性别苦恼的临床研究新进展(DSM-5新标准)

New Progress of Clinical Research to Gender Dysphora(DSM-5 Update)

性别苦恼(Gender dysphoria)既往称为性别认同障碍(Gender identity disorder),又称性别改变症(Transsexualism)。是指一个人在心理上无法认同自己与生俱来的性别,相信自己应该属于另一种性别。或是指性别方面的心理障碍者深信称之为自己是另一性别的人,并可能考虑改变自己的性别角色,对自己的身体进行女性化或男性化处理,以取得更大的舒适性与自我认同的性身份。美国精神病学会在2013年5月出版了《精神疾病诊断与统计手册》第5版(DSM-5)。DSM-5去除"性别认同障碍"诊断名称,而改为"性别苦恼"。这等同于"性别认同"的"去病化",肯定性别认同的"多元性"。自此,性别认同的差异不再有正常与不正常之分。近年来,在人类性学、精神病学和临床心理学领域对性别苦恼进行了大量的临床研究。根据DSM-5的标准和新的临床研究成果,本文对性别苦恼的病因和发病机制、临床表现、诊断标准、诊断和鉴别诊断、治疗、预防和保健进行了分析。

Gender dysphoria（GD）previously called gender identity disorder（GID）,also known transsexualism.It refers to a discomfort with one＇s gender assigned at birth.Individuals who have persistent gender dysphoria typically have an experienced gender identity that differs significantly from the sex they were assigned at birth,and may consider changing their gender role and feminize or masculinize their body to achieve greater comfort with self and identity.American Psychiatry Association（APA）has published〈Diagnostic and Statistical Manual of Mental Disorders,5th Edition〉（DSM-5）in 2013.DSM-5 has removed the ＂gender identity disorder＂ ＇s diagnosis name and change to ＂gender dysphoria＂.This is equivalent to ＂gender identity＂ into ＂treat illness＂,and affirmed gender identity of ＂diversity＂.Since then,difference of gender identity is no normal or abnormal points.In recent years,A lot of clinical research on gender dysphoria has been practiced in human sexuality,psychiatry,and clinical psychology fields.According to update of DSM-5 and new achievement of clinical research,this paper has analyzed to etiology and pathogenesis,clinical manifestations,diagnostic criteria,diagnosis and differential diagnosis,treatment,prevention and health care of gender dysphoria.