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What happens when someone is born a woman but feels like they should be a man? In this lesson, we’ll look closer at gender identity disorder, its symptoms, and changing views on it as a mental disorder.

Gender Identity Disorder

In 1993, Brandon Teena was raped and murdered because his friends found out that he was born Teena Brandon. The man they’d been hanging out with, they discovered, was born a woman and they reacted violently to that news. In psychological terms, Brandon Teena had gender identity disorder, a psychological disorder that involves identifying with the opposite sex rather than the one a person was born as.Gender identity disorder can be viewed as a discrepancy between sex and gender. Sex is based on the genitalia that you are born with: someone with a vagina is a woman, while someone with a penis is a man.

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On the other hand, gender is the sex with which you mentally identify.In most people, sex and gender match: women feel like women and men feel like men. But in someone with gender identity disorder, their sex and gender are different.

This can lead to people feeling like they are trapped in the wrong body. Brandon Teena, for example, had the sex of a woman but the gender of a man.

Diagnosis

Imagine that you are a psychologist and someone comes to see you. This person was born a woman, but dresses as a man and identifies himself as a man.

He wants to go through sex reassignment surgery to become a man physically as well as mentally and emotionally, and his doctor has asked that he see you as part of a pre-operation procedure.Most psychologists use a book called the Diagnostic and Statistical Manual for Mental Disorders, or DSM for short, to diagnose patients with mental disorders like gender identity disorder. The DSM is on its fifth version, called the DSM-5. However, the fourth edition, the DSM-IV, is more commonly used. So you’re using the DSM-IV and you look up gender identity disorder. There’s a checklist there of the symptoms of the disorder.

It is:

  1. Persistently associating with the opposite sex. This identification should be mental and emotional and not tied to wanting to have the advantages of the opposite sex. For example, if your patient wanted to be a man merely because men are more respected and get paid better, you could not diagnose him with gender identity disorder.
  2. Feeling uncomfortable with your physical sex.

    Your patient, like other people with gender identity disorder, feels like he was born in the wrong body and is not comfortable with his female sex organs.

  3. The patient was not born with both sex organs. Sometimes, people are born with both male and female sex organs. A person who was born intersex has other biological explanations underlying their gender confusion and, therefore, is not considered to have gender identity disorder.
  4. The condition causes distress or impairment.

    If your patient is upset and/or is unable to succeed in his job or in social situations, they are experiencing distress and/or impairment.

Historical and Changing Views

Twenty years ago, when Brandon Teena was murdered, little was known about people with gender identity disorder. Then, as with most of history, people who were different from the norm were automatically seen as sick or deviant.

For example, until the late 1980s, homosexuality was largely considered to be a mental disorder. In addition, premenstrual dysphoric disorder, a type of very severe PMS, has been added and taken out and added back in to the DSM several times. Clearly, history and society play a large role in what is considered to be a psychological disorder.Today, science has shown that some people actually are born with the sex organs of one gender, but that certain areas of their brains, intolerance for some sex hormones and certain genes, all point them towards identifying with the other gender. The term transgender has become popular as a non-judgmental term for persons who identify with one gender even though they have the sex organs of the other gender.There are several arguments in recent years that have been made against gender identity disorder as a mental illness.

First, diagnosing the condition as a ‘disorder’ can cause discrimination and implies judgment. Next, because there is a biological basis for people to be transgendered, some people argue that it is not a mental disorder at all and should not be included in the DSM.Finally, one of the key criteria for gender identity disorder is that it causes distress or impairment. Many people argue that the distress and impairment is a result of society’s unwillingness to accept transgendered persons, not a result of the condition of being transgendered.In response to the criticism that the term gender identity disorder is judgmental, the new DSM-5 has replaced it with a new mental illness called gender dysphoria.

Gender dysphoria is very similar to gender identity disorder. The only major difference is that gender dysphoria is only diagnosed in people who feel significant distress or impairment as a result of their gender identity, not as a result of society’s view of their gender identity. In reality, of course, it is difficult to figure out the cause of distress or impairment.

Lesson Summary

Gender identity disorder is a psychological disorder that involves identifying with the gender opposite of the sex you were born. There are many criticisms of gender identity disorder as a mental illness, including the fact that it is discriminatory towards transgendered persons.

Learning Outcomes

After you have viewed this lesson, you should be able to:

  • Describe gender identity disorder
  • Differentiate between sex and gender
  • Discuss what the DSM is and tell which version is used more
  • List the symptoms for gender identity disorder
  • Recall the term transgender and illness called gender dysphoria

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