Is there a desire to confuse, to create divisions between people, to misinform by appealing to the ignorance, stereotypes and emotional hooks of ordinary people, especially those with less culture ?
So, for many people, tackling this challenging subject means looking at the dark part of themselves that they would like to suppress at all costs.
That is why, as a scientific researcher with more than twenty years of experience in this field, I am going to publish a few articles on the subject, with the aim of showing how this demonic alliance between governments, the WHO and Big Pharma (the usual inescapable trinomial of falsehood that has reigned for decades) has, over the years, spread a systematic lie at every level in order to establish the well-known concept of “divide and rule”.
To divide humanity even more, instead of uniting it.
Mother Nature loves bio-diversity.
Unfortunately, our society hates it.
Gender identity disorder, transgender, gender incongruence, and gender dysphoria are terms used to refer to people who, as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), human beings who “…exhibit marked incongruence between their assigned sex (usually at birth, referred to as their birth gender) and their lived/expressed gender”.
My aim, as always, is to provide information using authoritative sources…
“Transgender” is the term that is commonly used in the media and politics today (imagine a little bit why…), but besides being totally inaccurate and without any medical/scientific meaning, it creates mental confusion and above all controversy.
That is why I have never used it in this blog.
My goal, as always, is to provide information using authoritative sources, in this case, how to correctly assign and report ICD-10-CM/PCS codes for the topics covered.
In this blog, the source is the DSM-5 because the documentation that coders see in the medical record is typically based on the diagnostic criteria and definitions in the DSM-5.
ICD-10-CM classifies this diagnosis as “gender dysphoria“.
DSM-5 defines it as “gender dysphoria”, and WHO, in ICD-11, classifies it as “gender incongruence“; if we add “transgender”, we have four different terms that often refer to the same issue.
Are all these terms synonymous?
The answer is – mostly – “yes”.
Is there a desire to confuse in order to create divisions among people, to misinform by appealing to the ignorance, stereotypes and emotional hooks of ordinary people, especially those with less culture?
The answer is – definitely – “yes”.
Terms defined
Dysphoria (from the Greek dysphoros, meaning “hard to bear“) literally means deep state of discomfort or dissatisfaction.
However, the term “dysphoria” is not limited to or synonymous with “gender dysphoria” : for example, Code 6 Postpartum Mood Disorder includes the umbrella term “postpartum dysphoria“, also known as “postpartum blues” or “postpartum sadness.
Incongruity can be translated as inconsistency or incompatibility. Carl Rogers, PhD (1902-1987), an American psychologist and one of the founders of the humanistic approach to psychology, introduced the concept of incongruence in the 1950s.
Although the common usage of the term means inconsistency or incompatibility, Rogers defined “congruence” as the correspondence between experience and consciousness.
Therefore, “incongruence” means “lack of congruence“, or “feelings not aligned with one’s actions“.
Transgender – definitions vary, but “transgender” generally refers to a gender identity or expression that is different from a person’s assigned or birth sex.
I remind you again that the term “transgender” is NOT included in any of the ICD-10-CM code descriptions and is NEVER used in any definition.
Gender identity – is defined in the DSM-5 as “...a category of social identity and refers to the identification of an individual as male, female, or occasionally some category other than male or female“.
Obviously, this is a deliberately ambiguous and tendentious definition, since there is no such thing as “occasional identification“, which would imply that these latter people suffer from some “gender identity/gender dysphoria” disorder, but rather that we most likely fall into some diagnosis of transvestitism or GIDNOS (both of which will be covered in the continuation of this article).
Of course, “gender identity” is not a disorder per se; it is simply the gender with which a person identifies.
In fact, there is no ICD-10-CM code for “gender identity.”
Now that we have defined the terms, let’s address the issue from a coding perspective.
Here are the codes as they appear in the table for category F64 Gender Identity Disorders.
F64.0 Transsexualism
Gender identity disorder in adolescence and adulthood Gender dysphoria in adolescents and adults
Gender dysphoria, unspecified Gender role disorder NOS
Other terms, as they appear in the Code, are defined as follows :
F64.0 Transsexualism, or “transsexual” is defined in the DSM-5 as a human being when referring to a human being.”…. who seeks, or has had, a social transition from male to female or female to male, which in many, but not all, cases also involves somatic transition through intersex hormone treatment and genital surgery (sex reassignment surgery)“.
The inclusion terms are “gender identity disorder in adolescence and adulthood” and “gender dysphoria in adolescents and adults“.
F64.1 Dual-role transvestism. The term or diagnosis that comes closest to the DSM-5 is “cross-dressing disorder“.
It appears in the chapter on “Paraphilic Disorders“, not in the chapter on “Gender Dysphoria“.
Paraphilic disorders include voyeuristic disorder, exhibitionist disorder, sexual masochism, pedophilia and cross-dressing, the latter defined as “engaging in sexually arousing cross-dressing”.
“Dual-role cross-dressing” appears in the research review and is essentially defined as a person, usually male, who wears clothing of the opposite sex in order to experience temporary membership in the opposite sex, has no sexual motivation for cross-dressing, and does not desire to become permanently the opposite sex.
