History and exam
Key diagnostic factors
There should be the presence of both a desire to live as another gender and a seeking of bodily transformation to resemble as closely as possible that other gender role. This should have been present for at least 2 years. There should be absence of any psychiatric symptomatology that might directly account for these feelings.
Patients often have already taken steps regarding clothing and hairstyle in order to resemble another sex. Their mannerisms often resemble those of the other sex, particularly in born-female patients.
Other diagnostic factors
Libido tends to be low in born-male patients and normal in born females. Most born-female patients are sexually interested in women. Born-male patients might be interested in either sex. Sexual orientation is much less diagnostically significant than libido.
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