Talk:Gender dysphoria/Archive 4

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No one is "assigned" a gender at birth.
I must reiterate that some are POV-pushing by attempting to use the term "assigned at birth" modifying "gender". Almost nobody is "assigned" a gender at birth. Reality is that nature fixes gender for huge majority of the population at the time of conception into one of two apparent classifications. While exceptions to this are known to exist, they are called birth defects, and they are extremely rare. Perhaps about 0.05%. Further, nobody 'knows' they are "transgender" (or not) at the time of their own birth; And, I believe that there is no test yet, and certainly no reliable test, to determine at birth whether any given baby will eventually believe himself to be other than the gender his anatomy appeared to be at birth. Google 'assigned definition' to see why the term "assigned" is improper in that context. One rare exception occurs if the gender of the baby is seen at birth to be ambiguous: Under such circumstances, surgery can usually be used to remove the ambiguity, and the decision as to which gender the baby will become can be said to "assign" gender to the baby. 71.222.33.159 (talk) 09:17, 10 February 2017 (UTC)


 * First of all, User:Flyer22 Reborn already responded to you on your Talk page, and User:Jytdog reminds us that a Talk page is not a forum for general discussion of the topic, meaning that your personal thoughts and opinions about how things should be, or what gender assignment, birth defects, transgender people or anything else really are is simply not germane and doesn't belong on the Talk page. So please try to stick to comments about how to improve the article and work to gain consensus with other editors rather than preach at them, and you'll have better success here.


 * In reply to your specific issue about the term "assigned gender": Wikipedia follows the usage found in reliable sources and the generally accepted terms are gender assignment, including the expressions "assigned male at birth" and "assigned female at birth".  So, contrary to your statement, everyone is assigned a gender at birth, and it happens at the moment the doctor says, "It's a boy!" or, "It's a girl!".  That's what Reliable Sources say, so that's what Wikipedia says.  It's as simple as that.  Mathglot (talk) 10:07, 10 February 2017 (UTC)


 * No. In this case, erroneous usage (even if it is claimed to be common) requires that we consider the selection terms themselves to be used in the article.  Last I heard, the Oxford English Dictionary listed over 800,000 words, although 300,000 were archaic.  There are almost always multiple ways to describe a given thing, some good, some bad.  Even the article "Sex Assignment" acknowledges, in its second paragraph, that "Even though the term assignment suggests a decision on the part of the parents or medical professionals...", indicating that it is misleading in that way.  Many other non-misleading words could be chosen:  "Identified", "observed", "classified", "determined", etc.  I'm not objecting to having a reference to "sex assignment" in the article, as a reminder of that specific usage, but better terms should be used primarily.  While Reliable Sources may use that term, due to common usage, nobody seems to have argued against the use of those more-appropriate words.  As for your statement about "assigned male at birth", a good clue about its rare usage can be determined from Google Trends:  It reports not enough data to display, clearly indicating that its (common) usage is recently concocted;  "assigned female at birth" seems to have just barely enough data to display, displaying an initial tiny peak in October 2009.  (I'm not ignoring Jan/Feb 2004, perhaps that is an algorithmic artifact, since Google started that year?)  Anyway, a good indication of bias is that Flyer22 Reborn said in the History of the article, "As for using the term "sex change," that is a horrible idea; did not agree with the IP...."  Contrary to that, the term "sex change" is not an "idea", at least not a recent one: it has apparently existed for over 80 years.   (See "Sex Reassignment Surgery")  And "Sex Change" is also an article on WP, clearly indicating its propriety.   Flyer22 Reborn is clearly displaying his biases and his agenda to manipulate the article away from terminology that is unquestionably correct, but nevertheless is currently disfavored by the Dreaded Political Correctness Police.  (DPCP)   71.222.33.159 (talk) 19:04, 10 February 2017 (UTC)
 * If you don't bring reliable sources (as we define that here in WP ) in your next post and deal with the sources already cited in this article, I will remove your next post and close this thread.  Your analyses of google search results, are not  reliable sources here in WP.   This talk page is not a forum. Jytdog (talk) 19:41, 10 February 2017 (UTC)
 * That sounds like threats and intimidation!  Typical for Wikipedia, I hear.  People think they WP:OWN articles, and can threaten, block, and ban anybody they want, especially those who have contrary opinions.  And ESPECIALLY with articles that touch upon subjects which are affected by Political Correctness.  I guess you forget this is the TALK page, not the article, huh?  Shall I report you to the WP:ANI for your Wikibullying?   71.222.33.159 (talk) 20:29, 10 February 2017 (UTC)
 * Expressing an opinion is fine when that opinion is backed up by reliable sources. That hasn't happened here yet. --Neil N  talk to me 20:35, 10 February 2017 (UTC)

Embarrassing (to Jytdog and Flyer22Reborn) Fact About this Article.

User:Jytdog preaches to us https://en.wikipedia.org/wiki/User:Jytdog that WP:Secondary Sources are VERY important! But notice that User:Flyer22 Reborn cites Note 45 of the main article, which is a primary source, and he uses its embarrassingly-frequent usage of the term "sex affirmation surgery". In that one document, the term is used a whole 19 times. Why should that document define things here? After all, a person who wanted to push POV could select a document which uses HIS preferred term. But do the Google search for "Sex change surgery", and you get 388,000 results. Do the search for "sex reassignment surgery", and you get 438,000 results. Do the search for "sex affirmation surgery", and you get 21,200 results. To the search for "sex confirmation surgery", and you get 3,750 results. I contend that "sex change surgery" and "sex reassignment surgery" are, by far, much more popular. And, of course, it is obvious that things like "sex affirmation surgery" is a Political-Correctness-pushed invention. Check Google Trends, and it doesn't have enough data to show a result for the "affirmation" or "confirmation" combinations, but you do get valid data when searching for "sex change surgery" and "sex reassignment surgery". Ergo, the people on this Article, trying to bring it back to using "sex affirmation surgery", are clearly pushing POV. I can, and will, find cites for that, but given these Google results, that will be quite easy. What will be harder will be getting those people who think they WP:OWN this article to quiet down and to stop pushing their peculiar POV. 71.222.33.159 (talk) 06:20, 11 February 2017 (UTC)


 * I have removed references to "assigned" sex or gender in the article. The meaning of the sentences involved were clear without that word; using "assigned" added confusion.   75.175.96.6 (talk) 08:02, 12 February 2017 (UTC)


 * I have changed a few references of "gender identity", to "desired gender", where the prior usage falsely implies that desire changes fact. I do not change all instances, since not all examples have this implication.  I am complying with WP:BRD.  Other editors are not "discussing".  75.175.96.6 (talk) 08:51, 12 February 2017 (UTC)


 * A Reliable Source, the Chicago Tribune, refers both to "Sex Change surgery" and "sex reassignment surgery". http://www.chicagotribune.com/news/83461403-157.html    I will make the corresponding edits; Usage of "sex affirmation surgery" is a much more rarely used Politically-Correct neologism that is not NPOV and misleading:  The surgery itself doesn't "affirm" anything; it changes physical facts.   75.175.96.6 (talk) 08:58, 12 February 2017 (UTC)
 * Thus far you are a) not dealing with the pile of reliable sources supporting the current content and b) not bringing any new sources that comply with WP:MEDRS, which is the guideline for sourcing content about health (popular press like the Trib is not OK.). You are the one who wants to make changes; the WP:BURDEN is on you, and no one else, to provide sources and policy-based arguments based on them.  Jytdog (talk) 09:02, 12 February 2017 (UTC)

The IP talks about my supposed biases above, even though, in the past on this very talk page, I have been accused having a bias against transgender people for sticking to our policies or guidelines. One such matter concerned whether or not to move this article away from the "Gender identity disorder" title. No matter what I do on topics like these, someone will suspect bias on my part.

As for use of "sex assignment" or "gender assignment," those are the terms that are most common today for a person not identifying with the sex/gender they were thought to be at birth; we should be using them. As for "sex change," if we go by some professional thoughts on the matter, "sex change" is inaccurate because people do not really change what you refer to as "biological sex" (if "biological sex" is strictly interpreted to mean chromosomes). If we go by some transgender arguments on the matter, "sex change" is inaccurate because some brain anatomy research indicates that some transgender people are biologically the sex they identify as. (I should note that such research is sometimes debated among researchers because these same type of brain scans controversially indicate that a number of gay men have brains similar to women and a number of lesbian women have brains similar to men.) Flyer22 Reborn (talk) 23:22, 12 February 2017 (UTC)

Also, IP, I'm a "she," not a "he." Flyer22 Reborn (talk) 05:43, 13 February 2017 (UTC)
 * As for this statement:

If we go by some transgender arguments on the matter, "sex change" is inaccurate because some brain anatomy research indicates that some transgender people are biologically the sex they identify as.

As for the second use of the word some in that statement, why only some transgender people?? Georgia guy (talk) 15:19, 13 February 2017 (UTC)
 * almost no disease or condition is homogenous. you may want to read Causes of transsexuality. Jytdog (talk) 17:44, 13 February 2017 (UTC)


 * "Some" because there is no research that indicates or proves it to be a majority or "all" case. And let us not forget that transgender can be a broad term. Flyer22 Reborn (talk) 03:33, 15 February 2017 (UTC)

Comments through edit notes
User:Florian Blaschke and User:Flyer22 Reborn knock it off. You are cluttering up my watchlist with this behavior. If you want to discuss content do it here. Jytdog (talk) 17:39, 20 May 2017 (UTC)


 * Sorry about that, Jytdog. I was employing a single use of WP:Dummy edit. It was a simple statement that I did not feel the need to address on the talk page, especially since Florian Blaschke is aware that I do not like when editors engage in WP:Editorializing. I was not going to have a full discussion via edit summaries, which is against WP:Dummy edit. Flyer22 Reborn (talk) 16:47, 22 May 2017 (UTC)

IP edits to lead etc.
, you have made significant revisions to the article and, as warned on your talk page and in edit summaries, you are currently engaged in an edit war. Please discuss your proposed changes here to get consensus from other editors before continuing. Funcrunch (talk) 05:33, 29 August 2017 (UTC)
 * User decided to ignore this invite, so I've reported to AN3.  Eve rgr een Fir  (talk) 05:46, 29 August 2017 (UTC)


 * It's disruption, pure and simple. Something like this needs no discussion. I requested page protection. Flyer22 Reborn (talk) 19:17, 29 August 2017 (UTC)
 * For clarification, that edit was from a different IP than the one who was edit-warring earlier. Funcrunch (talk) 19:24, 29 August 2017 (UTC)
 * I'm sure it's the same editor. The person is an IP hopper. Flyer22 Reborn (talk) 20:00, 29 August 2017 (UTC)


 * If they are two different people, the timing and IP ranges are suspicious. In cases like these, an IP will get so frustrated after being repeatedly reverted that they will make an edit like this one. But the IP is free to defend his/her/their name here on this talk page. Flyer22 Reborn (talk) 20:21, 29 August 2017 (UTC)

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Too encompassing, overlap
I think the introduction is overlapping a bit too much with transgenderism and additionally is asserting things it can't support. Correct me if i'm wrong but dysphoria is still not well understood and, as with many new disorders, the literature is constantly changing. And like many mental disorders, it is defined by its symptoms and not by its cause.

