The most recent edition of this manual, the DSM-5, eliminates the term "gender identity disorder," which was long considered stigmatizing by mental health specialists and LGBT activists.
The new DSM refers only to "gender dysphoria," which focuses the attention on only those who feel distressed by gender identity issues. Having this still available as a diagnosis ensures a transgender person can still access related health care if needed. Hormone treatment would be one example. Another would be counseling for those who need help dealing with their emotions.
Nonconformity is common in kids.
Children as young as 3 can show early signs of gender identity issues, some mental health experts say. These children are not intersex -- they do not have a physical disorder or malformation of their sexual organs. The gender issue exists in the brain, though whether it's psychological or physiological is hotly debated.
Some children engage in gender nonconformity behavior, meaning they tend to take on roles and activities associated with the opposite gender. This could be a boy who grows his hair long or paints his nails, or a girl who wears only male clothing. From 2 percent to 5 percent of boys and 15 percent to 16 percent of girls exhibit gender nonconforming behavior, according to a 2012 Pediatrics editorial. For most, the behavior fades as they grow older.
This is not the same as a transgender identity, where the child is certain he/she was meant to be the opposite sex.
Transgender hormone therapy for children is a relatively new practice in the United States. Programs for transgender children exist in cities including Los Angeles, Seattle and San Francisco. The kids are treated by pediatric endocrinologists after long evaluations by mental health professionals.