Reflections on the Legal Battles Over Prisoners with Gender Dysphoria

Stephen B. Levine

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Table 1

DSM-5 Criteria for Gender Dysphoria in Adolescence and Adults

A. A marked incongruence between one's experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by two of the following:

1. A marked incongruence between one's experienced/expressed gender and primary and/or secondary sex characteristics

2. A strong desire to be rid of one's primary and/or secondary sex characteristics because of a marked incongruence with one's experienced/expressed gender

3. A strong desire for the primary and/or secondary sex characteristics of the other gender

4. A strong desire to be of the other gender (or some alternative gender different from one's assigned gender)

5. A strong desire to be treated as the other gender (or some alternative gender different from one's assigned gender)

6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one's assigned gender)

B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning. (Ref. 9, pp 452–3)