Family Physicians Should Become Aware of Aspects of Gender Identity Disorder, Expert Says

   According to a presentation at the 2010 Annual Scientific Sessions of the American Academy of Family Physicians in Denver, physicians should be educators and advocates for those with gender identity disorder (GID) and their families within their own communities.

   The presentation was made by Jennifer Burnett, MD, Assistant Professor of Community Medicine at the University of California at Fresno and a member of the faculty at the Fresno Family Practice Residency Program. She is a frequent lecturer on GID.

   According to her, GID (also known as transsexualism) is not a psychiatric problem; nor is it some immoral/sexual lifestyle choice. Rather, GID is a congenital anomaly. But unlike most birth defects, it is entirely invisible; the abnormality is not on the outside but in the brain, where a person’s self‐ concept of being male or female lies.

   “Whereas it seems inconceivable to almost everyone that a person’s gender identity could be opposite to their genital sex,” Dr. Burnett said. “For those with GID, it is the most evident thing they know about themselves. Children with GID often know they are different well before the age of five. They can be observed to routinely choose to play with toys of the opposite sex and they show a marked preference for dressing themselves up and role‐playing as the opposite gender.”

   Later on in life, Sex Reassignment Surgery (SRS) is an option that does not carry automatic happiness. According to Dr. Burnett, “It is a long and difficult path, fraught with many hazards. Most of those transitioning are subjected to terrible losses -- divorce, estrangement from their children, loss of their jobs, and abandonment by friends and other family members. Relationships within their churches or other social organizations may quickly deteriorate and they are frequently forced to leave. However, since there is no other effective treatment for GID, transitioning is usually their only option.”

   The physician’s role in helping the patient with GID is to recognize that GID is a medical condition that is not amenable to any type of psychiatric intervention, she told attendees. After that is the need to learn the basics of GID and prepare to counsel patients. There are a number of websites and books that will enable family physicians to gain additional knowledge of GID and appropriate diagnosis and treatment, Dr. Burnett said.