The Gender Identity/gender Dysphoria Questionnaire for Adolescents and Adults
Deogracias, Joseph J., Johnson, Laurel L., Meyer-Bahlburg, Heino F. L., Kessler, Suzanne J., Schober, Justine M., Zucker, Kenneth J., The Journal of Sex Research
Gender identity (or core gender identity) has been defined as a person's basic sense of self as a male or female (Stoller, 1964a). Because most males have a male gender identity and most females have a female gender identity (in accordance with one's original legal sex and usually based on the appearance of the genitalia at birth), gender identity often is conceptualized in a bipolar, dichotomous manner with a male gender identity at one pole and a female gender identity at the other pole. Individuals who have an uncertain or confused gender identity or who are transitioning from one gender to the other, however, do not fit into this dichotomous scheme.
For patients who experience subjective distress (gender dysphoria) regarding their gender identity, the DSM (American Psychiatric Association, 2000) has adopted a categorical nosological perspective, in the sense that a person does or does not meet the criteria for gender identity disorder (GID). Of course, one could create a dimensional measure from the DSM criteria for GID by counting, for a particular patient, the number of indicators that are present, but this has not been common practice in either the clinical or research literature. More than 30 years ago, when Fisk (1973) coined the term gender dysphoria, it was apparent that this construct could be conceptualized dimensionally and, if appropriately operationalized, would hold great promise in assessing the degree to which an individual is struggling with his or her gender identity (vis-a-vis one's birth sex).
In the normative developmental literature, gender identity mainly has been operationalized with regard to cognitive milestones, such as the ability to correctly self-label oneself as a boy or as a girl (Slaby & Frey, 1975), with much less attention given to affective appraisals. Zucker et al. (1993), however, developed a gender identity interview for children (GIIC), a dimensional measure, that was designed to assess both cognitive and affective gender identity confusion. A factor analysis confirmed a two-factor structure to the GIIC, and both factors significantly discriminated clinic-referred children with gender identity problems from controls (see also Meyer-Bahlburg et al., 2004, and Jurgensen, Hampel, Hiort, & Thyen, 2006).
Unfortunately, only a few studies have attempted a dimensional assessment of gender identity/gender dysphoria in adolescent and adult populations. In one study, Docter and Fleming (2001) reported on a dichotomously answered l l3-item questionnaire, originally termed the cross-gender questionnaire (Docter & Fleming, 1992), which included items pertaining to gender identity and gender dysphoria in biological males. It was administered to 61 male-to-female (MtF) transsexuals and 455 transvestites. Docter and Fleming (2001) identified a 5-factor solution, of which one factor (26 items) was labeled "transgender identity." On this factor, the MtF transsexuals had a significantly higher mean scale score than did the transvestites. A number of the items on this factor would not, however, be applicable to biological females and, to date, this questionnaire has not been given to nonclinical comparison groups. Cohen-Kettenis and van Goozen (1997) reported on the psychometric properties of the unpublished Utrecht gender dysphoria scale (GDS; in Dutch), which consists of 12 questions rated on a 5-point scale. They reported that the total score successfully discriminated male and female transsexuals from same-sex controls, although information on specificity and sensitivity was not provided (see also Doom, Kuiper, Verschoor, & Cohen-Kettenis 1996).
At present, there are a number of reasons why it would be important to have a dimensional measure of gender identity/gender dysphoria for both adolescents and adults. First, although GID has a very low prevalence (American Psychiatric Association, 2000), some clinicians have argued that there has …
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Publication information: Article title: The Gender Identity/gender Dysphoria Questionnaire for Adolescents and Adults. Contributors: Deogracias, Joseph J. - Author, Johnson, Laurel L. - Author, Meyer-Bahlburg, Heino F. L. - Author, Kessler, Suzanne J. - Author, Schober, Justine M. - Author, Zucker, Kenneth J. - Author. Journal title: The Journal of Sex Research. Volume: 44. Issue: 4 Publication date: November 2007. Page number: 370+. © 2007 Taylor & Francis Group, LLC. COPYRIGHT 2007 Gale Group.
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