To receive a diagnosis of Gender Identity Disorder, a person must meet two criteria. The person must exhibit a "strong and persistent cross-gender identification" and display a "persistent discomfort with his or her sex or sense of inappropriateness in the gender role of that sex," according to the Diagnostic and Statistical Manual of Mental Disorders.

"Trans individuals are uncomfortable in receiving a diagnosis, feeling that it's apologizing and saying they're diseased," says Matthew Skinta, a clinical psychology graduate student at Kent State. "There are others that really take a lot of comfort in feeling like there's a label and that this is a phenomenon that they're not alone in."

The majority of children diagnosed with GID grow out of the diagnosis by adolescence. Of those who do not or are diagnosed in adulthood, few proceed with sex-reassignment surgery. Though there are no recent U.S. studies, a European study suggests around one in 30,000 adult males and one in 100,000 adult females seek sex-reassignment surgery, according to the Diagnostic and Statistical Manual of Mental Disorders.

Patients are encouraged to try nonsurgical means of feeling more comfortable with themselves, says Skinta. If the individual is still unhappy, he or she must complete years of therapy to ensure understanding of the sex-reassignment procedure and consequences.

"People are treated differently," says Skinta. "Obviously, whether or not doors are held open, or who defers to you, or whether or not someone starts a fight with you at the bar -- all of these things vary according to your gender presentation."

Prior to surgery, an individual must also complete a year of the real-life test of living as the opposite gender. But the surgical procedures are becoming more successful. Operations for sex-reassignment surgery for male to female transsexuals have been done for decades, but quality outcomes for female to male surgery is a new accomplishment in the field, Skinta says.

In general, there is more research on GID in males than in females. Skinta says this could explain why it is presumed that there are more males with the disorder.

Suggested Reading:

• Middlesex: A Novel by Jeffery Eugenides
• Venuses Penuses: Sexology, Sexosophy, and Exigency Theory by John Money
• Myths of Gender: Biological Theories About Women and Men by Anne Fausto-Sterling

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