Gender dysphoria and disorders of sex development: Progress in care and knowledge edition:1st pages:231-254
This chapter gives an overview of the care for adults with gender dysphoria from the last decades of 1900 until recently, with a short vision for the future. The view on the care of individuals with gender issues has changed tremendously. This evolution is described here: from a psychotic illness, through a rather strict definition of "transsexualism", towards a broader description of gender-variant individuals. Also, the treatment has evolved simultaneously: from antipsychotic drugs, through medical treatment (hormones and surgery) of the "true transsexual" and the psychotherapeutic approach with the adult with "secondary transsexualism", towards a variety of possible treatments and transitions (social and/or physical), determined by the preference of the individual in consultation with the mental healthcare provider. In most recent years, the focus has been on de-pathologization of gender-variance; on the human rights of gender-variant people; on the effect of stigmatization, discrimination, and victimization; and on ways to prevent these negative social experiences.
Although the care of individuals with gender dysphoria has improved significantly over the past 50 years, more work needs to be done. Twenty-first-century gender care described in this volume should also be more readily available in the Southern Hemisphere and the Asian-Pacific Region. In the meantime, research evaluating treatment with the continuous aim of improving the care for individuals with gender dysphoria remains an important focus,