Gender dysphoria

Gender dysphoria (GD) refers to persistent discomfort stemming from an incongruence between assigned and experienced gender, as stipulated in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Estimates of prevalence state 4.6 in 100,000 individuals suffer from GD, although referrals to gender clinics worldwide are rising. While GD often co-occurs with affective disorders, severe psychiatric problems, such as schizophrenia and bipolar disorder, are not more prevalent. GD is the result of a complex interaction between multiple genetic and environmental factors, and the exact aetiological mechanisms are largely unknown. Clinical management of adolescents, but especially children, with GD solicits a different approach from management of GD in adults. After gender-confirming treatment, most report significant improvement in GD, psychological symptoms, quality of life, and sexual function. While guidelines for treatment have been outlined, clinical practice will evolve significantly in the light of increasing diversity of treatment requests and greater client autonomy