GD at a new chapter inside ICD

How to reclassify GD as Z or U?

How to subdivide items to ensure medical coverage for a good health, as necessary and not cosmetic?




Let's imagine the classification in Chapter Z, under item 77 now vacant.

      Z.77 Diagnosis and treatment of Gender Dysphorias (GD)


      Z.77.0 - Pre-Teen Typology


      Z.77.1 - Adults and Teen Typology


      Z.77.2 - Secondary surgery transitions for each Condition


      Z.77.3 - Hormone therapy for each Condition


      Z.77.4 - MtF Sexual Reassignment Surgeries (SRS)


      Z.77.5 - FtM Sexual Reassignment Surgeries (SRS)


      Z.77.6 - MtF SRS post-op care


      Z.77.7 - FtM SRS post-op care


Z.77 Diagnosis and treatment of Gender Dysphorias (GD)

Including all procedures necessary for diagnosis, classification of different conditions and necessary treatment for any condition of gender dysphoria.

Among the typical conditions highlight:

    Crossdressing (CD), mild to moderate conditions of GD
    Transgender (TG), conditions of moderate to intense GD
    Transsexualities (TS) - the extreme condition of GD
    There are not very well defined situations, we consider DGNOS - not otherwise specified, we classify as a fourth type.
The diagnosis always includes a period of anamnesis, the answers to tests and questionnaires that facilitate the typological classification and a preventive mental screening - to detect possible mental problems - to protect the patient and prtepare the patient for possible mental weaknesses.

Z.77.0 - Pre-Teen Typology

During pre-teen, may not be classified well-defined types, but we can define ranges of intensity of Unexpected Femininity and Unexpected Masculinity.

Parents and guardians are the first to realize these possibilities of unexpected femininity or masculinity.

It is suggested that a monitoring and anamnesis, and when possible the test of conditions when are observed unexpected intensities.

The technique of testing with Games - Web-based - may be an effective way to evaluate pre-adolescent children. It shows a very appropriate methodology to evaluate these conditions.

Z.77.1 - Adults and Teen Typology

Teen and adults, and even old people, literate and able to express themselves with greater ease, can be evaluated and tested in their typologies.

Through anamnesis interviews and tests we can classify any person with a GD as inside one of four categories defined:

    Crossdressers (CDs) - with intensity in her femininity (or masculinity) unexpected, very limited, so that one does not wish bodily changes, but only use of clothing, makeup and accessories, easily reversible.
    Transgenders (TGs) of moderate to severe intensity, when you want to change aspects in non-genital body. Hair, face, breasts, curves in MTFs, and beard, body hair and muscles developed in FTMS. BUT NOT IN ANY WAY, a sexual reassignment, because the Transgender want to keep the original genitals healthy and functional. The transgender wants to preserve its ability to original sexual action, always.
    Transsexualities (TSs) - when the person is not satisfied with less than the extreme transition, genital and complete, whether MtF or FtM. (The FTMs also has to cope with limited possibilities of genital correction techniques).
    There are many gray areas between CDs and TGs - people who want "a little more feminine body," ie, are at the limit between the two conditions. There are also gray areas between TGs and TSs - people that want not to use the original genitals, but is afraid of a surgery - or can not afford - to fix a quality transgenital surgery. These conditions can be classified as atypical GDNOS, on a case by case basis by its own characteristics.
Special Remark.

When we evaluate a GD person, at the mental screening we may observe potential problems. These problems most of the time will not interfere on the GD necessities of the person. If there is a sign of a real mental problem, the patient need to be followed up by a mental expert - mental expert on the real mental problems the person may need some help. Help for the specific mental condition, but not necessarily for the living of the GD.

Z.77.2 - Secondary surgery transitions for each Condition

    CDs have no need for hormones or body surgeries. But it may be convenient to have a hair treatment, also beard and body hair removal.
    TGs - It is advisable to maintain the reversibility. Breast implants and other body parts in MTFs. Hormones, which affect the genitals on its functionality should be avoided.
    TSs MtF needs - it is advisable to cross hormone therapies and are likely to be needed facial feminization surgeries (FFS). Perhaps breast implants, hair treatments and even implants, laser beard extermination, and body hair extermination.TSs FtM needs - hormone therapy, mastectomy, complete hysterectomy, and special neophallus prostesis, at least.
Remark:

In prepubertal children, which show high intensity of unexpected gender identity, should be postponed puberty, chemically, to define later with greater certainty the type that fits the child.

Z.77.3 - Hormone therapy for each Condition

    For CDs, a good hair recovery may take some anti-androgen
    For TGs, The same as for CDs
    For TSs the same, plus a whole program of cross hormones, MtF or FtM. The human body needs time to react to hormones, so one should expect cross hormone programs that last for one or a couple of years, at least.

Z.77.4 - MtF Sexual Reassignment Surgeries (SRS)

    CDs do not need these surgeries
    TGs either.
    Transsexuals need these corrective surgeries. A quality SRS surgery should have to consider the possibility of orgasm and pleasure after the operation, its full functionality and aesthetics. For TSs, these corrective surgeries are essential.

Z.77.5 - FtM Sexual Reassignment Surgeries (SRS)

For transsexuals (TSs) FTMS, there are two current techniques possible.

    The Neophaloplasties considering donor regions, such as the forearm and abdomen
    Metaioidioplasties that reposition the tissues of the original clitoris building a generally small but functional and sensible penis.
These corrective genital surgeries are essential for FtM transsexual people.

Z.77.6 - MtF SRS post-op care

Include dilation kits and dilation techniques and learning of the female orgasm.

Z.77.7 - FtM SRS post-op care

Includes learning the prudent use of the neo-phallus obtained by neophaloplasty or metaioidioplasty.

May include metaioidioplasty caps to make the small neophallus bigger for better functionality.



Remarks:



    Suggestions for improvement of these descriptions are very welcome.
    These same descriptions can be classified in Chapter U's CID - if more convenient.


Services fast access

We may help CD's

You may have a fast 2 step evaluation, and orientation through the CD-pack, to develop controlled and small body changes

TGs non TSs

You need also the complete 4 step diagnosis, and we may help you on partial transitions with wise, sure and safe orientation.

TSs/HBs

You may follow our full program, to develop a new body, with the most perfect possible SRS.
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