Gender Identity Disorder 34
The majority of well-screened transsexuals who have had sex reassignment treatment report positive outcomes in terms of well being, happiness, and psychosocial adjustment.
Better surgical results predict better postoperative adjustment.

Treatment and outcome
Treatment aims
The aim of treatment in children is to develop social skills and comfort in the biological sex role.
The aim of treatment for non-sex-reassignment candidates is to encourage acceptance of the biologic sex and increased ability to function within it.
The aim of hormonal treatment in males is to increase the patient’s physical resemblance to female norms (e.g. breast enlargement, feminization of body contour and skin texture, decrease in body hair and facial hair).
The aim of hormonal treatment in females is to increase the patient’s physical resemblance to male norms (e.g. cessation of menses, increase in hair and muscle mass, clitoral growth, voice deepening).
The aim of treatment for transsexuals is achieve effective functioning in society as a member of the opposite sex.

Gender Identity Disorder 35 Pharmacological

Gender Identity Disorder 35 Pharmacological treatment
No pharmacological treatments exist for children.
Pharmacological treatment has not been effective in reducing cross-sex desires in adults.
Hormonal treatment
Standards of care for hormonal treatment of gender identity disorder have been developed and should be followed.
The wearing of cross-sex clothing in daily life under psychiatric supervision for at least 1 year is advised before beginning hormone treatment.
Hormonal treatment for adults (estrogens** for men, androgens** for women) modifies physical sex characteristics to agree with the patient’s sex identity (i.e. sex reassignment).
Hormonal treatment should ideally be accompanied by an ongoing
psychotherapeutic relationship with the patient for a minimum of 3-12 months.

** off-label use

Many effects, such as deepening of the voice in women, may be irreversible. Blood chemistry monitoring is required, including liver function tests, prolactin levels, and hormone status and serum lipids.

Gender Identity Disorder 36
Standard dosage
Estrogens for men (may take 2 years or more to achieve maximal breast growth). Androgens (testosterone) for women.

Contraindications
Estrogens are contraindicated in:
• Active or past thrombophlebitis, thrombosis or thromboembolic
Disorders

Marshall university 1-1-1004 gender identity disorder a misunderstood diagnosis by Kristopher j cook marshall digital scholar

A group of physicians from Saudi Arabia recently reported on several cases of XX intersex children with congenital adrenal hyperplasia (CAH), a genetically inherited malfunction of the enzymes that aid in making steroid hormones. [...] In the United States and Europe, such children, because they have the potential to bear children later in life, are usually raised as girls. Saudi doctors trained in this European tradition recommended such a course of action to the Saudi parents of CAH XX children. A number of parents, however, refused to accept the recommendation that their child, initially identified as a son, be raised instead as a daughter. Nor would they accept feminizing surgery for their child. [...] This was essentially an expression of local community attitudes with [...] the preference for male offspring.[80]

Thus it may be said that determining the sex of children is actually a cultural act, and the sex of children is in fact socially constructed.[79] Therefore, it is possible that although sex seems fixed and only related to biology, it may be actually deeply related to historical and social factors as well as biology and other natural sciences.

Biological factors and views[edit]

See also: Sexual differentiation and Sex determination and differentiation (human)

The biology of gender became the subject of an expanding number of studies over the course of the late 20th century. One of the earliest areas of interest was what is now called gender identity disorder (GID). Studies in this, and related areas, inform the following summary of the subject by John Money. He stated:

The term "gender role" appeared in print first in 1955. The term gender identity was used in a press release, November 21, 1966, to announce the new clinic for transsexuals at The Johns Hopkins Hospital. It was disseminated in the media worldwide, and soon entered the vernacular. The definitions of gender and gender identity vary on a doctrinal basis. In popularized and scientifically debased usage, sex is what you are biologically; gender is what you become socially; gender identity is your own sense or conviction of maleness or femaleness; and gender role is the cultural stereotype of what is masculine and feminine. Causality with respect to gender identity disorder is sub-divisible into genetic, prenatal hormonal, postnatal social, and post-pubertal hormonal determinants, but there is, as yet, no comprehensive and detailed theory of causality. Gender coding in the brain is bipolar. In gender identity disorder, there is discordance between the natal sex of one's external genitalia and the brain coding of one's gender as masculine or feminine.[81]

