Flow to treatment for gender dysphoria（gender identity disorder）

diagnosis of gender identity disorder

case of gender identity disorder

Before starting treatment, the first step is to diagnose gender identity disorder.
If possible, a doctor who is familiar with gender identity disorder is recommended.

For example, they are diagnosed by a doctor certified by the Japan Society for Gender Identity Disorder (gid) or a psychiatrist who can see gender dysphoria.

Currently, this name is rarely used worldwide for gender identity disorder. Gender dysphoria is often used.Gender identity disorder is a disorder in which the gender of your body is not the same as that of your choice (gender identity). And in a broader sense, it’s a state of having a sense of incongruity about gender.

The most important thing to diagnose is whether you recognize your sex.
If the biological gender is female but you are confident that you are “Male”, then FTM (Female to Male). Although he is a man, he is convinced that “Female”. In this case, MTF (Male to Female).

However, you may not know if you are a man or a woman, or you may think that you are neither. These are also referred to as FTX, MTX, and X Gender, although they are not official diagnostic names.

When it’s so obvious, sometimes it’s not, but in any case, there’s still a “gender dysphoria”.
Gender dysphoria that occurs in addition to gender identity disorder.Gender dysphoria is not limited to these gender identity disorders, transgender disorders, and even disorders called sexual differentiation disorders, in which gender identity differs from that of the body.

Gender dysphoria that occurs in addition to gender identity disorder

Sex disorders include congenital adrenal hyperplasia and congenital adrenogenital disorders, such as androgen insensitivity syndrome.
Abnormal production of male hormones may occur when the body is female, or male hormones may not affect organs and indicate a female external genitalia when the body is male.

In both cases, secondary sexual characteristics begin at puberty, but they are usually recognized by adulthood because of symptoms such as menarche and lack of breast enlargement, which are supposed to begin.

In this case, a sex-determining chromosome test is done to distinguish it from gender identity disorder. If it is a sex differentiation disease, we will investigate in detail what kind of disease it is.
・Sex chromosome genetic testing may be needed at this point, so we recommend testing in advance.

Flow to treatment of FTM and MTF

If you have a medical certificate

Items to bring to the hospital: a medical certificate or written opinion, or a letter of introduction from a doctor.
If desired, proceed to hormone therapy, surgery (FTM: thoracic surgery, ovariohysterectomy, MTF: orchiectomy, vulva formation, etc.).

Those who have not yet been diagnosed

Sex chromosome analysis is available in our hospital (You can use your insurance card.).
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・initiation of therapy
・regular hormone injections
Female hormone treatment of MTF
About FTM male hormone treatment

Measurement of hormone levels, checking liver and kidney functions
If sick, visit another department as needed (I will write a letter of introduction.)
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・FTM is the flow to mastectomy (chest operation)
In the case of FTX, if you can’t have a chest operation without a medical certificate, people with FTX won’t be able to have an operation, so you don’t have to bring a medical certificate. Please tell me if you want a medical certificate.
MTF is orchiectomy, breast augmentation surgery for MTF
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Sex reassignment surgery in Japan and abroad (SRS)
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The gender change for Japanese nationals is as follows. Please follow the laws of your home country regarding gender change for non-Japanese nationals.
If you are not Japanese, you can be treated without a medical certificate.
If you have a medical certificate of gender dysphoria in your home country, please bring it.

In 2004, the “Act on Special Cases in Handling Gender for People with Gender Identity Disorder” was enacted. In the case of gender identity disorder, the gender can be changed if the requirements are met.
How to apply to a family court for a change of gender (family register)
(Family courts of each prefecture where the residence certificate is located)
・The first written medical certificate will not be accepted, so you will need the signatures of two psychiatrists on the sample of the medical certificate prepared by the Ministry of Health, Labour and Welfare.

This GID medical certificate form is prepared by the medical institution, so you don’t need to prepare it separately.

Related Sites
Procedures for renaming gender identity disorder