Transsexualism: Clinical Guide To Gender Identity Disorder • What Is GID? • Treating Patients With GID • Hormone Therapy • HRT Complications • Sex Reassignment Surgery Treatment Needs Include Psychiatric Comorbidities.

Adults with gender identity disorder (GID)—commonly termed transsexualism—may seek psychiatric assessment and treatment for a variety of reasons. Some—but not all—might be candidates for hormone replacement therapies or sex reassignment surgery (SRS). For those with gender dysphoria, psychological assessment and psychotherapy are suggested and sometimes required. Your role in the GID patient’s gender exploration and transition must be tailored to his or her gender identity and individual circumstances. For patients who are not candidates for surgery or cannot afford it, you may assist in exploring options for living with one’s gender identity. WHAT IS GID? Gender identity disorder is a rare, complex condition in which individuals of unambiguous genotype and phenotype identify with the opposite gender. One in 54,000 individuals are estimated to have GID: * 75 % are biologic males desiring reassignment to female gender (MTF) * 25 % are females desiring to be male (FTM).1 Persons with GID who undergo sex reassignment surgery represent the severe, dramatic end of a wide spectrum of cross-gender identifications and behaviors that DSM-IV-TR (Table 1)2 and the International Classification of Diseases (Table 2)3 have attempted to classify. GID does not describe intersex conditions such as incomplete masculinization or feminization syndromes with ambiguous genitalia