However the intro not only folds in a cause but one without proof; "as a result of the sex and gender they were assigned at birth." Confusingly, the next sentence says "these cases" as if the previous sentence is not discussing gender dysphoria in general but a subclass of gender dysphoria (considering that the sentence ends with "and the person is transgender", it sounds as if the writer is not describing gender dysphoria but transgenderism, which is discussed in the second paragraph as well).

Honestly, i think the first two paragraphs need to be entirely rewritten. I think a good replacement should contain something similar to the following:

"Gender dysphoria (formerly known as Gender Identity Disorder, or GID) is a mental disorder characterized by prolonged distress with a person's gender."

Optionally you could include a sentence like

"This may include discomfort and/or deattachment with primary and/or secondary sexual characteristics and/or discomfort with gendered perceptions of the affected person."

although its been a while since ive looked at the DSM. If anyone has a link to an online version let me know, otherwise illl probably try to rent a copy. Either way, to my knowledge a big difference between gender dysphoria and GID is the lack of an identification requirement, otherwise non-transgender sufferers would be left out.

I do think transgenderism is related enough to warrant mention on this article but im not sure where. I also think a section of theoretical causes of gender dysphoria is warranted. But to my knowledge gender dysphoria isnt a subset of transgenderism, nor visa versa, and the intro should avoid overexplaining.

Thoughts? Cgottsch (talk) 23:02, 9 September 2017 (UTC)


 * I'm not completely following your line of thinking. Are you suggesting that people with gender dysphoria are not transgender? Maybe part of the misunderstanding (me not completely following what you are stating) is due to the fact that the term transgender is not always defined the same way? Its meaning can be strict (as it often is in common discourse) or it can be broad. See the Transgender article. Also see the Transsexual article. Gender dysphoria is an aspect of those topics, and those with gender dysphoria are labeled transgender. Going by some definitions/concepts of transgender, however, not all transgender people have gender dysphoria. We refrain from adding "is a mental disorder" because the DSM-5 has made an effort to de-stigmatize gender dysphoria, which is mentioned in the lead and lower in the article. I do not think your proposed wordings would be improvements, especially the second, longer one. And either way, we should be sticking to what the sources state. Flyer22 Reborn (talk) 01:31, 10 September 2017 (UTC)


 * We've also refrained from using the "formerly known as gender identity disorder" wording because the term gender identity disorder is still used, although a lot less these days, and because the criteria is a bit different for gender dysphoria. Flyer22 Reborn (talk) 01:36, 10 September 2017 (UTC)


 * With this edit, I changed "In these cases" to "In this case." Flyer22 Reborn (talk) 01:46, 10 September 2017 (UTC)

I reverted an IP, per what I stated above in this section. If Cgottsch is the IP, then Cgottsch needs to sign in and make their case with WP:Reliable sources. Scholarly ones. Anyone else wanting to retain this removal, even though the transgender mention is crucial for explaining what gender dysphoria is, needs to make their case with reliable academic sources as well. No WP:Original research. Proposed alternative wording supported by one or more academic sources would also be welcomed since what significance being transgender has to gender dysphoria should be in the lead. Otherwise, the other transgender mentions in the lead are without good context. Flyer22 Reborn (talk) 22:09, 30 October 2017 (UTC)

And if we are speaking in terms of gender dysphoria in children, it's true that the vast majority of the children cease to have gender dysphoria before adulthood and instead later identify as lesbian, gay or bisexual, but, during evaluation of the children and reports on the research, they very likely fell under under the "transgender children" category. Flyer22 Reborn (talk) 22:29, 30 October 2017 (UTC)

Using Wikipedia to further political causes
It is a common tactic in political discussions to label gender dysphoria as a disease. The American Psychiatric Association clearly says otherwise in the DSM-5 when they included the emphatic statement "gender nonconformity is not in itself a mental disorder".

The APA tells us that gender dysphoria is not a disease. Saying otherwise violates the policy of No Original Research by substituting the decision of the APA with the authors research. It violates the policy of Neutral Point of View by taking up the point of view of those who want to denigrate transgender people. It violates the policy of Verifiability by stating false information.

The APA changed its diagnosis of gender dysphoria in 2013, making gender dysphoira a different diagnosis from gender identity disorder. They are not synonyms according to the APA and wikipedia is not the place to push personal views that are unsupported by the community of psychiatrists. — Preceding unsigned comment added by 73.53.33.199 (talk) 06:24, 15 November 2017 (UTC)


 * User:73.53.33.199 please read the very, very long discussion at Talk:Gender_dysphoria/Archive_3. Jytdog (talk) 06:30, 15 November 2017 (UTC)


 * Jytdog Please do not ever enter into an edit war with anyone who is stating their reasons with a pathetic response of "Nope", ignore the stated reasons following Wikipedia polices and threaten that person with the edit war warning. Then follow that up with pointing to a discussion that only agrees on moving the article to "Gender Dysphoria". Your response is completely unacceptable behavior. If you do not wish to discuss this subject in perpetuity then I suggest that you stop editing Wikipedia and stop watching this page specifically.
 * Let me know if and when you ever wish to address the valid points of wikipedia editors. I no longer expect that of you, but there is always hope. Until then, go ahead and request protection for this page. The only one who is abusing the wikipedia system here is you. — Preceding unsigned comment added by 73.53.33.199 (talk) 07:29, 15 November 2017 (UTC)
 * Please let us all know when you have reviewed the very long discussion linked above. Your claims of how the content came to say what it says, are incorrect. Jytdog (talk) 23:39, 15 November 2017 (UTC)


 * IP, if I or other editors were trying to present gender dysphoria as a disease or hammer home the idea that it is a disorder, do you think I would have made this edit which removed text that framed the condition as a psychiatric disorder? That stated, the condition is still is in a manual called the "Diagnostic and Statistical Manual of Mental Disorders." And, yes, the American Psychiatric Association (APA) states that "gender nonconformity is not in itself a mental disorder," but it also states that "the critical element of gender dysphoria is the presence of clinically significant distress associated with the condition." The key element to a disorder (well, the main and usual key element anyway) is distress, and gender dysphoria is defined by distress. The DSM-5 renamed "gender identity disorder" to "gender dysphoria" to reduce the stigma associated with the word disorder and transgender issues. So the condition got a rename; it also got a slight change in criteria. Gender identity disorder and gender dysphoria are the same exact thing, but they are considered synonymous for the most part. Flyer22 Reborn (talk) 18:29, 17 November 2017 (UTC)

Semi-protected edit request on 19 December 2017
Sex is determined by doctors, not assigned. Every instance of "were assigned at birth" should be replaced by "have". Every instance of "assigned sex" should be replaced by "sex". Every instance of "people assigned female at birth" should be replaced by "females". Every instance of "people assigned male at birth" should be replaced by "male". Every instance of "male assigned at birth" should be replaced with "male". I hope you do understand that an article about a mental disorder is a place of science, not political correctness. I am not actively trying to be politically incorrect. Dieknon (talk) 14:08, 19 December 2017 (UTC)
 * Red information icon with gradient background.svg Not done: please provide reliable sources that support the change you want to be made. Sex assignment at birth is a widely used phrase throughout the literature, including medical literature.  Eve rgr een Fir  (talk) 15:53, 19 December 2017 (UTC)

Proposed change
In my opinion, the first two sentences are formulated in an unnecessarily imprecise and awkward, and possibly slightly misleading, way. To start (as all sources on the topic will tell you), the distress is not directly the result of a person's assigned sex, but specifically of a mismatch, namely between the externally assigned gender and the experienced gender identity. So why not simply write that? Then, unlike what the current text suggests, the problematic sex assignment is not necessarily identical with that assigned at birth. See, for example, the famous example of "John/Joan" (see also the article on Gender identity, section Nature vs. nurture). Finally, the second sentence talks about "these cases", which lacks a clearly identified antecedent in the first sentence. Below are the current text and a proposed replacement. 50.255.8.233 (talk) 20:03, 28 July 2017 (UTC) Current text:

Gender dysphoria or gender identity disorder (GID) is the dysphoria (distress) a person experiences as a result of the sex and gender they were assigned at birth. In these cases, the assigned sex and gender do not match the person's gender identity, and the person is transgender. Proposed text:

Gender dysphoria or gender identity disorder (GID) is the dysphoria (distress) a person experiences as a result of a mismatch between their gender identity as personally experienced and the gender as assigned to them by their environment (family, friends, teachers, ...), usually stemming from sex assignment at birth. A person whose gender identity does not match this assigned gender is transgender.
 * Red information icon with gradient background.svg Not done: please establish a consensus for this alteration before using the template. jd22292 (Jalen D. Folf) (talk) 15:09, 29 July 2017 (UTC)
 * How does one go about to establish a consensus? Is there something like a "Call for Consensus"? 50.255.8.233 (talk) 17:34, 29 July 2017 (UTC)
 * I think you made a reasonable argument. I don't think it's necessary to create a new section just to establish consensus unless that breaks some Wikipedia rule or other; we can discuss it here. As to your proposed text, I would suggest tweaking and trimming it somewhat, as follows:
 * Revised proposed text:
 * Revised proposed text:


 * Gender dysphoria or gender identity disorder (GID) is the dysphoria (distress) a person experiences as a result of a mismatch between their gender identity and the gender attributed to them by others, usually stemming from sex assignment at birth. A person whose gender identity does not match this assigned gender is transgender.
 * Funcrunch (talk) 17:47, 29 July 2017 (UTC)
 * Thank you. I appreciate your effort to simplify the wording but have two minor issues with your revision. The first is that "by others" is vague—the distress arises when the transgender person experiences social pressure to conform to the attributed gender, which happens only when the "others" are an important part of their immediate environment. So I think "by their environment" is better than "by others". The second issue is that if you use "attributed" in the first sentence—which I think is better here than "assigned"—this should be echoed in the second sentence, "does not match this attributed gender".
 * The Great Leader of our country has decided, in His Unfathomable Wisdom, that it is better for his subjects if they cannot access Wikipedia. The method I use now to edit is only occasionally available to me; the next time I will be able to edit here may be days or even weeks from now. 50.255.8.233 (talk) 18:24, 29 July 2017 (UTC)


 * Regarding the current wording, the reason I have stuck by "sex and gender" is because, as I stated here and here at Talk:Sex assignment, along with the assigned sex, comes the assigned gender. As we know, a person who is assigned male will usually be raised as a boy, and a person assigned female will usually be raised as a girl. Those with gender dysphoria not only express discontent with assigned sex, but also assigned gender. This is why "or" instead of "and" seemed too much like an exception to me. But then again, a transgender person might not have distress about their body; there are transgender people who state that, in terms of the sex and gender distinction, they are fine with their assigned sex because it's the assigned gender that bothers them rather their body and what others view as a male or female body. The aforementioned David Reimer case is a unique case since his original assigned sex/assigned gender was not the issue; it was the sex assignment that came afterward. And since Wikipedia currently defines sex assignment as an "at birth" matter (and so do most other sources), instead of as also being "a later" matter, I'm not sure that we should be challenging the "discontent with both the assigned sex and gender" aspect based on the Reimer case.


