Report of the American psychiatric association task force on treatment of gender identity disorder

BoththediagnosisandtreatmentofGenderIdentity Disorder(GID)arecontroversial. Althoughlinked,theyareseparate issues andtheDSMdoesnot evaluate treatments.TheBoard ofTrustees(BOT)oftheAmericanPsychiatricAssociation(APA), therefore,formedaTaskForcechargedtoperformacriticalreview of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included anopinion as to whetheror not sufficient credible literature exists for development of treatmentrecommendationsbytheAPA. The literatureontreatmentofgender dysphoria in individuals with disorders of sex development was also assessed. Thecompleted reportwas accepted by theBOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as theprimaryoutcomemeasure, current evidencewasjudged sufficient to support recommendationsforadultsintheformofan evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variantminors, and the rights of persons of any agewho are gender variant, transgender or transsexual.