Gender incongruence/gender dysphoria and its classification history

Abstract

In this article we discuss the changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification of gender identity-related conditions over time, and indicate how these changes were associated with the changes in conceptualization. A diagnosis of ‘transsexualism’ appeared first in DSM-III in 1980. This version also included a childhood diagnosis: gender identity disorder of childhood. As research about gender incongruence/gender dysphoria increased, the terminology, placement and criteria were reviewed in successive versions of the DSM. Changes in various aspects of the diagnosis, however, were not only based on research. Social and political factors contributed to the conceptualization of gender incongruence/gender dysphoria as well.

Keywords:

• Gender Incongruence
• Gender Dysphoria
• Classification History
• American Psychiatric Association
• Diagnostic and Statistical Manual (DSM)
• International Classification of Diseases (ICD)
• World Health Organization.

Declaration of interest

The second author was chair of the American Psychiatric Association's DSM-5 GID Subworkgroup of the Workgroup on Sexual and GIDs and a member of the WHO’s Working Group on the Classification of Sexual Disorders and Sexual Health, which made proposals on gender diagnoses for the International Classification of Diseases (ICD-11).