 * I think your proposed wording is too wordy. So I prefer Funcrunch's wording to yours. Stating "by environment" without "family, friends, teachers" is vaguer (more vague?) than stating "by others." And stating "family, friends, teachers" to clarify what "by environment" means is too wordy. But we also don't want people thinking that "assignment" means that anyone (such as a friend, acquaintance, etc.) can assign a sex/gender to a person (such as by simply calling the person a male or female, or a boy or a girl)...when what we are talking about is assignment at birth. So I propose dropping "as assigned to them by their environment" and "attributed to them by others." I don't think that either is needed. The following works fine: "Gender dysphoria or gender identity disorder (GID) is the dysphoria (distress) a person experiences as a result of a mismatch between their gender identity and assigned sex or gender. A person whose gender identity does not match their assigned sex or gender is transgender." This wording incorporates "or" so that "sex" and "gender" are either interpreted as synonyms or as distinct, and this covers the aforementioned exceptions. The only issue with this wording may be that it removes "at birth," but readers can click on the Sex assignment article to see "at birth," and sources don't typically support the "usually" wording. The "at birth" portion is simply part of the definition without the "usually" qualifier. This 2017 "Terminological Approaches in the European Context" source, from Cambridge Scholars Publishing, however, reports that the DSM-5 states "usually"; it says, "Individuals with gender dysphoria have a marked incongruence between the gender they have been assigned to (usually at birth, referred to as natal gender) and their experienced/expressed gender." Flyer22 Reborn (talk) 02:13, 31 July 2017 (UTC)
 * If we use the terminology of "assigned gender" (as does the DSM-5 and is increasingly common), your objection of "at birth" being part of the definition (which is only true for the current version of the Sex assignment article in Wikipedia, not in general) disappears. And what better source for "usually" than the DSM-5 itself? For another source, if that should be necessary, the 2016 edition of the book Teaching for Diversity and Social Justice defines gender assignment by: "Gender assignment is the assignment of gender that typically occurs simultaneously with the assignment of sex at birth, ...". [My emphasis by underlining.] 50.255.8.233 (talk) 04:39, 5 August 2017 (UTC)


 * "At birth" is usually included in the definition, and this is what I stated. The aforementioned report on what the DSM-5 states also includes "at birth." The DSM-5 using the word usually does not trump the fact that the literature typically does not include the "usually" qualifier or similar. Furthermore, as been discussed times before at WP:Med, the DSM-5 does not trump what the overwhelming literature reports; it is still subject to the WP:Due weight policy, which is clear that we give most of our weight to what most of the literature states. The term assigned sex sex assignment is more prevalent in the literature than assigned gender gender assignment. So per this and what I stated above, I object to omitting it. In this case, it also makes more sense to use the name of the Wikipedia article instead of its WP:Alternative name. I stand by the proposed wording I made above, but I am willing to change it so that it includes "usually." So I now propose: "Gender dysphoria or gender identity disorder (GID) is the dysphoria (distress) a person experiences as a result of a mismatch between their gender identity and assigned sex or gender, the latter of which are usually assigned at birth." Flyer22 Reborn (talk) 18:41, 6 August 2017 (UTC) Edit: Regarding the prevalence of terminology, regular Google and Google Books show sex assignment as more prevalent, but Google Scholar and Google Ngram are reporting differently. This is why we have WP:GOOGLEHITS and why Google Ngram (as noted in its Wikipedia article) has been criticized. Either way, I still think that "assigned sex or gender" should be retained. Google Trends shows "sex assignment" as more popular. Flyer22 Reborn (talk) 19:31, 6 August 2017‎ (UTC)


 * Or: "Gender dysphoria or gender identity disorder (GID) is the dysphoria (distress) a person experiences as a result of a mismatch between their gender identity and assigned sex or gender. The assignment is usually made at birth."


 * But I think that my proposed wordings flow better without the "at birth" part, and it resolves your issue with the current lead giving the impression that gender dysphoria is solely an "at birth" matter. I understand that you want "assigned sex" removed as well, but I've noted why I don't agree with removing it and am suggesting compromises. Flyer22 Reborn (talk) 18:53, 6 August 2017 (UTC)

If you compare (using Google Trends) "Assigned sex" versus "Assigned gender" you see a completely different picture. But I'm not sure how reliable this is; the flatlining looks suspicious.

My original proposal mentioned "sex assignment". The sole reason for my suggestion to remove this was to resolve the objection to the inclusion of the word "usually". At the moment, any remaining disagreement seems to be on stylistic issues. I still prefer my original proposal; although more wordy, I feel it reads more smoothly than your (Flyer22 Reborn's) alternative proposals. Actually, I think that also User:Funcrunch's revised proposed text is preferable to yours. The issues I had with it were truly minor. 50.255.8.233 (talk) 14:59, 7 August 2017 (UTC)


 * Yes, it seems to be a stylistic issue. I still prefer my proposals. If you look at my first proposal, I only made slight alterations to Funcrunch's proposal; this includes changing "and the gender attributed to them by others" to "and assigned sex or gender" and changing "this assigned gender is transgender" to "their assigned sex or gender is transgender." And I was clear why I prefer my suggested wording. Flyer22 Reborn (talk) 22:10, 7 August 2017 (UTC)


 * Oh, I also cut out "usually stemming from sex assignment at birth." But as we can see, I reconsidered adding "usually" and mentioning "at birth." Flyer22 Reborn (talk) 22:14, 7 August 2017 (UTC)


 * For the record, I am very much against the attempts to water down the parenthetical descriptor of dysphoria with words like "dissatisfaction" or "discomfort". TheValeyard (talk) 21:08, 9 August 2017 (UTC)
 * For the record I am against your use of personal attacks in your edit summaries. There is a HUGE difference between trying to water something down and using the actual, literal definition of dysphoria. We can either a) use the actual definition of dysphoria; or b) remove the parenthetical altogether. I'm removing it because apparently there is an issue with using definitions here. ‡ Єl Cid, Єl Caɱ̩peador  ᐐT₳LKᐬ  00:02, 10 August 2017 (UTC)
 * Further, look at our article on dysphoria which is linked in the text, if you don't agree with dictionary and medical dictionary definitions. ‡ Єl Cid, Єl Caɱ̩peador  ᐐT₳LKᐬ  00:05, 10 August 2017 (UTC)
 * A Wikipedia article is not a reliable source, el cid, but don't worry, that's a rookie mistake. We can look at actual medical sites and see how they describe it, such as WebMD which uses phrasing of "feel strongly" and "severe distress, anxiety, and depression". Or Psychology Today, which says it is "defined by strong, persistent feelings". Look at those words... "strong", "severe". Your edit chooses a watered down...one could go as far as saying milquetoast... characterization of the term that does not meet the accepted medical description. TheValeyard (talk) 00:35, 10 August 2017 (UTC)


 * You're confusing the definitions of dysphoria and gender dysphoria. The issue at question was how to define dysphoria in the parenthetical, not gender dysphoria. As such, I removed 'dysphoria' altogether, it seems to be defining the concept by using its own word. ‡ Єl Cid, Єl Caɱ̩peador  ᐐT₳LKᐬ  00:41, 10 August 2017 (UTC)
 * Yes agree totally. That first sentence is ridiculous. Saying that the distress comes from being "assigned" a gender at birth is insane. In the real world, people are not assigned genders at birth. They exhibit very obvious sexual characteristics (such as a penis or vagina) that correlate to their biological gender. And people recognize that. This incredibly biased language in the article makes it sound like doctors are flipping a coin, and the language also suggests that recognizing a person's gender is what's doing the harm here... which is also insane. There are SO many people who grow up crazy places like San Francisco, in an environment where they are not "gendered," and as adults they are incredibly unhappy and confused. The kids who had to go through this are just now starting to reach adulthood and I know many of them. Failing to recognize a person's gender does far more harm than recognizing it. Much better and more accurate language would be: "Gender dysphoria" is the distress a person experiences as a result of feeling that their gender does not match their biological sex. (replacing comments from User:223.206.167.52 Trackinfo (talk) 08:50, 24 December 2017 (UTC)

Words in the definition of the original proposal were altered by an IP at 17:36, 9 August 2017 in, completely changing the sense of the proposal. This was at 00:51, 10 August 2017‎. Consider double-checking any comments you made between those two times, especially if they were a reaction to words in the original proposal, to ensure that they convey the meaning that you intended. Mathglot (talk) 02:33, 10 August 2017 (UTC)

Off by two orders of magnitude?
This statement in the lead seems off by a factor of 100: "It is estimated that about 0.005% to 0.014% of people assigned male at birth and 0.002% to 0.003% of people assigned female at birth would be diagnosed with gender dysphoria, based on 2013 diagnostic criteria, though this is considered a modest underestimate." Anyone have a copy of DSM-5 handy so they can check this? Mathglot (talk) 00:40, 11 August 2017 (UTC)
 * So, DSM-5 (2013) does indeed make this claim on p. 454, or one similar, in the section on "prevalence". I might quibble with the choice of words "would be diagnosed" as I don't believe the prevalence numbers are limited to those that seek treatment that might result in a diagnosis (it would be useful to settle that question) but the prevalence numbers in the lead do agree with the sentence in the article, which says, "For natal adult males, prevalence ranges from  0.005% to 0.014%, and for natal females, from 0.002% to 0.003%".
 * An interesting consequence of these figures, taken in conjunction with the recent Williams Institute figures on the prevalence of transgender Americans (0.6%), is that only about 1 to 3% of Americans who identify as transgender have dysphoria, or flipping it around, 97–99% do not. It is of course WP:SYNTH to combine the separate figures and thus not admissible, and we'd need an independent source that makes this claim, if we wanted to add it to the article. Mathglot (talk) 08:08, 30 August 2017 (UTC)
 * That would indeed be WP:SYNTH, and that figure (1 to 3%) sounds ridiculously low to me. While not all trans people experience dysphoria, dysphoria is one defining characteristic of being trans. Funcrunch (talk) 14:30, 30 August 2017 (UTC)


