This Section is designed for healthcare professionals and GP Practice staff.

For public information, please visit the Brighton and Hove CCG public home page.

The Approach To Treatment

Guide To Supporting Patients Accessing Specialist Gender Identity Services

Section 4.2

The current approach to treatment is based on the diagnosis of ‘gender dysphoria’. Gender dysphoria refers to discomfort or distress caused by a discrepancy between a person’s gender identity and their assigned sex at birth, associated gender role and/or primary and secondary sex characteristics. It is important to note the following:

  • Being trans or gender variant is not a mental illness but is part of normal human variation (see the World Professional Association for Transgender Health (WPATH) Statement in the table below)
  • Not all trans people experience gender dysphoria, i.e. their gender variance does not cause them to feel discomfort or distress but may be accepted and embraced
  • There are specified criteria concerning how a gender dysphoria diagnosis is determined and who is medically qualified to make the diagnosis, i.e. specialist clinicians
  • Although gender dysphoria and gender identity disorder appear as diagnosable mental health problems in the Diagnostic Statistical Manual of Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10), these diagnoses are highly controversial, with strongly contested debates about their validity and inclusion
  • While the concept of gender dysphoria is contested, some people report experiencing this as a devastating condition that impairs mental health and blights functional living, leading in some cases to self-harm and suicide if left unaddressed
  • Specialist Gender Identity Services (SGIS) diagnose and treat gender dysphoria but they also provide services to people with ‘atypical gender development’ who do not experience gender dysphoria.


Introduction Guide Home Page
Section 1.0 About This Guide
Section 1.1 Why This Guide Is Needed
Section 1.2 Current Context
Section 2.0 Developing Understanding About Trans People
Section 2.1 New Thinking About Gender
Section 2.2 About Trans Identities
Section 2.3 About Gender Pronouns
Section 3.0 High Quality Services for Trans People
Section 3.1 Getting It Right
Section 3.2 A Special Note on Children and Young People
Section 3.3 A Special Note on Screening: Screen for the Organs Present
Section 4.0 Understanding the Patient Groups
Section 4.1 Understanding Specialist Gender Identity Services
Section 4.2 The Approach to Treatment
Section 4.3 Treatment Protocols
Section 4.4 Available Treatments - Adults
Section 4.5 Available Treatments - Children and Young People
Section 4.6 The Role of the GP
Section 5.0 Changing NHS Records
Section 5.1 Information Sharing - The Gender Recognition Act 2004
Section 5.2 Medical Reports
Section 6.0 Supporting Patients
Section 6.1 Sources of Information and Support
Section 7.0 Glossary

From the WPATH Standards of Care for the Health of Transsexual, Transgender, and Gender Non-conforming People

The World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transsexual, Transgender, and Gender Non-conforming People states:

Some people experience gender dysphoria at such a level that the distress meets criteria for a formal diagnosis that might be classified as a mental disorder. Such a diagnosis is not a license for stigmatization or for the deprivation of civil and human rights … A disorder is a description of something with which a person might struggle, not a description of the person or the person’s identity.  Thus, transsexual, transgender, and gender-nonconforming individuals are not inherently disordered. Rather, the distress of gender dysphoria, when present, is the concern that might be diagnosable and for which various treatment options are available (p. 5-6).

Source: WPATH (2012) Standards of Care for the Health of Transsexual, Transgender, and Gender Non-conforming People