The ICD is an international version of the DSM. According to the HBSOC: The purpose of the DSM-IV and ICD-10 is to organize and guide treatment and research. These nomenclatures were created at different times and driven by different professional groups through a consensus process. There is an expectation that the differences between the systems will be eliminated by the year 2000. At this point, the specific diagnoses are based to a larger extent on clinical reasoning than on scientific investigation. It has not been sufficiently studied, for instance, whether sexual attraction patterns predict whether or not a patient will be a mentally healthier person in five years with or without the triadic sequence.
The ICD-10 now provides five diagnoses for the gender identity disorders.
ICD - 10
Transsexualism (F64.0) has three criteria:
- The desire to live and be accepted as a member of the opposite sex, usually accompanied by the wish to make his or her body as congruent as possible with the preferred sex through surgery and hormone treatment
- The transsexual identity has been present persistently for at least two years
- The disorder is not a symptom of another mental disorder or a chromosomal abnormality
Dual-role Transvestism (F64.1) has three criteria:
- The individual wears clothes of the opposite sex in order to experience temporary membership in the opposite sex
- There is no sexual motivation for the cross-dressing
- The individual has no desire for a permanent change to the opposite sex
Gender Identity Disorder of Childhood (64.2) has separate criteria for girls and for boys.
- For girls:
- The individual shows persistent and intense distress about being a girl, and has a stated desire to be a boy (not merely a desire for any perceived cultural advantages to being a boy) or insists that she is a boy.
- Either of the following must be present:
- persistent marked aversion to normative feminine clothing and insistence on wearing stereotypical masculine clothing
- persistent repudiation of female anatomical structures, as evidenced by at least one of the following:
- an assertion that she has, or will grow, a penis
- rejection of urination in a sitting position
- assertion that she does not want to grow breasts or menstruate
- 3. The girl has not yet reached puberty
- 4. The disorder must have been present for at least 6 months
- For boys:
- 1. The individual shows persistent and intense distress about being a boy, and has a desire to be a girl, or, more rarely, insists that he is a girl
- 2. Either of the following must be present:
- preoccupation with stereotypic female activities, as shown by a preference for either cross-dressing or simulating female attire, or by an intense desire to participate in the games and pastimes of girls and rejection of stereotypical male toys, games, and activities
- persistent repudiation of male anatomical structures, as evidenced by at least one of the following repeated assertions:
- that he will grow up to become a woman (not merely in the role)
- that his penis or testes are disgusting or will disappear
- that it would be better not to have a penis or testes
- 3. The boy has not yet reached puberty
- 4. The disorder must have been present for at least 6 months
Other Gender Identity Disorders (F64.8) has no specific criteria
Gender Identity Disorder, Unspecified has no specific criteria.
Either of the previous two diagnoses could be used for those with an intersexed condition.