Money refers to attempts to distinguish a difference between biological sex and social gender as "scientifically debased", because of our increased knowledge of a continuum of dimorphic features (Money's word is "dipolar") that link biological and behavioral differences. These extend from the exclusively biological "genetic" and "prenatal

A group of physicians from Saudi Arabia recently reported on several cases of XX intersex children with congenital adrenal hyperplasia (CAH), a genetically inherited malfunction of the enzymes that aid in making steroid hormones. [...] In the United States and Europe, such children, because they have the potential to bear children later in life, are usually raised as girls. Saudi doctors trained in this European tradition recommended such a course of action to the Saudi parents of CAH XX children. A number of parents, however, refused to accept the recommendation that their child, initially identified as a son, be raised instead as a daughter. Nor would they accept feminizing surgery for their child. [...] This was essentially an expression of local community attitudes with [...] the preference for male offspring.[80]

Thus it may be said that determining the sex of children is actually a cultural act, and the sex of children is in fact socially constructed.[79] Therefore, it is possible that although sex seems fixed and only related to biology, it may be actually deeply related to historical and social factors as well as biology and other natural sciences.

Biological factors and views[edit]

See also: Sexual differentiation and Sex determination and differentiation (human)

The biology of gender became the subject of an expanding number of studies over the course of the late 20th century. One of the earliest areas of interest was what is now called gender identity disorder (GID). Studies in this, and related areas, inform the following summary of the subject by John Money. He stated:

The term "gender role" appeared in print first in 1955. The term gender identity was used in a press release, November 21, 1966, to announce the new clinic for transsexuals at The Johns Hopkins Hospital. It was disseminated in the media worldwide, and soon entered the vernacular. The definitions of gender and gender identity vary on a doctrinal basis. In popularized and scientifically debased usage, sex is what you are biologically; gender is what you become socially; gender identity is your own sense or conviction of maleness or femaleness; and gender role is the cultural stereotype of what is masculine and feminine. Causality with respect to gender identity disorder is sub-divisible into genetic, prenatal hormonal, postnatal social, and post-pubertal hormonal determinants, but there is, as yet, no comprehensive and detailed theory of causality. Gender coding in the brain is bipolar. In gender identity disorder, there is discordance between the natal sex of one's external genitalia and the brain coding of one's gender as masculine or feminine.[81]

Money refers to attempts to distinguish a difference between biological sex and social gender as "scientifically debased", because of our increased knowledge of a continuum of dimorphic features (Money's word is "dipolar") that link biological and behavioral differences. These extend from the exclusively biological "genetic" and "prenatal hormonal" differences between men and women, to "postnatal" features, some of which are social, but others have been shown to result from "post-pubertal hormonal" effects.

Although causation from the biological—genetic and hormonal—to the behavioral has been broadly demonstrated and accepted, Money is careful to also note that understanding of the causal chains from biology to behavior in sex and gender issues is very far from complete. For example, the existence of a "gay gene" has not been proven, but such a gene remains an acknowledged possibility.[82]

There are studies concerning women who have a condition called congenital adrenal hyperplasia, which leads to the overproduction of the masculine sex hormone, androgen. These women usually have ordinary female appearances (though nearly all girls with congenital adrenal hyperplasia (CAH) have corrective surgery performed on their genitals). However, despite taking hormone-balancing medication given to them at birth, these females are statistically more likely to be interested in activities traditionally linked to males than female activities. Psychology professor and CAH researcher Dr. Sheri Berenbaum attributes these differences to an exposure of higher levels of male sex hormones in utero.[83]

Sexual reproduction[edit]

Main article: Sexual reproduction

Sexual differentiation demands the fusion of gametes that are morphologically different.

—Cyril Dean Darlington, Recent Advances in Cytology, 1937.
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today is oct 27 2018

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