Genderdysphorie is characterized by a strong identification with the opposite sex; those concerned believe to be the victim of a biological error and feel cruelly imprisoned in a body that does not fit their subjective gender identity. People with the most radical expression of Genderdysphorie are called transsexuals.
Genderdysphorie is characterized by a strong identification with the opposite sex; those concerned believe to be the victim of a biological error and feel cruelly imprisoned in a body that does not fit their subjective gender identity. People with the most radical expression of Genderdysphorie are called transsexuals .. sex, gender and gender identity and gender are not the same. Sex refers to the biological status of a person: male, female, or Gender Queer. Gender identity refers to sex, from which a person feels sexually attracted. Gender identity principle means the perceived sense of what sex you belong, d. h. whether people view themselves as male, female, transgender or describe themselves quite differently. Gender role is the objective, public expression of gender identity and includes everything people say and do to and to show himself other the extent to which they are the gender with which they identify. The gender role behavior is governed by the respective traditional notions of masculinity and femininity, where there is a growing cultural acceptance that some people do not want male and female fit or not necessarily fit into the traditional dichotomy. In Western cultures is non-gender-conforming (tomboyish) behavior in young girls (the i. General. Is not considered a disorder of sex) rather tolerated as unmanly or “Sissi-like” behavior in boys. Many boys like to play girls or mother and try it on the clothes of her sister or mother. This behavior is usually part of normal development. A mismatch with gender in children is not considered a malfunction and remains rarely persist into adulthood or leads to gender dysphoria, even if the probability of not matching boys is greater to be homosexual or bisexual. Gender dysphoria In most people are biological (innate) gender, gender identity and gender role congruent. However, in people with a Genderdysphorie there is a certain contradiction between innate gender and gender identity. Gender incongruence itself is not considered a failure. However, if the perceived discrepancy between the innate sex and perceived gender identity caused distress or impairment in a significant way to diagnose gender dysphoria may be appropriate. Suffering is usually a combination of anxiety, depression and irritability. People with severe gender dysphoria, which are often referred to as transsexuals, can cause serious, disturbing and long-term symptoms and have a strong desire to change her body medically and / or surgically to adjust their body stronger gender identity. This state to call a “Genderdysphorie” may increase the suffering; Patients should be informed that the term is never interpreted judgmental. Transsexualismus occurs in about 1 of 11,900 males and 1 female of 30,000 births. Some scholars argue that this diagnosis is primarily a medical condition similar to disorders of sex development, and not generally a mental disorder. Conversely, some members of the transgender community also consider extreme forms of Nichtübereiinstimmung with sex simply as a normal variant of human sexual identity and gender expression. Although etiology Biological factors (eg. as Geschlechtskomplementierung, prenatal hormonal milieu) largely determine the gender identity, but it is the creation of a safe, non-conflicting gender identity and gender role by social factors (eg., by the nature of the emotional attachment of parents to each other and their relationship to the child). Some studies show a higher concordance rate for gender dysphoria in monozygotic twins than in dizygotic twins, suggesting that there is a hereditary component. Rarely is transsexuality of ambiguous genitals (intersex conditions [disorders of sexual development]) or a genetic aberration (z. B. Turner’s syndrome, Klinefelter’s syndrome) associated. Are sex designation and education confusing (z. B. in unequivocal elements genitalia or genetic syndromes that alter the appearance of the genitalia as Androgeninsensitivitätssyndrome), allows children with regard to their gender identity and gender roles are uncertain. What is the role environmental factors in this case, is controversial. Are sex designation and education but consistent, even the existence of unknown sex characteristics can not influence the gender identity of a child often. Symptoms and discomfort symptoms of gender dysphoria in children gender dysphoria in childhood is often manifested at the age of 2 to 3 years. Children Tuen often include you prefer clothes of the opposite sex (cross-dressing) They insist to belong to the opposite sex you want to wake up with the opposite sex you prefer to participate in the stereotypical games and activities of the opposite sex you have negative feelings towards her genitals A little girl z can. B. insist it will get a penis and a boy; possibly it urinates even while standing. A boy can fantasize about being feminine and Rauf games and competitions out of the way. He would perhaps sit down while urinating and want to get rid of penis and testicles. In boys, the suffering of the physical changes during puberty often request feminizing somatic treatments during adolescence follows. Most children with Genderdysphorie first be examined between 6 and 9 years of age; at this age is already Genderdysphorie chronisch.Symptome of gender dysphoria in adults Although symptoms of Genderdysphorie or feeling began to be different in most transsexuals in early childhood, to face some until adulthood before. Male-to-female transsexual may as attract the opposite sex and to come until later in life at first to accept her against gender identity. Marriage and military service are common among transsexuals who try before their opposite sex (transgender) feelings run away. Once they accept their opposite-sex feelings, many transsexuals assume a compelling public against sex role. Some male birth transsexuals are content to satisfy a more feminine look and get papers as a woman (z. B. driver’s license), which helps them to work and in society than women to live. For others it comes to serious problems, which include potentially anxiety, depression and suicidal behavior. These problems may be related to social and family stressors associated with the lack of acceptance of behaviors that do not match the sex. Specific diagnosis Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), personality disorders primarily problems with diagnosis in all age groups gender dysphoria is expressed in different age groups. But for the diagnosis in all age groups, the DSM-5 Kritereien require the presence of the following two characteristics: significant mismatch between the innate sex and perceived gender identity (cross-gender identification), which has been available for ? 