Which diagnosis best fits duration, episodicity, and exclusions?
A
Gender dysphoria
Marked incongruence between one's experienced/expressed gender and assigned gender, ≥6 months; in adolescents/adults: ≥2 of: incongruence between experienced gender and primary/secondary sex characteristics; strong desire to be rid of primary/secondary sex characteristics; strong desire for sex characteristics of experienced gender; strong desire to be of experienced gender; strong desire to be treated as experienced gender; strong conviction of having typical feelings/reactions of experienced gender
AA. Marked incongruence between one's experienced/expressed gender and assigned gender, ≥6 months; in adolescents/adults: ≥2 of: incongruence between experienced gender and primary/secondary sex characteristics; strong desire to be rid of primary/secondary sex characteristics; strong desire for sex characteristics of experienced gender; strong desire to be of experienced gender; strong desire to be treated as experienced gender; strong conviction of having typical feelings/reactions of experienced gender B. Condition is associated with clinically significant distress or impairment
BA. Over ≥6 months, recurrent and intense sexual arousal from cross-dressing, as manifested by fantasies, urges, or behaviours B. Fantasies, urges, or behaviours cause clinically significant distress or impairment
Common specifiers
AWith a disorder of sex development; Posttransition; Mild; Moderate
BWith fetishism; With autogynephilia; In a controlled environment; In remission
Differential flags
ANormal gender nonconformity (without distress or impairment - not a disorder); Transvestic disorder (sexually arousing cross-dressing; without gender incongruence); Body dysmorphic disorder (preoccupation with appearance features; not gender identity)
BGender dysphoria (persistent gender incongruence; not primarily sexual arousal; may overlap); Non-distressing cross-dressing or drag (cultural/social; no sexual arousal or distress - not a disorder); Fetishistic disorder (object arousal without specific cross-dressing theme)