F64.2 Gender identity disorder in childhood or “gender dysphoria in children”
You may wonder why, at least for consistency, the description of code F64.1 is not “Gender Disorder of Adolescence and Adulthood“.
The answer is quite simple.
Following are the ICD-11 codes and definitions for adolescence or adulthood gender incongruence (HA60) and childhood gender incongruence (HA61)
Below are the ICD-11 codes and definitions for Gender Incongruence in Adolescence or Adulthood (HA60) and Gender Incongruence in Childhood (HA61): :
HA60 Gender Incongruence in Adolescence or Adulthood
Gender incongruence in adolescence or adulthood is characterized by a marked and persistent incongruence between one’s experienced gender and one’s assigned gender, often leading to a desire to “transition”, to live and be accepted as a person of the experienced gender through hormone treatments, surgery, or other health services to make one’s body conform to the experienced gender as much as desired and possible.
Diagnosis CANNOT be made before the onset of puberty.
Gender behaviors and preferences are NOT a basis for diagnosis.
“Transsexual” and “transsexualism” are inclusive terms for code HA60.
Thus, when we compare F64.0 with HA60, we see that the descriptions of the respective codes have changed, but the meaning remains the same.
Childhood gender incongruence is characterized by a marked incongruence between a person’s expressed experience/gender and the sex assigned before puberty.
It includes a strong desire to be of a sex other than the assigned sex; a strong dislike of the child’s own sexual anatomy or expected secondary sexual characteristics, and/or a strong desire for expected primary and/or secondary sexual characteristics that correspond to the experienced sex; and fantasy games, toys, or activities and playmates that are typical of the experienced sex rather than the assigned sex.
Incongruence must have been present for at least TWO years.
Gender-variant behaviors and preferences are NOT in themselves a basis for diagnosis.
Now that all the technical terms have been defined, let’s look at some possible examples from everyday life.
Unfortunately, as we all know, there is a lot of misinformation on this subject, and rogue politicians (but unfortunately also many doctors) – of all stripes – cleverly play on people’s emotional hooks to muddy the waters even more for purely electoral purposes (maintaining their own little garden of supporters).
Example 1 : An adult human being diagnosed with “gender dysphoria” presents for male-to-female genital organ reassignment surgery. Code F64.0 Transsexualism.
Example 2 : A male human being is treated for anxiety due to several years of secretly dressing in his girlfriend’s clothes and fear of being found out.
He is given a history and prescribed an anxiolytic. Code F64.1 Dual role transvestism.
Example 3 : A 10-year-old girl is brought to the pediatrician because she asked for a soccer ball for her birthday.
The pediatrician documents that the girl only wants the ball to play with her brothers, feels no discomfort, and has not expressed a desire to be a boy.
Nothing is prescribed for her and no treatment or counseling is recommended. No code is assigned.
Example 4 : An adult male is under great stress because he strongly believes that he cannot conform to his family’s gender role expectations. Code F64.9 Gender dysphoria, unspecified.
Example 5 : An individual was admitted for routine surgery.
During the admission process, he was asked to identify his gender.
The person refused, stating that he does not identify as male or female because he does not believe in the “concept of gender”.
It is documented that his gender identity is “currently unknown.” No code is assigned.
I recommend being very careful about feeding certain currents of thought…
In 1948, shortly after the end of World War II, the controversial figure of Dr. Alfred Kinsey presented American society with a snapshot of the population’s sexual practices in two completely different books (Sexual Behavior in the Human Male in 1948 and Sexual Behavior in the Human Female in 1953) : not only adultery and homosexuality (at that time truly taboo subjects for public opinion), but also S&M practices, voyeurism, masturbation.
And, unfortunately, also pedophilia and zoophilia.
The reception of this work by American society – still decidedly puritanical at the time – was at first rather frosty, not least because Dr. Kinsey accused his contemporaries (not without some justification) of hypocrisy and of being an “obstacle” to a happy and uninhibited sexuality.
Later counter-studies showed that Kinsey lied by exaggerating his findings by a factor of 1 to 10 to present a society much more oriented toward “deviant” sexual practices.
But I recommend that we be very careful about feeding certain currents of thought (which are spreading very dangerously, especially in Europe) that seek to reintroduce an Inquisition worthy of Torquemada, instead of proposing a model of healthy and non-deviant sexuality.
On the other hand, we know that the European continent is becoming more and more Islamized, and we know that this religion is certainly not very open on certain issues.
In short, many “traditionalist” politicians who appear to the masses as staunch “opponents” of the New World Order are in fact covert flankers.
The study I am about to present will examine the social and legal conditions in which many people affected by so-called gender dysphoria live.
It will review numerous research studies that show that most continue to live on the margins of society due to stigmatization, exclusion from social and work life, violence and, as a result, widespread poor health.
Some states are taking steps to address human rights issues and provide better legal protection, but this is not enough to ensure a normal life.
The solution to the problem is knowledge, certainly not the enforcement of “laws”.
