Treatment for a person diagnosed with GD may include psychological counseling, supporting the individual's<unk>  expression, or hormone therapy or surgery. This may involve physical transition resulting from medical interventions such as hormonal treatment, genital surgery, electrolysis or laser hair removal, chest/breast surgery, or other reconstructive surgeries. The goal of treatment may simply be to reduce problems resulting from the person's transgender status, for example, counseling the patient in order to reduce guilt associated with cross-dressing. Guidelines have been established to aid clinicians. The World Professional Association for Transgender Health (WPATH) Standards of Care are used by some clinicians as treatment guidelines. Others use guidelines outlined in Gianna Israel and Donald Tarver's Transgender Care. Guidelines for treatment<unk> ally follow a "harm reduction" model. Children Medical, scientific, and governmental organizations have opposed conversion therapy, defined as treatment viewing<unk>  nonconformity as pathological and something to be changed, instead supporting approaches that affirm children's diverse<unk>  identities. People are more likely to keep having<unk>  the more intense their<unk> , cross-gendered behavior, and verbal identification with the desired/experienced<unk>  are (i.e. stating that they are a different<unk>  rather than wish to be a different<unk> . Studies have reported higher rates of desistance among young children. A 2016 review of 10 prospective follow-up studies from childhood to adolescence found desistance rates ranging from 61% to 98%, with evidence suggesting that they might be less than 85% more<unk> ally. These studies have been criticized on the grounds that they count as 'desistance' cases where the child met the criteria for<unk>  identity disorder as defined in the DSM-III or DSM-IV, but would not have met the updated criteria for<unk>  in the DSM-5, established in 2013. Additionally, the evidence offered has been criticized for citing studies which have been labelled conversion therapy for discouraging social transition and trying to prevent a transgender outcome. The diagnostic criteria for<unk>  used in the studies only required<unk> -nonconformity, and did not require a child to state a transgender identity or a desire for medical or social transition. Most childhood desisters go on to identify as cisgender and gay or lesbian. Professionals who treat<unk>  in children sometimes prescribe puberty blockers to delay the onset of puberty until a child is believed to be old enough to make an informed decision on whether hormonal or surgical<unk>  reassignment is in their best interest. A review commissioned by the UK Department of Health found that there was very low certainty of quality of evidence about puberty blocker outcomes in terms of mental health, quality of life and impact on<unk> . The Finnish government commissioned a review of the research evidence for treatment of minors and the Finnish Ministry of Health concluded that there are no research-based health care methods for minors with<unk> . Nevertheless, they recommend the use of puberty blockers for minors on a case-by-case basis, and the American Academy of Pediatrics state that "pubertal suppression in children who identify as TGD transgender and<unk>  diverse<unk> ally leads to improved psychological functioning in adolescence and young adulthood.". In the United States, several states have introduced or are considering legislation that would prohibit the use of puberty blockers in the treatment of transgender children. The American Medical Association, the Endocrine Society, the American Psychological Association, the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics oppose bans on puberty blockers for transgender children. In the UK, in the case of Bell v Tavistock, an appeal court, overturning the original decision, ruled that children under 16 could give consent to receiving puberty blockers. Psychological treatments Until the 1970s, psychotherapy was the primary treatment for<unk>  and<unk> ally was directed to helping the person adjust to their assigned sex. Psychotherapy is any therapeutic interaction that aims to treat a psychological problem. Psychotherapy may be used in addition to biological interventions, although some clinicians use only psychotherapy to treat<unk> . Psychotherapeutic treatment of GD involves helping the patient to adapt to their<unk>  incongruence or to explorative investigation of confounding co-occurring mental health issues. Attempts to alleviate GD by changing the patient's<unk>  identity to reflect assigned sex have been ineffective and are regarded as conversion therapy by most health organizations. Biological treatments Biological treatments physically alter primary and secondary sex characteristics to reduce the discrepancy between an individual's physical body and<unk>  identity. Biological treatments for GD are typically undertaken in conjunction with psychotherapy; however, the WPATH Standards of Care state that psychotherapy should not be an absolute requirement for biological treatments. It is known that some mental disorders are important to evaluate and treat before proceeding with hormones or surgery, as treatment of these mental disorders can sometimes make the wish for altering one's body disappear or significantly lessen. Psychotherapy, hormone therapy, and sex reassignment surgery can be effective at treating GD when the WPATH Standards of Care 6 are followed. Hormonal treatments have been shown to reduce a number of symptoms of psychiatric distress associated with<unk> . A WPATH commissioned systematic review of the outcomes of hormone therapy "found evidence that<unk> -affirming hormone therapy may be associated with improvements in quality of life scores and decreases in depression and anxiety symptoms among transgender people." The strength of the evidence was low due to methodological limitations of the studies undertaken. Some literature suggests that<unk> -affirming surgery is associated with improvements in quality of life and decreased incidence of depression. Those who choose to undergo sex reassignment surgery report high satisfaction rates with the outcome, though these studies have limitations including risk of bias (lack of randomization, lack of controlled studies, self-reported outcomes) and high loss to follow up. For adolescents, much is unknown, including persistence. Disagreement among practitioners regarding treatment of adolescents is in part due to the lack of long-term data. Young people qualifying for biomedical treatment according to the Dutch model (including having GD from early childhood on which intensifies at puberty and absence of psychiatric comorbidities that could challenge diagnosis or treatment) found reduction in<unk> , although limitations to these outcome studies have been noted, such as lack of controls or considering alternatives like psychotherapy. More rigorous studies are needed to assess the effectiveness, safety, and long-term benefits and risks of hormonal and surgical treatments. For instance, a 2020 Cochrane review found insufficient evidence to determine whether feminizing hormones were safe or effective. Several studies have found significant long-term psychological and psychiatric pathology after surgical treatments. In 2021, a review published in Plastic And Reconstructive Surgery found that less than 1% of people who undergo<unk> -affirming surgery regret the decision.
Gender dysphoria
Gender identity
Body integrity dysphoria
Sexual anhedonia
Sexual relationship disorder
Emotional dysregulation
Sexual addiction
Extended female sexuality