex, desire to live or be treated as the other sex, or the conviction that he or she has the typical feeling and reaction of the other sex.


An individual with GID experiences persistent discomfort with his or her sex or feels a sense of inappropriateness in the gender role of that sex.


In children, the disturbance is manifested by any of the following:


  1. In boys, assertion that his penis or testes are disgusting or will disappear or assertion that it would be better not to have a penis, aversion toward rough-and-tumble play, and rejection of male stereotypical toys/ activities
  2. In girls, rejection of urinating in a sitting position, assertion that she has (or will grow) a penis, assertion that she does not want to grow breasts or menstruate, or marked aversion toward normative feminine clothing


In adolescents and adults:


  • The disturbance is manifested by symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex.
  • The disturbance is not concurrent with a physical intersex condition.
  • The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.



Young boys with Gender Identity Disorder are preoccupied with feminine toys and activities. They enjoy playing with dolls, dressing up in feminine clothing, and emulating maternal roles. They avoid traditional boys’ activities like wrestling, playing ball, or playing with cars and trucks.


Young girls with Gender Identity Disorder often display negative reactions to normal girl activities. They tend to play with boys and engage in traditional boy games (e.g., playing with cars and trucks, shooting hoops, and rough-and-tumble play). They refuse to wear dresses and other feminine clothing.


Children with this disorder often express unhappiness about their assigned sex. This distress frequently interferes with daily activities. As children get older, they have trouble developing relationships with peers of the same sex. As the disorder becomes more noticeable, many children will get teased and avoid social/school functions.


Adults with Gender Identity Disorder have a strong desire and preoccupation to live as the other sex. They feel uncomfortable and awkward about their sexual assignment. At times they will adopt the social role of the other sex and cross dress either in public or private. Some will go to the extent of undergoing hormonal/surgical manipulation. This constant preoccupation with being the other sex interferes with social, occupational, and familial relationships.


Individuals with Gender Identity Disorder may attempt suicide and/or acquire substance-related disorders. They may also be at risk for Generalized Anxiety Disorder, Personality Disorders, and Depression.

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