 * Well, it's a consequence of the math. Either something is off somewhere, i.e., either the DSM-5 "0.002% dysphoric" is wrong, or the Williams Institute "0.6% tg" is wrong, or we're wrong that 1 to 3% of tg's dysphoric is too low.  They can't all be right. I assumed it was DSM-5, but now I really don't know. Or maybe my math is off, but I don't see it. Mathglot (talk) 09:16, 31 August 2017 (UTC)

Feedback requested from WT:WPMATH and WT:WPSTAT. Mathglot (talk) 11:43, 24 December 2017 (UTC)


 * I too have checked the DSM figures. I haven't checked the Williams Institute figures.
 * As I interpret them, the DSM figures are getting at the probability P(D) of a randomly chosen person having gender dysphoria, while the Williams Institute figures are getting at the probability P(T) of a randomly chosen person being transgendered. The two are not identical. However, they can be related by Bayes theorem:
 * $$P(T) = \frac{P(T|D)}{P(D|T)} P(D).$$
 * It has been claimed above that "dysphoria is one defining characteristic of being trans". This is some statement about P(T|D) and/or P(D|T). There is enough slop in the statement that I (as an ignoramus) wouldn't be surprised if two orders of magnitude could creep in. Nailing it down would require some precise clinical definitions and then data?
 * But since all of this is unallowable synthesis anyway, is it just idle chatter? Mgnbar (talk) 16:14, 24 December 2017 (UTC)


 * If indeed less than 0.02% have gender dysphoria, but more than 0.5% are transgenders, then necessarily (and without Bayes theorem or anything like that) less than 1 out of 25 transgenders have gender dysphoria; in other words, more than 96% of transgenders have no gender dysphoria. This is arithmetics, not probability. If all dysphoria are transgenders, then we just divide and get less than 1 out of 25. Otherwise, still less. Boris Tsirelson (talk) 19:55, 24 December 2017 (UTC)


 * Yes, it is arithmetically possible for both sets of numbers to be correct. The discussion here is asking a more subtle question: How can they be so different, if it's true that "dysphoria is one defining characteristic of being trans"?
 * In my notation, you are effectively computing the ratio P(T|D) / P(D|T) and finding it to be 25 (say). I am dissecting this ratio into its numerator and denominator, in case that helps other editors resolve their cognitive dissonance. (In epidemiology and medical diagnosis, paradoxes often arises from confusion of conditional probabilities.)
 * For example, suppose that "dysphoria is one defining characteristic of being trans" means that every dysphoric person is transgendered. Then P(T|D) = 1. But suppose that P(D|T) = 0.01, because most transgendered people are not dysphoric, because there are other reasons to be transgendered. Then the ratio is 1 / 0.01 = 100 and you have your two orders of magnitude. (N.B. This is a hypothetical example, not informed by any topical knowledge of gender.)
 * Of course, the other explanation to consider is that the studies used different methodology, happened at different times, got different answers due to random variation, etc. In other words, maybe one or both of them is simply wrong. Mgnbar (talk) 20:38, 24 December 2017 (UTC)


 * Mgnbar, Boris, thanks so much for your feedback. It's definitely not idle chatter, even if it would be unallowable synthesis in the article. My underlying question was essentially your "How can they be so different" point above.  I'm still struggling between the possibilities of a) one of them just being wrong, vs. b) different methodologies, definitions, variation, etc.  One doesn't like to assume that highly reputable organizations make an error of that, uh, magnitude, but it does happen. If one of them is wrong, it's DSM. (Note: the DSM figure wasn't 0.02% but 0.002%, but I don't know if that materially changes your argument.)
 * It does sometimes happen that two reliable sources sometimes disagree on matters of fact, and the tag Disputed inline exists to document such cases. Maybe this is the time to place that tag, if and until we can get some resolution of this seeming impasse. Mathglot (talk) 23:12, 24 December 2017 (UTC)
 * Here's a "methodology/definitions" issue I hadn't considered: transition accompanied by HRT and SRS where appropriate, effectively "cures" dysphoria, which is to say, the distress goes away after such treatement in the vast majority of cases. So, in my view, it depends when you measure dysphoria, pre- or post-treatment. Perhaps the apparent contradiction in numbers lies there somewhere?
 * There is, of course, another possibility, namely that my assumption (and that of Funcrunch) that only a tiny percentage of trans individuals have (or had) dysphoria is wrong, but since it's part of the definition, that seems impossible. Mathglot (talk) 23:46, 24 December 2017 (UTC)
 * DSM doesn't seem to cite any sources. Is there an expanded DSM with sources? Boris and I have told you everything that pure math/stats can, I think. Good luck. Mgnbar (talk) 01:17, 25 December 2017 (UTC)


 * It is not surprising to me that the number of transgender people has suddenly and radically increased, since it is now considered acceptable or even fashionable whereas recently it was considered to be a mental illness or sexual perversion. JRSpriggs (talk) 04:46, 25 December 2017 (UTC)


 * Mgnbar, agreed, thanks for your input, and Boris's.
 * One other possibility that should be kept in mind when investigating of the issue, is possible confusion of incidence vs. prevalence. In this case, I don't think it applies, because such a misunderstanding might have skewed the interpretation in the other direction; but it's nevertheless something to keep in mind when looking at this. Mathglot (talk) 05:18, 25 December 2017 (UTC)


 * JRSpriggs: The article Talk page is for discussions about how to improve the article and not a forum for expounding your personal opinions. Further thoughts about your tone deaf comment are in the domain of user behavior, and not germane here; you can find them at your talk page. Cordially, Mathglot (talk) 06:10, 25 December 2017 (UTC)

Management section should include this
https://www.ncbi.nlm.nih.gov/pubmed/8839957/ — Preceding unsigned comment added by 97.104.70.92 (talk) 08:29, 16 January 2018 (UTC)


 * Is the patient actually happy with the treatment? Or is the drug merely bludgeoning him/her into submission? JRSpriggs (talk) 09:20, 16 January 2018 (UTC)


 * It was published in 1996, not 1956. It is safe to assume they weren't strapped down and forced to take the drugs. They wouldn't take the drugs unless they were happy with the treatment. The article ought to include this; it might help somebody. It's also mighty interesting. 97.104.70.92 (talk) 06:48, 27 January 2018 (UTC)


 * Sounds like cherry-picking to me, and we should rely on a preponderance of reliable, secondary sources, not just on one primary source with an outlier result, which if not supported by a few dozen or hundreds of other primary sources, is also a fringe view. And we don't make safe assumptions, we cite. It is interesting. It should not be in the article. Mathglot (talk) 06:28, 4 February 2018 (UTC)

Gender Dysphoria Causes
Currently in the text "Researchers disagree about the nature of distress and impairment in people with GID. Some authors have suggested that people with GID suffer because they are stigmatized and victimized;[19] and that, if society had less strict gender divisions, transsexual people would suffer less.[20]"

This suggest that researchers disagree but only provides one position (and a tertiary source at that with only 10 citations!). That is bad science people.

Proposed edit.

WP:EDITREQ Although some believe that persons with GID suffer with stigmatization and victimization (19); Long term follow up studies found; "The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8–4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8–62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9–8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0–3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls."

135.23.244.37 (talk) 04:38, 9 February 2018 (UTC)
 * A primary source from Sweden? No. See WP:PRIMARY and WP:MEDRS.  Eve rgr een Fir  (talk) 06:41, 9 February 2018 (UTC)

GID =/= Gender Dysphoria. GID defunct diagnosis
Please remove the conflation of GID with gender dysphoria. GID is a defunct and some would say discredited diagnosis:

https://www.glaad.org/blog/apa-removes-gender-identity-disorder-updated-mental-health-guide

92.22.46.211 (talk) 16:35, 14 April 2018 (UTC)


 * We know that the DSM-5 renamed and somewhat re-classified "gender identity disorder" to "gender dysphoria." The article already mentions this. The change in this manual doesn't mean that we are not going to mention "gender identity disorder" in the lead (per WP:Alternative title) and cover it lower in the article. "Gender identity disorder" is treated as a synonym is some sources for "gender dysphoria," albeit a reclassified and updated diagnosis, and most of the research on this topic uses the older term/is about the older diagnosis (because it was used longer). Most of the sources in this article are those that use the older term/refer to the older diagnosis. Flyer22 Reborn (talk) 17:46, 14 April 2018 (UTC)


 * Also, the International Statistical Classification of Diseases and Related Health Problems (ICD) doesn't yet use the term "gender dysphoria" and might soon be using a different term for the diagnosis. Flyer22 Reborn (talk) 17:56, 14 April 2018 (UTC)

___

Semi-protected edit request on 24 June 2018
Change: "{{Infobox medical condition (new)
 * name           = Gender dysphoria
 * synonyms       = Gender identity disorder" to "{{Infobox medical condition (new)
 * name           = Gender dysphoria
 * synonyms       = Gender identity disorder, gender incongruence"

Thank you. 108.245.173.217 (talk) 12:54, 24 June 2018 (UTC)
 * Red information icon with gradient background.svg Not done: please establish a consensus for this alteration before using the {{tlx|edit semi-protected}} template. - FlightTime  ( open channel ) 13:04, 24 June 2018 (UTC)

Establishing a consensus
Gender incongruence is a diagnosis in the ICD-11 that overlaps with gender dysphoria in the DSM-5. Indeed, since the ICD-11 is more popular in non-American countries, it is probably best to at least mention the diagnosis. 108.245.173.217 (talk) 13:13, 24 June 2018 (UTC)
 * It's not about what's more popular. ICD-11 is the future but it will be years before it's implemented. ICD-10-CM is what is officially in use for billing in the United States. DSM-5 is not used for billing and I think it is given too much prominence. Even their mappings to ICD codes are dubious, though at least they did issue a correction changing the F64.1 mapping to F64.0. There isn't really an overlap issue either, because the ICD codings are a complete system that can be used without reference to the DSM. There's no reason to use DSM-5 for anything really since you can just use ICD-10, or in the future ICD-11 when implemented, directly. The real issue is whether the DSM should be treated as the base standard authority for wikipedia articles at all.--67.140.182.177 (talk) 05:32, 27 July 2018 (UTC)


