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DSM-5 may split sexual disorders, gender identification

PHILADELPHIA — Researchers have proposed two separate classifications for sexual disorders and gender identification disorders here at the 2012 American Psychiatric Association Annual Meeting.

Currently, in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the classification is referred to as “Sexual and Gender Identity Disorders.”

The work group assigned to draft revisions of sexual disorders in the upcoming DSM-5 investigated three diagnostic classes: sexual dysfunctions, paraphilias and gender identity disorder (GID).

According to Kenneth Zucker, PhD, chair of the work group, several options were considered when looking at GID:

• Delete GID as a psychiatric diagnosis.

• Reclassify GID as a V-code.

• Retain GID as a psychiatric diagnosis with no change to the diagnostic criteria.

• Reform the GID diagnostic criteria.

• Move GID out of the mental health section.

“There’s probably going to be a final divorce in DSM-5, where each class of diagnosis will have its own chapter,” Zucker said.

The final proposed changes in the DSM-5 include:

• Changing the name of gender identity disorder to “gender dysphoria.”

• Tightening the diagnostic criteria for children.

• More detailed and polythetic diagnostic criteria for adolescents and adults.

• Re-introducing subtyping to determine whether a patient has a physical intersex condition.

• Deleting the sexual attraction specifier.

“A lot of people felt that if we removed the word ‘disorder’ from the name of the diagnosis, it would be less stigmatizing.” Zucker said. “There are other diagnoses in the DSM where the word ‘disorder’ is not in the title. … We got many positive comments on the website (www.dsm5.org) about that. Secondly, ‘gender dysphoria,’ which is a term quite familiar to clinical sexologists going back to the early ’70s, captures in a much better way the core phenomenology of the diagnosis.”

To view or comment on proposed changes in the DSM, visit www.dsm5.org.

For More Information:
Zucker K. Symposium S044.5 Presented at: the 2012 American Psychiatric Association Annual Meeting; May 5-9, 2012; Philadelphia.

Disclosure: Dr. Zucker reports no relevant financial disclosures.