452 Gender Dysphoria
Gender Dysphoria
Diagnostic Criteria  
Gender Dysphoria in Children 302.6 (F64.2)
A. A marked incongruence between one’s experienced/expressed gender and assigned
gender, of at least 6 months’ duration, as manifested by at least six of the following
(one of which must be Criterion A1):
1. A strong desire to be of the other gender or an insistence that one is the other gen-
der (or some alternative gender different from one’s assigned gender).
2. In boys (assigned gender), a strong preference for cross-dressing or simulating fe-
male attire; or in girls (assigned gender), a strong preference for wearing only typ-
ical masculine clothing and a strong resistance to the wearing of typical feminine
clothing.
3. A strong preference for cross-gender roles in make-believe play or fantasy play.
4. A strong preference for the toys, games, or  activities stereotypically used or en-
gaged in by the other gender.
5. A strong preference for playmates of the other gender.
6. In boys (assigned gender), a strong rejection of typically masculine toys, games,
and activities and a strong avoidance of rough-and-tumble play; or in girls (as-
signed gender), a strong rejection of typically feminine toys, games, and activities.
7. A strong dislike of one’s sexual anatomy.
8. A strong desire for the primary and/or secondary sex characteristics that match
one’s experienced gender.
B. The condition is associated with clinically significant distress or impairment in social,
school, or other important areas of functioning.
Specify if:
With a disorder of sex development  (e.g., a congenital adrenogenital disorder such