 * IP, what proof do you have that "the ICD-11 is more popular in non-American countries"? Some people keep thinking that the DSM is restricted to the United States, but that is not true. Furthermore, the DSM documents a topic in more detail than the ICD. Flyer22 Reborn (talk) 06:30, 27 July 2018 (UTC)
 * Right now we're in the middle of a paradigm shift. The ICDs put out by the WHO are the international standard. ICD-11 is going to take a few years to come into force and be fully implemented, but it has been released and it represents the future. The DSMs are for a more specialized field, psychiatry/psychology. But ICD-11 takes gender incongruence out of the mental disorder realm. That's the paradigm shift, to get away from treating it as a mental disorder. A similar thing happened when homosexuality was removed from the DSM. Had Wikipedia been around then there would have been a lot of debate over the change too. But anyway the ICDs are the global standard. In the US ICD-10-CM is currently used for billing. DSM-5 is a niche product that will lose relevance for gender issues in the future. See this WHO page: "Gender incongruence, meanwhile, has also been moved out of mental disorders in the ICD, into sexual health conditions." --67.140.182.177 (talk) 03:46, 2 August 2018 (UTC)
 * I know about the history of the DSM. I'm stating that the DSM is widely used as well and is not restricted to the United States. Nor is it solely contributed to by the United States. With regard to mental health, the DSM is mentioned and deferred to more often than the ICD in the literature. Stating that "the ICDs are the global standard" is an opinion. Flyer22 Reborn (talk) 09:20, 2 August 2018 (UTC)
 * I added more information about DSM-5, ICD-10, and ICD-11. Hope that helps. Kaldari (talk) 01:43, 11 August 2018 (UTC)
 * Above, we were debating popularity. But your expansion of diagnosis material is very likely to be helpful to people, yes. Flyer22 Reborn (talk) 12:15, 11 August 2018 (UTC)

Percentages, and signs and symptoms material
The percentages (41% and 1.5%) don’t have a reference. Where did you get those numbers? Also, the section for Signs/Symptoms seems to focus the topic more on MTF persons rather than the group as a whole. Could the wording for that section be changed or did the research focus more on FTM? Mshep02 (talk) 04:29, 11 August 2018 (UTC)
 * We shouldn't change the wording to be general when it's specifically about trans women. Trans women and trans men are (as you likely know) two very different groups, with distinct histories. More can be added to that section about trans men, if supported by one or more WP:MEDRS-compliant sources. Flyer22 Reborn (talk) 12:15, 11 August 2018 (UTC)

Semi-protected edit request on August 30, 2018
Please change the “isn’t” in the infobox under “Differential diagnosis” to “is not” in compliance with MOS:CONTRACTION. Thanks 2601:642:4300:21E7:91B9:882C:3B12:FC8D (talk) 11:30, 30 August 2018 (UTC)
 * Yes check.svg Done Sam Sailor 21:45, 30 August 2018 (UTC)

Semi-protected edit request on 7 September 2018
Footnote 32 has the wrong page numbers. It should be 1740-1747. The citation in the text should be for page 1741, not page 1568. Here's the book in question: https://www.docdroid.net/d4r1/the-merck-manual-of-diagnosis-and-therapy-2011-19th-edn.pdf#page=1750 VBachani (talk) 13:17, 7 September 2018 (UTC)
 * Yes check.svg Done. Thanks . Adrian J. Hunter(talk•contribs) 06:44, 8 September 2018 (UTC)

Gender Dysphoria NOT Gender identity disorder
Gender dysphoria, formerly Gender identity disorder.

NOT

Gender Dysphoris, or Gender identity disorder.

Gender Dysphoria is not a synonym to Gender Identity Disorder.

Please change now. HollyKara (talk) 17:28, 13 August 2018 (UTC)
 * We've discussed this in the past. There are sources that state that they are synonyms, with some stating that "gender dysphoria" is the updated term and/or criteria. While the DSM-5 uses the term "gender dysphoria," some other sources, especially older sources, use the term "gender identity disorder." With regard to the DSM, these older sources show that gender identity disorder is defined somewhat differently than gender dysphoria. This article covers both aspects (and most of the sources currently in the article use the "gender identity disorder" terminology). We shouldn't change all of the "gender identity disorder" instances in this article to "gender dysphoria" when the sources specifically use/are specifically about gender identity disorder. All of this is why we have avoided stating "formerly" in the lead sentence. But since this keeps coming up, I am considering a different way to include "gender identity disorder" as the WP:Alternative title. Flyer22 Reborn (talk) 18:27, 13 August 2018 (UTC)
 * I agree that it's probably too early to remove GID, as the term is still actively in use. I wonder if we could re-word the intro, though, to make GID less prominent or emphasize that the term has fallen from favor. Kaldari (talk) 20:24, 13 August 2018 (UTC)

Ender32881 and Mathglot, regarding this and this, our very own Wikipedia article currently states, "The DSM-5 moved this diagnosis out of the sexual disorders category and into a category of its own. The diagnosis was renamed from gender identity disorder to gender dysphoria, after criticisms that the former term was stigmatizing. Subtyping by sexual orientation was deleted. The diagnosis for children was separated from that for adults, as 'gender dysphoria in children'. The creation of a specific diagnosis for children reflects the lesser ability of children to have insight into what they are experiencing, or ability to express it in the event that they have insight." This "Ferri's Clinical Advisor 2014 E-Book: 5 Books in 1" source, from Elsevier Health Sciences, page 445, refers to them as synonyms, although it also states that gender dysphoria is an element of gender identity disorder. This was back in 2013, when the DSM-5 changes were just about to come out or had recently come out. This 2016 "Lesbian, Gay, Bisexual, and Transgender Healthcare: A Clinical Guide to Preventive, Primary, and Specialist Care" source, from Springer, page 459, states that some prefer the term gender dysphoria over the term gender identity disorder. This Encyclopædia Britannica Online source states, "Gender dysphoria (GD), also known as gender identity disorder (GID)." This Psychology Today source states, "Gender dysphoria (formerly gender identity disorder)." This WebMD source states, "Gender dysphoria used to be called 'gender identity disorder.'" Both terms/diagnoses are about the distress a person experiences as a result of the sex and gender they were assigned at birth. The gender identity disorder diagnoses was renamed "gender dysphoria" and somewhat changed. So given this and what the above sources state, in what way are we saying that they are not synonyms? Because they are named differently? Because of the changes to the diagnosis format? When it comes to covering/bolding both terms in the lead, per WP:Alternative title, the issue for me has been what I stated above. I've objected to "formerly known as" because of the changes to the diagnosis format (making them not identical) and because so much material in the article is supported by sources that use the term gender identity disorder, and I therefore feel that it's inappropriate to state "gender dysphoria" in place of "gender identity disorder" text when the text is supported by sources that use the term gender identity disorder and may be about how the diagnosis was before 2013. But there is no getting around the fact that it's the same subject, just revamped in a way. This is also why I've objected to "formerly known as" -- because a number of things are true under either diagnosis format. It was also because the DSM-5 alone does not own the terms gender identity disorder and gender dysphoria. We (usually) don't simply go by one authority's terminology or definition. We do usually cite just one or two sources when defining something, but the definition is usually supported by various sources and/or authorities. Still, since a number of sources associate the terms gender identity disorder and gender dysphoria with the DSM first and foremost, we should perhaps go ahead and put in "formerly known as," or use Ender32881's wording of "previously understood as" (or similar), and update the article with sources that use the term gender dysphoria as much as possible. By this, I mean trade out the "gender identity disorder" sources for "gender dysphoria" sources. But given the history of the topic, and that gender identity disorder is more prevalent in the literature because of its years of use over gender dysphoria, we perhaps can't update everything with "gender dysphoria" sources. We could move "gender identity disorder" (still bolded) to the third sentence (make material about it the third sentence), and note there that it used to be the favored term for the condition, and that it was reclassified as "gender dysphoria" by the DSM-5 in 2013. The rest of the lead would need tweaking to accompany the change. Flyer22 Reborn (talk) 22:26, 16 August 2018 (UTC)


 * Flyer22 Reborn, You've made a strong case, and it appears some of my impressions are mistaken. I had thought that GID, as a disorder, was not synonymous with the stress felt by the condition but involved features of personality disorder that transcend any distress a patient might be feeling about it, and in fact, some with GID might have the "condition" but not the stress. It seems to me some DSM disorders are not necessarily accompanied by stress, although it can be one of the entries on the list which they typically formulate as "X or more of the following, for T amount of time", but maybe I"m mistaken about that.  Whereas, for dysphoria, it's inherent in the very name of it, that distress is involved.  Furthermore, it had been my impression that whereas the locus of the distress, the dysphoria, is in the person having it, some individuals feeling dysphoria might in fact feel perfectly at home in their own skin, and the dysphoria is merely a reaction to societal disapproval, and thus might be worse in some locations than others.  I'll have to look up some of your links and read a bit more about this. Mathglot (talk) 05:55, 17 August 2018 (UTC)
 * "Distress," rather than "stress," is more so the key with regard to mental diagnoses such as this. It's why the Diagnosis section states, "In addition, the condition must be associated with clinically significant distress or impairment." Gender dysphoria wasn't always (and still isn't always) seen as an exact synonym of "gender identity disorder." It was sometimes used broadly to mean any conflict (an internal personal conflict) between gender identity and sex assignment. And as you can see, the Ferri's Clinical Advisor source states that gender dysphoria is an element of gender identity disorder. The Encyclopædia Britannica Online source notes the history of the GID diagnosis. For example, it states, "Since appearing in DSM-III, the GID entries have changed with each subsequent DSM revision. The most-significant revision was the DSM-IV (1994), which combined 'Transsexualism' with 'Gender Identity Disorder of Childhood' into one overarching diagnosis, 'Gender Identity Disorder.' ('Transvestic Fetishism,' once listed among the gender disorders, has been reclassified as a sexual paraphilia.) DSM-5 further revised the diagnosis, which was renamed 'gender dysphoria' and given its own chapter distinct from 'Sexual Dysfunctions and Paraphilic Disorders.' This diagnostic label is more consistent with clinical sexology terminology and removes the connotation that people with gender nonconformity are 'disordered' by only pathologizing the discontent experienced by these patients." Flyer22 Reborn (talk) 01:06, 18 August 2018 (UTC)

Gender Identity Disorder WAS listed as a mental disorder, however, they changed this in DSM-5 because not all trans folks feel distressed with the incongruence between their mind (gender), and body (assigned sex at birth). What you are doing by saying "or" is that it is okay to use either "or". This is not true. Even the World Health Organization had said that this is not a mental disorder and are making the changes. WPATH has also stated this. Yet, we have someone who is holding this public wiki resourse captive by not making the reqested changes. Instead using bold font indicating a bitgoted leaning personal opinion, instead of clearly stating that this is no longer an accepted disagnosis, nor is at acceptable term to use to describe gender dysphoria. It still remains that not everyone who experiences a gender/body incongruence experiences distress. Many trans folks do not medically transition, or transition only socially. There must be a clear distinction which you have not provided. HollyKara (talk) 16:42, 8 September 2018 (UTC)
 * "Gender Identity Disorder" is still the term used by the current ICD (ICD-10), which is the diagnostic manual used by most medical insurance companies. Thus, it's fairly important that doctors and insurance professionals are able to easily look up what "Gender Identity Disorder" refers to. ICD-11, which should be approved next year, is switching to "Gender incongruence" and will no longer be using "Gender Identity Disorder". I think that as soon as ICD-11 is officially approved we should remove "Gender Identity Disorder" from the lead, but not before. As much as I agree with the argument of HollyKara, I think that Wikipedia has to reflect actual usage, and the ICD is a very prominent source with widespread use. Kaldari (talk) 21:11, 8 September 2018 (UTC)


