History and exam

Key diagnostic factors

common

incongruence between birth-assigned sex and experienced gender

Gender incongruence, as defined in ICD-11, is characterised by a marked and persistent discordance between an individual´s experienced gender and their birth-assigned sex, which often leads to a desire to ‘transition’, in order to live and be accepted as a person of the experienced gender, for example, through hormonal treatment, surgery or other healthcare services.[1]

altered appearance or affect

Patients may adopt the clothing, hairstyles, vocal styles, and mannerisms of their experienced gender.[2]

Risk factors

weak

autism spectrum disorder (ASD)

Some observations suggest people with gender incongruence and gender dysphoria show more features of ASD than the general population.[12][13][26]​ At one gender clinic prevalence of autistic traits consistent with a clinical diagnosis of ASD among individuals undertaking treatment was 5.5%, compared with reports of 0.5% to 2.0% ASD diagnoses in the general population.[26]

congenital adrenal hyperplasia

Associated with a slightly elevated rate of gender incongruence/dysphoria.[20][21][22]​​

Klinefelter's syndrome

Associated with a slightly elevated rate of gender incongruence/dysphoria.[18]

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