6 months. Clinically significant distress or functional impairment resulting from this mismatch diagnosis in children addition to the required for family properties have children ? 6 have the following: a strong desire or insistence are to the opposite sex (or any other sex) a strong preference of dressing, as is typical for the other Geechlecht and in girls, the resistance to wearing typical female clothes a strong preference for cross-gender roles in games. A strong preference for toys, games, and activities that are typical of the opposite sex. A strong preference for playmates of the opposite sex a strong rejection of toys, games and activities that are typical of sex, with their innate gender matches a strong dislike of their anatomy A strong desire for the primary and / or secondary sex characteristics, to her perceived gender identity match the identification with the opposite sex can not be limited only to the desire for the perceived cultural advantages of the opposite sex is. Thus, for example, in a boy who wants to be a girl to experience the same special treatment as his little sister, probably no Genderdysphorie vor.Diagnose in adolescents and adults addition to the required for family characteristics, adolescents and adults have ? 1 have the following: the strong desire to get rid of (or in young adolescents to prevent the development of) their primary and / or secondary sex characteristics A strong desire for the primary and / or secondary sex characteristics that correspond to their perceived gender A strong desire the opposite sex (or any other sex) a strong desire to be treated like the opposite sex a strong belief that they have the typical feelings and reactions of the opposite sex The diagnosis in adults focuses on the identification of significant distress or obvious impairment of social, occupational and other important functional areas. The nonconformity with gender alone is not sufficient for diagnosis. Psychotherapy therapy for certain patients motivated, gender cross-hormone therapy and sex reassignment sometimes non-gender-conforming behavior such. B. to dress gegengeschlechtlich, may not require treatment if it is accompanied without concomitant psychological distress or impairment of function. If treatment is needed, their goal is to help the patient to adapt, not dissuade them from their identity. Attempts to change gender identity in adults have not been successful and are now considered unethical. Most transsexuals who require treatment, are born as men who feel the female sex belong and consider their sexual organs and male characteristics in disgust. With the improvement of treatments female-to-male transsexual is increasingly being seen in medical and psychiatric practices, even if the incidence only a third of male-to-female is in Western cultures of transsexuality. The primary objective of transsexuals who seek medical help is not psychotherapy, but a hormone treatment and surgery, which are approaching their physical appearance of their perceived gender identity. having lived the combination of psychotherapy, hormonal readjustment, at least one year in the perceived gender and surgical sex reassignment may be curative if the disorder is properly diagnosed and the medical practitioners adhere to internationally recognized standards for the treatment of gender identity disorders, which in the World Professional Association for transgender Health (WPATH) are available. Although patients are no longer required with gender dysphoria to undergo psychotherapy before gender cross-hormonal and surgical procedures should be considered, psychologists can do the following to help patients to make their decisions. Evaluation and treatment of comorbid disorders (eg depression, substance use disorders) the help patients with the negative effects of stigmatization (z. B. rejection, discrimination) cope help to express their gender as it is pleasant If necessary, the change of gender role and the Coming Out patients facilitate male-to -Ms-transsexuality feminizing hormones in moderate doses (z. B. estradiol transdermal patches 0.1 to 0.15 mg / day) plus electrolysis and other feminizing treatments can adapt to a female Geschlechterro lle stabilize. Feminizing hormones have significant positive impacts on the symptoms of gender dysphoria, often before any visible changes in secondary sexual characteristics occur (eg. As breast growth, decreased facial and body hair growth, redistribution of fat to the hips). Feminizing hormones without psychological support or surgery, are all that some patients need to feel sufficiently comfortable as a woman. Sex change is requested by many male-to-female transsexuals. The surgery involves the removal of the penis and testicles, and the construction of an artificial vagina. Part of the penis is obtained as a clitoris, which is sexually usually sensitive and preserves the ability to orgasm in most cases. The decision to seek a sex change operation, often raises important social problems for patients. Many of these patients are married and have children. A parent or spouse who changed his sex and his gender role will have a significant adjustment problems in all intimate relationships and lose loved ones in this process. In follow-up studies have shown that a geschlechtsumwandelnde operation could help some transsexuals to live a happier, more productive lives; it is therefore justified for highly motivated, properly assessed and treated transsexuals who have lived at least 1 year full-time in the opposite sex role. Usually cases the victims helps the candidate to support groups that can be found in most major cities sind.Frau-to-male transsexual female-to-male patients often ask early after a mastectomy, because it is difficult, in the male gender role to live with a large amount of breast tissue; Breast binding often makes it hard to breathe. Then hysterectomy and oophorectomy can be carried out by androgenic hormones (z. B. Testosteronester preparations 300 to 400 mg i.m. every 3 weeks or equivalent doses of androgen-transdermal patches or gels) after one pass. Testosterone preparations deepen the voice permanently induce more male muscle and fat distribution induce hypertrophy of the clitoris and promote the growth of facial and body hair. Patients can apply one of the following: An artificial phallus (neophallus) can be formed from the transplanted skin from the inner forearm. Leg or abdomen (phalloplasty) placed a micro penis, designed from distant from the pubic mound fat tissue and the testosterone hypertrophied clitoris (metoidioplasty) through surgery particular patient can be helped to achieve a better fit and greater life satisfaction. Female-to-male transsexuals should live, analogous to male-to-female transsexuals, before irreversible gender surgery at least 1 year in the male gender role. The anatomical results of neophallus surgically produced are often functionally and visually less satisfactory than a surgically produced Neovagina in male-to-female transsexuals, which probably leads to fewer demands for a genital her gender OP of woman-to-man transsexuals. Complications are common, especially in method of prolonging the urethra into the neophallus.