Gender Identity Disorder: Disorder, Crisis, or Spiritual Phenomenon???

Gender Identity Disorder or The Crisis of Gender Identity? This is a social issue that has recently been a true question in my mind. I'm studying to be a social worker and in the long run I hope to be a marriage and family therapist. I introduced my career goals to give a background as to why I'm interested in researching this topic or better still to really take a look at whether struggles with gender identity is a crisis created within the mind, a disorder as a result of biological, environmental, or socially learned stressors, or if it is a matter of spiritual influence (oh no he's talking about spiritual stuff run run run!!!). The first part of this will be a description of what the DSM-IV describes as the diagnostic criteria for diagnosing a person with Gender Identity Disorder or a person who is experiencing a gender identity crisis.

DSM-IV-TR Diagnostic Criteria for Gender Identity Disorder:

•There must be evidence of a strong and persistent cross-gender identification.
•This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
•There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex.
•The individual must not have a concurrent physical intersex condition.
•There must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning .

•In adolescents and adults, the disturbance is manifested by symptoms such as a stated desire to be the other sex,
•Frequent passing as the other sex,
•Desire to live or be treated as the other sex,
•Or the conviction that he or she has the typical feelings and reactions of the other sex.

GID in Children
•In children, the disturbance is manifested by four or more of the following:
•Repeated desire to be, or insistence that he or she is, the other sex
•In boys, preference for cross-dressing or simulating female attire, in girls, insistence on wearing only stereotypical masculine clothing
•Strong and persistent preferences for cross-sex roles in make-believe play or persistent fantasies of being the other sex
•Intense desire to participate in the stereotypical games and pastimes of the other sex
•Strong preference for playmates of the other sex

Here is a breakdown of further diagnostic criteria as described by the DSM-IV:

•Preoccupation with the wish to live as a member of the opposite sex.
•Intense desire to adopt the social role of the other sex.
•Intense desire to acquire physical appearance of opposite sex through hormonal or surgical manipulation.
•In children and adolescents there maybe social isolation, peer teasing, and rejection.

•Adults with GID are uncomfortable being regarded by others as or functioning in society as a member of their designated sex.
•The sexual activity of these individuals with same-sex partners is generally constrained by the preference that their partners neither see nor touch their genitals.

From just reading a few of the diagnostic criteria you can only get a glimpse of what individuals who face this identity crisis have to endure. It is never easy in my opinion to not be comfortable with who you are, having low self-esteem, social isolation, ridicule, hatred, etc; I can't relate to not being comfortable with being born a male, as I identify myself, live as, and believe that I was meant to be a man, but I have dealt with a negative self-image, or low self-esteem, and I know that it isn't an easy thing to face, but I wonder what individuals who are dealing with a gender identity crisis, GID, or just not being comfortable with being born the gender nature assigned to them; what is it like for them, what are their true thoughts, what do they face everyday when they look at themselves in the mirror, and how can society truly gain an understanding of what they are facing? Before I enter anymore of my thoughts let me give you more on what the DSM-IV says about Gender Identity.

Associated Descriptive Features/Disorders:

•Social Isolation
•Ostracism
•Low self-esteem
•School aversion/dropping out
•Boys often show marked feminine mannerisms.
•Mental lives may revolve around activities that lessen gender distress.
•Some males with the disorder may engage in prostitution putting them at risk for HIV infection. •Suicide attempts and Substance-Related Disorders are commonly associated.
** The DSM-IV describes associated descriptive features/disorders section as including clinical features that are frequently associated with the disorder, but are not considered essential in making the diagnosis.

Children with GID may manifest coexisting:
•Separation Anxiety Disorder
•Generalized Anxiety Disorder
•Symptoms of Depression
Adolescents are at risk for:
•Suicidal Ideation/Attempts
•Depressive Symptoms may be present. Associated Personality Disorders are more common among males than among females.

Specifiers: Based on Sexual Orientation-

•Sexually Attracted to Males
•Sexually Attracted to Females
•Sexually Attracted to Both
•Sexually Attracted to Neither.
*Males with GID include considerable proportions with all four specifiers.
Virtually all females with GID will receive the same specifier - Sexually Attracted to Females- although there are exceptional cases involving females who are Sexually Attracted to Males.

(So if a person was diagnosed with Gender Identity Disorder one of these specifiers could be added on to the diagnosis. And example would be an individual who was diagnosed with Gender Identity Disorder who is sexually attracted to females).

Although I have all this information set before me, nothing within my readings have given an exact cause of gender identity. There are three theories that I've read about which are the biological theory, the social learning theory, and the cognitive-development theory. The biological theory gives a more detailed look into the cause of Gender Identity Disorder, the latter two theories speak more to an individual learning gender roles through social and environmental observation, and thoughts/understanding of gender over time. So here is where my question that is within my title comes from. What is gender identity confusion? Is it a psychological disorder? Is it a gender identity crisis that occurs when something biological goes wrong during conception or birth? Is it gender confusion that results from socially learned behavior? Is it a combination of physical/spiritual influence? I don't have the answers, but I will in my next post on Gender Identity Disorder, talk about what I think and feel. I want everyone who will read the next post to understand that it will be purely an opinion piece. I'm hoping not to offend anyone in either of these posts, but to open up dialogue and intellectual discussion.

Here is the link to the video from YouTube about the 20/20 special on GID.

http://www.youtube.com/watch?v=Utpam0IGYac

Please watch and tell me what you think.

Reference-

American Psychological Association. (2000). DSM-IV-TR: Diagnostic statistical manual of mental disorders (Revised 4th Ed.). Washington, D.C.: American Psychological Press, Inc.