 * HollyKara, like I indicated above, I understand wanting to present the term gender identity disorder in some other way in the lead, but it shouldn't be removed. Wikipedia has rules such as WP:Due and WP:Alternative title; we don't go by other editors' personal opinions. And commentary such as "bigoted" does not help your cause. Do see WP:Personal attacks and WP:Advocacy as well. As for disorders, they are commonly defined by distress. Like the lead relays, "The American Psychiatric Association, publisher of the DSM-5, states that 'gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition.' " So, yeah, when transgender is used as a broad term, including any gender nonconformity, and does not mean people with the dysphoria, gender dysphoria does not apply to all transgender people. I have not seen the DSM-5 say that gender dysphoria is not a mental disorder, but the DSM-5 has been clear that it changed the name to reduce the stigma that comes with the term disorder, and the WHO removed "gender incongruence" from its mental illness listing and stated that "[w]hile evidence is now clear that it is not a mental disorder, and indeed classifying it in this can cause enormous stigma for people who are transgender, there remain significant health care needs that can best be met if the condition is coded under the ICD." You have not provided a clear distinction between the terms gender identity disorder and gender dysphoria. I, on the other hand, provided some history of the terms above, including sources seeing the terms as synonyms or essentially as synonyms. The words revised and renamed are clearly there above. So is the following: "This diagnostic label is more consistent with clinical sexology terminology and removes the connotation that people with gender nonconformity are 'disordered' by only pathologizing the discontent experienced by these patients." I will go ahead and change the "gender identity disorder" wording in the lead so that it's not in the first sentence. Flyer22 Reborn (talk) 21:33, 8 September 2018 (UTC)


 * I changed the wording to this. Once the ICD-11 is finalized, we should note in the same GID paragraph what the ICD used to call it and what it calls it now. Something else to take care of, per what I stated above, is wording in the article that uses "GID" instead of "GD." Like I noted, "so much material in the article is supported by sources that use the term 'gender identity disorder', and I therefore [question stating] 'gender dysphoria' in place of 'gender identity disorder' text when the text is supported by sources that use the term 'gender identity disorder' and may be about how the diagnosis was before 2013. [...] We should [...] update the article with sources that use the term gender dysphoria as much as possible. By this, I mean trade out the 'gender identity disorder' sources for 'gender dysphoria' sources. But given the history of the topic, and that 'gender identity disorder' is more prevalent in the literature because of its years of use over 'gender dysphoria', we perhaps can't update everything with 'gender dysphoria' sources." Still, we should validly try to be consistent with the terminology. Flyer22 Reborn (talk) 22:28, 8 September 2018 (UTC)

Interpretation of twin studies findings
Hello all, Let's take a look at the following line from the opening paragraph.:

" Some evidence suggests that twins who identify with a gender different from their assigned sex may experience such distress not only due to psychological or behavioral causes, but also biological ones related to their genetics or exposure to hormones before birth.[4|https://doi.org/10.1111%2Fj.1743-6109.2011.02567.x]"

The objective of twin studies (including on this one) is to study the expression of a condition in twins and draw insights and conclusions in all occurences, twins or the relation to gender dysphoria are not the subjects under study. Twins in these case are merely natural tools that provide identical developmental, and genetical variables.

The current wording reduces the claim of the study to the absolute facts, presumably, in order to present the most objective information to the reader, but in doing so misses the intent of the study.

I am going to try a number of incremental changes, starting with the following:

"Evidence from twin studies suggest that people who identify with a gender different from their assigned sex may experience such distress not only due to psychological or behavioral causes, but also biological ones related to their genetics or exposure to hormones before birth.[4|https://doi.org/10.1111%2Fj.1743-6109.2011.02567.x]"

Its subtle, but given the change in scope of the claim, I'd like to leave it for a couple of days before moving forward, to see if there is any opposition relating to Wiki standards or scientific interpretation, please let me know if you have any comments.

Thank you. — Preceding unsigned comment added by TZubiri (talk • contribs) 14:07, 4 October 2018 (UTC)
 * I do not understand your argument. Why did you change the text so that it doesn't include "some"? As for why I added "some," it was so that the language/statement didn't come across as absolute. Of course, the wording already states "suggests," which is softer than "found." As for "try a number of incremental changes," given the contentious nature of this article, it would be better if you propose changes here on the talk page first. Also do see WP:MEDRS; that is the standard for sourcing medical/health material on Wikipedia. Flyer22 Reborn (talk) 11:14, 5 October 2018 (UTC)


 * Maybe you wanted "twin studies" noted, which is why you added mention of it? Flyer22 Reborn (talk) 11:18, 5 October 2018 (UTC)

I increased the scope of the claim to include non-twins, my argument is that the goal of twin studies is usually not to draw conclusions from twins, but the object of study itself absent the twin dynamic. --TZubiri (talk) 00:20, 9 October 2018 (UTC)
 * I don't see how your wording includes non-twins. I'm not stating that I object to the rewording, but I'm not seeing that it was needed. Flyer22 Reborn (talk) 15:20, 9 October 2018 (UTC)

Redo
(This page should be redone its emotional not scientific.) — Preceding unsigned comment added by 2600:6C56:4108:63D:65E7:659C:6E63:9493 (talk) 15:44, 9 October 2018 (UTC)
 * Explain. Flyer22 Reborn (talk) 15:55, 9 October 2018 (UTC)

Transphobic content
This section:

Cites to the DSM-V, which isn't available in a full form online. But this passage seems like a negative stereotype about trans people that conflates gender dysphoria with sexual orientation and fetishism. Based on what is available online from the DSM (https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Gender-Dysphoria.pdf), the goal is to remove the fetishistic connotations from a diagnostic of dysphoria:

I would recommend this passage be removed unless someone can verify the contents of the actual DSM and provide evidence.

ArchibaldTheCat (talk) 02:04, 10 October 2018 (UTC)
 * We don't go by claims of "transphobic content." We go by what the literature states and with WP:Due weight. As for access to sources, see WP:SOURCEACCESS. But I will look at the cited pages. Flyer22 Reborn (talk) 14:27, 10 October 2018 (UTC)


 * Okay, below in the collapse box, is the relevant material from the online version of the DSM-5.

Prepubertal natal boys with gender dysphoria may express the wish to be a girl or assert they are a girl or that they will grow up to be a woman. They have a preference for dressing in girls’ or women’s clothes or may improvise clothing from available materials (e.g., using towels, aprons, and scarves for long hair or skirts). These children may role-play female figures (e.g., playing “mother”) and often are intensely interested in female fantasy figures. Traditional feminine activities, stereotypical games, and pastimes (e.g., “playing house”; drawing feminine pictures; watching television or videos of favorite female characters) are most often preferred. Stereotypical female-type dolls (e.g., Barbie) are often favorite toys, and girls are their preferred playmates. They avoid rough-and-tumble play and competitive sports and have little interest in stereotypically masculine toys (e.g., cars, trucks). Some may pretend not to have a penis and insist on sitting to urinate. More rarely, they may state that they find their penis or testes disgusting, that they wish them removed, or that they have, or wish to have, a vagina.

In both adolescent and adult natal males, there are two broad trajectories for development of gender dysphoria: early onset and late onset. Early-onset gender dysphoria starts in childhood and continues into adolescence and adulthood; or, there is an intermittent period in which the gender dysphoria desists and these individuals self-identify as gay or homosexual, followed by recurrence of gender dysphoria. Late-onset gender dysphoria occurs around puberty or much later in life. Some of these individuals report having had a desire to be of the other gender in childhood that was not expressed verbally to others. Others do not recall any signs of childhood gender dysphoria. For adolescent males with late-onset gender dysphoria, parents often report surprise because they did not see signs of gender dysphoria during childhood. Expressions of anatomic dysphoria are more common and salient in adolescents and adults once secondary sex characteristics have developed.

Adolescent and adult natal males with early-onset gender dysphoria are almost always sexually attracted to men (androphilic). Adolescents and adults with late-onset gender dysphoria frequently engage in transvestic behavior with sexual excitement. The majority of these individuals are gynephilic or sexually attracted to other posttransition natal males with late-onset gender dysphoria. A substantial percentage of adult males with late-onset gender dysphoria cohabit with or are married to natal females. After gender transition, many self-identify as lesbian. Among adult natal males with gender dysphoria, the early-onset group seeks out clinical care for hormone treatment and reassignment surgery at an earlier age than does the late-onset group. The late-onset group may have more fluctuations in the degree of gender dysphoria and be more ambivalent about and less likely satisfied after gender reassignment surgery.


