A 30-year-old individual assigned female at birth reports a persistent and strong identification as male since childhood, significant distress with female secondary sexual characteristics, and wishes to be referred to with male pronouns. There is no co-occurring psychotic disorder. Per DSM-5, the appropriate diagnosis is:

• A Transsexualism (ICD-10)
• B Ego-dystonic sexual orientation
• C Personality disorder with gender disturbance
• D Gender Dysphoria ✓

Explanation

DSM-5 uses the term Gender Dysphoria to describe the clinically significant distress arising from an incongruence between one's experienced/expressed gender and assigned sex at birth. The diagnosis requires a minimum of 6 months of marked incongruence and significant distress or impairment. DSM-5 deliberately shifted from 'Gender Identity Disorder' to reduce stigma while maintaining clinical recognition for those who need gender-affirming care. ICD-11 has further revised this to 'Gender Incongruence' placed in a non-mental-disorder chapter. 'Ego-dystonic sexual orientation' is an outdated ICD-10 concept; personality disorder is not appropriate here.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.