Gender Identity Clinic, Child, Youth, and Family Services, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada; email:
Department of Psychology, University of Lethbridge, Lethbridge, Alberta T1K 3M4, Canada.
Annu Rev Clin Psychol. 2016;12:217-47. doi: 10.1146/annurev-clinpsy-021815-093034. Epub 2016 Jan 18.
Gender dysphoria (GD), a term that denotes persistent discomfort with one's biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities.
性别焦虑症（GD）是指对自己的生物性别或被分配的性别持续感到不适的一种病症，该术语于 2013 年取代了《精神障碍诊断与统计手册》中性别认同障碍的诊断。已经描述了成人 GD 的亚型，根据性取向和发病年龄来定义；这些亚型表现出不同的发展轨迹和预后。患病率研究得出的结论是，不到每 10000 名成年男性和每 30000 名成年女性中就有 1 人患有 GD，但这种估计差异很大。成年 GD 与共病精神病理学的患病率升高有关，尤其是情绪障碍、焦虑障碍和自杀倾向。GD 的因果机制尚不完全清楚，但遗传、神经发育和心理社会因素可能都有贡献。虽然成人 GD 的治疗已经基本标准化，但可能会随着寻求治疗的人群的日益多样化、对客户自主权的更高要求以及对当前治疗方式的益处和局限性的理解的提高而不断发展。