 * Flyer22 Reborn (talk) 13:13, 12 October 2018 (UTC)
 * I tweaked the wording a bit. The part about "transvestic behavior with sexual excitement" is probably UNDUE since it's only mentioned in 1 sentence in the DSM text. (I would also be very surprised if that wording survived the next update.) Clearly, that entire section of the DSM is painfully archaic (the focus on sexuality, the assumption that there are only 2 sexual orientations (and 2 genders), etc.), but it is still one of the most important sources regarding gender dysphoria, so we need to reflect whatever the broader themes are at least. We're still missing a lot of basic information. For example, we had absolutely nothing in the "Signs and symptoms" section about gender dysphoria in those assigned female at birth. I added a sentence to get it started, but it should probably be fleshed out into a separate paragraph. Kaldari (talk) 22:53, 20 November 2018 (UTC)
 * Not sure that I agree with the removal of the "sexual excitement" aspect since it is a part of the discussion regarding trans women (although controversial), as noted in Causes of transsexuality article and the Blanchard's transsexualism typology article. The latter article, for example, in reference to the DSM-5, mentions "With autogynephilia (sexual arousal by thoughts, images of self as a female)." The sexual arousal aspect is often included as a main aspect separating late-onset trans women from trans woman who experienced gender dysphoria early on. So, no, not WP:Undue. Since it's a consistent finding, I doubt this aspect will be removed from the DSM, but the "transvestic behavior" wording will likely be removed at some point. As for two sexual orientations and two genders, it's what the researchers consistently find. If a bisexual identification was as common for the topic, the researchers would mention it or at least consider using the word ambiphilic. But you can see that the DSM is using the terms androphilic and gynephilic instead of the terms heterosexual and homosexual. These alternative terms are not as limiting and don't necessarily exclude bisexuality. As for genders, the gender dysphoria literature focuses on two genders -- boy/man and girl/woman -- because the cases are about that. It's not the case of a child being assigned male or female and then identifying as non-binary. It's the case of a child being assigned male or female and then identifying as a boy or a girl. Similar goes for adults with late-onset gender dysphoria; they usually identify as a man or as a woman. There are gender roles and other behaviors associated with these genders. Non-binary genders are not as fleshed out and third genders are another topic in terms of gender dysphoria as currently studied. All that stated, I agree that the section needs fleshing out. I'd prefer not to exclude material because it's controversial, though. Flyer22 Reborn (talk) 03:15, 21 November 2018 (UTC)
 * The DSM section doesn't just talk about androphilia and gynephilia. It also uses the terms "gay" and "lesbian", for example, "After gender transition, many self-identify as lesbian." These days, most trans folks (at least in the U.S.) self-identify as queer rather than gay or lesbian. In the largest survey conducted on the issue, the 2015 U.S. Transgender Survey, the most common sexual identity was "queer", followed by "pansexual", neither of which are mentioned in the DSM. And there are certainly plenty of non-binary folks who experience gender dysphoria. In the 2015 Transgender Survey, 31% identified as non-binary, so it seems like a pretty significant demographic. The DSM might as well have been written in the stone ages considering how much has changed about transgender culture (and academic research about it) since the DSM was written. But of course it's still an important source, so we have to use it. I don't think we should strictly parrot everything it says, however. Blanchard, who is the main person who created and pushed the autogynephilia theories in the 80s and 90s (and has a long history of pathologizing commonplace expressions of sexuality and gender), helped write those sections for the DSM-5 after all (amid vocal objections from the LGBT community). The era of looking at transgenderism through the lens of sexual deviation is over (mostly), and we shouldn't be perpetuating it any more than necessary. It's stigmatizing to transgender people, and bad science to boot. Kaldari (talk) 20:49, 21 November 2018 (UTC)
 * I didn't state that the DSM never uses words like lesbian. I quoted the DSM above, and it notes that "After gender transition, many self-identify as lesbian." But that line is focused on what trans women identify as. As for "most trans folks (at least in the U.S.) self-identify as queer rather than gay or lesbian," I've seen no academic sources that state such. Furthermore, we commonly get complaints about use of queer at the Queer and Genderqueer articles. There are still so many people in the LGBT community who object to that term. I'm aware of the aforementioned survey since it's used at both the Trans woman and Trans man Wikipedia articles, but I was clear with an IP at the Trans man article that the survey, which is U.S.-centric, does not trump what the academic literature generally states. I clearly pointed the IP to our WP:Due weight policy. As for non-binary people experiencing gender dysphoria, well, non-binary people fall under the broad category of transgender. And gender dysphoria is about the distress a person experiences as a result of the sex and gender they were assigned at birth. When it comes to the research on transgender people, it is mainly about transgender girls/women and transgender boys/men, without non-binary identification. There are enough sources stressing that being transgender and non-binary are not the same, and some of these sources are defining transgender in a strict way that would lead one to think that "non-binary" does not fall under "transgender." On top of that, some transgender people identify as both transgender and non-binary. In terms of the research on gender dysphoria, it almost exclusively focuses on transgender girls/women and transgender boys/men, and I mean "without non-binary identification."


 * If you know of academic sources on gender dysphoria focused on non-binary people, I'm certainly open to looking at them. This 2016 Psychology Today source states that some non-binary people "take hormones or undergo surgery, modifying attributes from body shape and muscle to sexual and reproductive traits to achieve an internal sense of physical congruence. (These can include procedures known to the trans community as 'top' and 'bottom' surgery, focused on the chest and reproductive organs, respectively.)", but, to experts on the topics of transgender and gender dysphoria, these people are considered transgender with gender dysphoria if they are seeking surgery for an internal sense of physical congruence, and, in that case, there are certain criteria a person must meet to get the medical care they want. The source mentions Jack Drescher, "who served on a committee on sex and gender identity for the latest edition of the American Psychiatric Association’s diagnostic manual (DSM-5)." In that source, he doesn't speak of non-binary identity with regard to gender dysphoria. The source also states, "Scant research has focused specifically on transgender people who espouse a nonbinary label. A few studies, including a 2008 paper by New School University psychologist Rhonda Factor, have found that about 70 percent of those identifying as nonbinary, or genderqueer, had been labeled female at birth. Factor suggests that those who are brought up as boys may be less likely to openly embrace a self-concept that blurs binary gender categories." Anyway, Psychology Today is considered a poor source in terms of WP:MEDRS.


 * Regarding my statement that "non-binary genders are not as fleshed out," I mean that there are obviously no gender roles or other behaviors that are specifically attributed to being non-binary, unless one is speaking of behaviors that can be identified as gender-neutral (or speaking of some third gender aspect). After all, non-binary is non-binary. There is no academic literature on people stating that they felt non-binary as a child. By contrast, there is much on people "feeling like a boy" or "feeling like a girl," "feeling like a man" or "feeling like a woman." And the Psychology Today source states, "Many who arrive at a nonbinary self-concept do so only after considering the more common transgender trajectory—which ends with identifying as either a man or a woman—and rejecting it as ill-fitting." And, to date, research shows that most children with gender dysphoria cease to have gender dysphoria by puberty or adolescence. Drescher also notes that "most children who exhibit signs of gender dysphoria do not grow up to be transgender adults."


 * As for Blanchard or bad science, I don't see that the DSM-5 is treating "transgenderism through the lens of sexual deviation." It made changes in part because of the "transgenderism through the lens of sexual deviation" view. I don't think that the sexual arousal aspect being noted as something that separates late-onset trans women from trans woman who experienced gender dysphoria early on is treating "transgenderism through the lens of sexual deviation" either. But it's not about what I, or we, think regardless. We are to follow the literature with WP:Due weight. Wikipedia is not the place to right the great wrongs. We follow what the academics state. Activists' voices have their places in articles like this, but Wikipedia is not the place for advocacy. Flyer22 Reborn (talk) 23:44, 22 November 2018 (UTC) Flyer22 Reborn (talk) 00:02, 23 November 2018 (UTC)
 * You make some good points, but I do have a couple rebuttals if you'll continue to humor me...
 * You argue above that most GD research only focuses on transwomen and transmen. While I'll agree that that is the case, there is a small but growing body of GD research that does include non-binary folks. As this 2015 GD study states: "Ten participants identified their gender as 'nonbinary,' reflecting a growing trend experienced clinically around the country." From Gender Dysphoria and Disorders of Sex Development: "Only recently, research on gender nonconformity and gender dysphoria has begun to examine the extent to which individuals may transition completely from one gender to another or may instead identify as a third gender or gender queer (Bockting & Ehrbar, 2005). Some gender-dysphoric children and adolescents describe discomfort with a binary system of gender that expects people to fall within socially prescribed norms for male or female. This group may not necessarily struggle with a sense of being in the wrong body, but rather struggle with an inability to conform to rigid binary gender expectations (Bockting & Ehrbar, 2005; Kessler & McKenna, 2000; Lombardi, 2009)."
 * You also argue that if a bisexual identification was common for people experiencing GD, the researchers would mention it or at least use the word ambiphilic. I would argue that that is actually the case these days. If you search Google Scholar for "gender dysphoria bisexual", you get 10,000 hits. Lots of those are false positives, but lots of them aren't. In the study I linked to earlier, 12% identified as bisexual and 20% identified as "other" (presumably pansexual or queer). Another example from Management of Gender Dysphoria: "Most children aged 5–12 years diagnosed as having GID do not persist in having GID as adolescents; rather, most become homosexual or bisexual adolescents and adults." From Gender Dysphoria and Disorders of Sex Development: "Prospective studies of boys and girls with GD show that, at follow-up, the proportion of participants with a same-sex or bisexual sexual orientation is substantially higher than the base rates in the general population." Some recent GD studies even use the term ambiphilic as you suggest.
 * Anyway, my point isn't that the DSM is fatally flawed, it's that our readers are going to expect Wikipedia to be a bit less behind-the-times. I personally think we should use the DSM with a grain of salt and try to augment it with more up-to-date research and terminology where possible. I'm not sure if you actually disagree with that, or were just prodding me to provide more actual sources :) Kaldari (talk) 09:22, 24 November 2018 (UTC)
 * The Psychology Today source notes that "Many who arrive at a nonbinary self-concept do so only after considering the more common transgender trajectory—which ends with identifying as either a man or a woman—and rejecting it as ill-fitting." Again, Psychology Today is a poor source in terms of WP:MEDRS, but it's correct about the transgender trajectory. When it comes to being diagnosed with gender dysphoria, it will almost always be the case that it's a transgender person who does not identify as non-binary. If non-binary identification happens, it usually comes after the person has identified as a boy/man or as a girl/woman. It was not that long ago that "genderqueer," "non-binary" and similar identities (excluding the third gender aspect) did not exist. In terms of the medical research on gender dysphoria, no one was stating that "I don't feel like a gender" or "I have no gender." They were stating that they feel like a boy or like a girl, or like a man or like a woman. And the vast majority of people with gender dysphoria today still don't state "I don't feel like a gender" or "I have no gender." It is only recently, beginning in the 1990s, like this "2009 "Encyclopedia of Gender and Society, Volumes 1-2" source, from Sage Publications, page 402, notes of genderqueer, that these other identities have taken hold. They have especially blossomed in the 2010s. And they are a good thing for those who question that they should just identify as a man or as a woman. But gender dysphoria is usually about feeling like the opposite sex or gender (within the gender binary since there is the argument that one cannot feel like a sex) of what one was assigned. Gender dysphoria is very much (though obviously not always) within the gender binary, and, if we are to attribute gender dysphoria to biology (at least somewhat) and state that some trans women's brains resemble cisgender women's brains more than they resemble cisgender men's brains, a gender binary or "sex binary" focus is understandable. Brain studies with regard to the causes of transsexuality are about biology, not social identities such as "non-binary." There are no studies about "non-binary people's brains." There are studies about the male brain and the female brain. Of course, some feminists reject the notion of the male brain and the female brain, but scientists know that there are some differences between male and female brains that attribute to behavior differences. It's not all social causes. Brain studies on this topic are flawed, though, since brain scans, for example, also show that cisgender lesbian women have brains more similar in shape to cisgender heterosexual men and cisgender gay men have brains more similar in shape to cisgender heterosexual women, and there is the 2015 "Sex beyond the genitalia: The human brain mosaic" meta-analysis, which indicates, "Brains with features that are consistently at one end of the 'maleness-femaleness' continuum are rare. Rather, most brains are comprised of unique 'mosaics' of features, some more common in females compared with males, some more common in males compared with females, and some common in both females and males."


