Psychiatry · Eating Disorders and Sexual Disorders

In DSM-5, Gender Dysphoria differs from the ICD-11 concept of Gender Incongruence in which important way?

  • A DSM-5 places Gender Dysphoria under Sexual Dysfunctions; ICD-11 retains it under personality disorders
  • B Both require a minimum 6-month duration but differ only in age cut-off criteria
  • C DSM-5 requires clinically significant distress/impairment (dysphoria) as a criterion; ICD-11's Gender Incongruence does not require distress and is placed under Sexual Health conditions, not mental disorders
  • D ICD-11 requires surgical confirmation; DSM-5 does not
Correct answer: C. DSM-5 requires clinically significant distress/impairment (dysphoria) as a criterion; ICD-11's Gender Incongruence does not require distress and is placed under Sexual Health conditions, not mental disorders

Explanation

ICD-11 made a landmark change by relocating Gender Incongruence from the mental disorders chapter (where it was in ICD-10 as 'Transsexualism') to a new chapter on 'Conditions Related to Sexual Health,' recognizing that gender incongruence per se is not a mental disorder. Crucially, ICD-11 does NOT require distress or impairment as a necessary criterion — it only requires a marked incongruence between experienced gender and assigned sex. DSM-5, in contrast, retains 'Gender Dysphoria' as a diagnosis specifically requiring clinically significant distress or functional impairment. This difference has significant implications for insurance coverage and de-stigmatization.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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