Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists

William Byne; Dan H Karasic; Eli Coleman; A Evan Eyler; Jeremy D Kidd; Heino F L Meyer-Bahlburg; Richard R Pleak; Jack Pula

doi:10.1089/trgh.2017.0053

Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists

Transgend Health. 2018 May 1;3(1):57-70. doi: 10.1089/trgh.2017.0053. eCollection 2018.

Authors

William Byne^{1

2}, Dan H Karasic³, Eli Coleman⁴, A Evan Eyler⁵, Jeremy D Kidd⁶, Heino F L Meyer-Bahlburg⁷, Richard R Pleak⁸, Jack Pula⁹

Affiliations

¹ Mental Illness Research Education and Clinical Center, James J Peters VA Medical Center, Bronx, New York.
² Department of Psychiatry, Icahn School of Medicine at Mount Sinai and Center for Transgender Medicine and Surgery at Mount Sinai, New York, New York.
³ Department of Psychiatry, University of California, San Francisco, San Francisco, California.
⁴ Program in Human Sexuality, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota.
⁵ Departments of Psychiatry and Family Medicine, University of Vermont College of Medicine, Burlington, Vermont.
⁶ Department of Psychiatry, Division on Substance Use Disorders, College of Physicians and Surgeons of Columbia University, New York, New York.
⁷ Division of Gender, Sexuality, and Health, New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York.
⁸ Department of Psychiatry, Division of Child and Adolescent Psychiatry, Hofstra North Shore-LIJ School of Medicine, Albert Einstein College of Medicine, Zucker Hillside Hospital, Ambulatory Care Pavilion, Glen Oaks, New York.
⁹ Department of Psychiatry, Division of Gender, Sexuality and Health, College of Physicians and Surgeons of Columbia University, New York, New York.

Abstract

Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however, medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinically competent, and culturally attuned care to gender-variant patients, including those who identify as transgender or transsexual or meet criteria for the diagnosis of Gender Dysphoria (GD) as defined by The Diagnostic and Statistical Manual of Mental Disorders (5th edition). The article will also be helpful for other mental health professionals. The following areas are addressed: evolution of diagnostic nosology, epidemiology, gender development, and mental health assessment, differential diagnosis, treatment, and referral for gender-affirming somatic treatments of adults with GD.

Keywords: assessment; gender dysphoria; gender transition; intersex; mental health; psychiatry; transgender.