 * What you cited about "This group may not necessarily struggle with a sense of being in the wrong body, but rather struggle with an inability to conform to rigid binary gender expectations" is exactly what a number of researchers who study gender dysphoria in children (and sometimes in adolescents and adults) state. But when such children are looked at in that way, there are some activists who argue that the experts are trying to convert the children and make it so that the children are not trans. While there are questionable therapists and similar out there, the ones who are very familiar with the topic of gender dysphoria in children state that gender norms can make a child uncomfortable in their own skin; it can make an effeminate boy feel that he should be a girl because he likes "girl things." It can make a girl who is a tomboy feel like she should be a boy because she likes "boy things." It's tougher on the boys, though, because being a tomboy is far more accepted in society than being an effeminate boy is. In the Causes section of the Gender dysphoria article, we currently state (with a reliable source supporting it) that "if society had less strict gender divisions, transsexual people would suffer less." On that note, there is the argument that if society had less strict gender divisions, or rather if there was no gender binary (in terms of "boys/men are supposed dress and behave this way" and "girls/women are supposed to dress and behave this way"), gender dysphoria may or would not exist.


 * As for sexual orientation goes, researchers know that many or most gay and lesbian people exhibited gender nonconformity and, in some cases, some degree of gender dysphoria in childhood. Like this 2014 "Nelson Essentials of Pediatrics E-Book" source, from Elsevier Health Sciences, page 75, states, they also know (based on the available research, though some consider it flawed) that the vast majority of children with gender dysphoria grow up to identify as gay/lesbian or bisexual and not as transgender (just like you cited and I've cited times before when arguing at the Gender dysphoria in children talk page). Regarding my statement about bisexuality, I stated "if a bisexual identification was as common for the topic," not "if it was common for the topic." And it's a fact that bisexual identification isn't as common among "adolescent and adult natal males with early-onset gender dysphoria"; they, like the DSM-5 states, "are almost always sexually attracted to men (androphilic)." Now the DSM-5 appears to be offering some leeway with the term androphilic, but it is the case that this group identifies as heterosexual more often than not. The late-onset group of trans women is different; research has consistently found these differences. The literature has often reported that there is more variation in sexual orientation identity among trans women than among trans men since trans men, like this 2014 "Principles and Practice of Sex Therapy, Fifth Edition" source, from Guilford Publications, page 252, states, have usually been found to identify as heterosexual, but it doesn't negate what the DSM-5 states about the sexual orientation aspects regarding trans women. I see no valid reason that we should be questioning the DSM-5 on these matters. Not when the questioning is based on WP:Primary sources instead of WP:MEDRS-compliant sources.


 * That "most children aged 5–12 years diagnosed as having GID do not persist in having GID as adolescents; rather, most become homosexual or bisexual adolescents and adults" doesn't negate what the DSM-5 states. What it does show is that most of those children cease to have gender dysphoria and are not truly transgender. Therefore, they are not bisexual transgender people or a transgender person of any other sexual orientation. Notice that the "adolescent and adult natal males" paragraph in the collapse box above is not focused on the sexual orientation of prepubescent children. If a person has gender dysphoria into adolescence (certainly past age 12), they are very likely to continue to have gender dysphoria and identify as transgender. This 2013 "Endocrinology Adult and Pediatric: Reproductive Endocrinology" source, from Elsevier Health Sciences, states that if the dysphoria persists into early puberty, "it is almost certainly permanent." Of course, "permanent" is a strong word considering that, as made clear by this 2016 "Surgical Management of the Transgender Patient" source, from Elsevier Health Sciences, gender dysphoria can be alleviated or "cured" with sex reassignment therapy. But the DSM-5 also notes that there can be "an intermittent period in which the gender dysphoria desists and these individuals self-identify as gay or homosexual, followed by recurrence of gender dysphoria."


 * As for Wikipedia, our readers actually often expect Wikipedia to be with, not behind, the times; it's why WP:RIGHTGREATWRONGS states, "Wikipedia doesn't lead, we follow. Let reliable sources make the novel connections and statements. What we do is find neutral ways of presenting them." And as we know, being neutral on Wikipedia does mean what being neutral means in common discourse. Either way, from what I can see and know of the literature, the DSM-5 is up-to-date on the gender dysphoria literature. I don't see that we should take the main diagnostic tool, other than the ICD, for the topic with a grain of salt. I'm all for up-to-date medical material if the sources are WP:MEDRS compliant. I don't put much stock into primary sources on the topic, and WP:MEDRS is clear why we shouldn't. Flyer22 Reborn (talk) 02:03, 25 November 2018 (UTC)
 * I only cited 1 primary source and it was to counter an argument you made. The other sources I linked to are clinical reference books, so definitely not primary sources. Kaldari (talk) 04:12, 25 November 2018 (UTC)


 * And the book references you cited do not counter what the DSM-5 states about gender dysphoria. Flyer22 Reborn (talk) 04:21, 25 November 2018 (UTC)
 * I didn't say that they did. They do however, add information that the DSM doesn't cover. Kaldari (talk) 04:34, 25 November 2018 (UTC)


 * >And it's a fact that bisexual identification isn't as common among "adolescent and adult natal males with early-onset gender dysphoria"; they, like the DSM-5 states, "are almost always sexually attracted to men (androphilic)." Now the DSM-5 appears to be offering some leeway with the term androphilic, but it is the case that this group identifies as heterosexual more often than not.
 * Frankly I just don't believe that's true. I don't yet have secondary sources to suggest otherwise, but I don't think there's a chance in hell that the majority of any gender dysphoric demographic identifies as heterosexual (or homosexual). That may have been true even 5 years ago, but it's not true now. Anyway, opinions are cheap without sources, so I guess we'll have to wait and see what turns up. As far as the rest of your arguments, they are basically arguing past me and not related to the points I was trying to make. Kaldari (talk) 04:27, 25 November 2018 (UTC)


 * Whether anyone believes it's true or not, it's what the literature generally reports in terms of "adolescent and adult natal males with early-onset gender dysphoria" and it's what the DSM-5, which is an authoritative source, states. People can also doubt that most trans men identify as heterosexual, but it is what the general literature has consistently found. And we should remember that not all transgender people have gender dysphoria (depending on how transgender is defined). I'm going by the research, not my personal opinions. I understand the points you were trying to make (and were making). I don't feel that my arguments were "arguing past [you] and not related to the points [you] were trying to make." But I do feel that there is no need to continue this discussion. Flyer22 Reborn (talk) 04:36, 25 November 2018 (UTC) Flyer22 Reborn (talk) 05:03, 25 November 2018‎ (UTC)

Semi-protected edit request on 19 November 2018
Add that gender dysphoria is not the same as gender nonconformity. According to the American Psychiatric Association, a cited source, they distinguish gender dysphoria from gender nonconformity, yet the wiki article suggests that they are synonymous when the quote "gender nonconformity is not in itself a mental disorder" is used. WaboTheGreat (talk) 21:59, 19 November 2018 (UTC) WaboTheGreat (talk) 21:59, 19 November 2018 (UTC)
 * The article is not suggesting that gender dysphoria and gender nonconformity are the same thing, but gender nonconformity is an aspect of gender dysphoria because the transgender person's gendered behavior deviates from their assigned sex/gender. To me, it's clear that the quote in the lead is stating that gender nonconformity itself is not gender dysphoria. Notice that the lead also states, "Some transgender people and researchers support declassification of the condition because they say the diagnosis pathologizes gender variance and reinforces the binary model of gender." "Gender nonconformity" redirects to the Gender variance article. Are you stating that you want us to change "The American Psychiatric Association, publisher of the DSM-5, stated that 'gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition." to "The American Psychiatric Association, publisher of the DSM-5, stated that gender nonconformity is not the same thing as gender nonconformity and that 'gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition."? If so, your suggested text makes one wonder why we even mention gender nonconformity, at least if it's not clear to someone why the American Psychiatric Association (and therefore we) are mentioning it. It would be better to note that although gender nonconformity is an aspect of gender dysphoria, gender nonconformity is not in itself a mental disorder; the critical element of gender dysphoria is the presence of clinically significant distress associated with the condition. Flyer22 Reborn (talk) 02:27, 20 November 2018 (UTC)
 * I understand that the article does not directly suggest that gender dysphoria and gender nonconformity are the same thing, but the article does not seem to make any clear distinction from what I can tell. I believe adding the distinction that the American Psychiatric Association had made would provide more clarity for the article. As for why the American Psychiatric Association mentions gender nonconformity, they are ensuring readers know that there is a difference between gender dysphoria and nonconformity. If I am not mistaken, gender dysphoria is the feeling of having been incorrectly assigned a gender at birth that does not align with what one identifies as, thereby causing distress. In contrast, gender nonconformity, according to the same American Psychiatric Association text, "refers to behaviors not matching the gender norms or stereotypes of the gender assigned at birth," which can be found in both transgender people and cross-dressers, which are distinct from one another. The American Psychiatric Association even distinguishes gender dysphoria from being gay/lesbian in the same paragraph, simply to avoid some common confusion regarding the terms and their associations. In any case, I am just suggesting that a clear distinction should be made between the two, since gender nonconformity is not defined in the article. Basically, I agree with how you phrased your last sentence. WaboTheGreat (talk) 18:37, 20 November 2018 (UTC)
 * Yes, gender nonconformity can be found in both transgender people and cross-dressers. Yes, it can be found in cisgender people, who are usually LGB (according to the available research). But gender nonconformity is not automatically an aspect of someone who is cisgender. Because a transgender person identifies with a sex/gender they were not assigned with at birth (when defining transgender strictly and not including other aspects, such as cross-dressers), gender nonconformity is automatically an aspect of someone who is transgender. It is an aspect of gender dysphoria. Anyway, I'll incorporate "although gender nonconformity is an aspect of gender dysphoria." Flyer22 Reborn (talk) 03:15, 21 November 2018 (UTC) Flyer22 Reborn (talk) 03:16, 21 November 2018 (UTC)


 * As seen here (followup edit here), I went with "gender nonconformity is not the same thing as gender dysphoria" for now since neither reference explicitly states that gender nonconformity is an aspect of gender dysphoria and I didn't feel like looking for a different source that makes that clear. I might add it later, although I think it's clear to readers that being transgender involves gender nonconformity. Like you noted, the American Psychiatric Association text states that gender nonconformity "refers to behaviors not matching the gender norms or stereotypes of the gender assigned at birth." Flyer22 Reborn (talk) 04:02, 21 November 2018 (UTC)

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 * Pictogram voting comment.svg Note: marking this as done for now.  ♪♫Al ucard   16♫♪  06:17, 23 November 2018 (UTC)