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What is Gender Dysphoria?

Gender dysphoria is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), published by the American Psychiatric Association, as a condition where an individual experiences significant discomfort or distress due to a discrepancy between their assigned gender at birth and their experienced or expressed gender identity.

The DSM-5 criteria for diagnosing gender dysphoria include the presence of a marked incongruence between one's experienced/expressed gender and assigned gender, lasting at least six months, manifested by at least two of the following:

1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics (or anticipated secondary sex characteristics in young adolescents).

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 (or a desire to prevent the development of anticipated secondary sex characteristics in adolescents).

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).

The condition causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The treatment for gender dysphoria often involves gender-affirming approaches such as hormone therapy, psychological counseling, and, for some, various forms of surgery. Psychotherapy is not aimed at changing one's gender identity per se, but rather at addressing the distress that may come with gender dysphoria. Supportive care can also include social transition to the gender with which the individual identifies. Treatment plans are highly individualized and focus on what is most distressing for the person.

Frequently Asked Questions

Services

What types of services do you provide?

We provide two main services: psychopharmacology evaluations and medication management. First, you’ll meet with a provider for an evaluation to determine your treatment plan, which may include medication, therapy, lifestyle changes, or other recommendations. Second, if medication is appropriate, our providers will help you manage and adjust your medication to make sure it works effectively.

What is the difference between therapy and medication management?

Therapy, sometimes called “talk therapy,” involves talking with a mental health professional to address mental health issues through dialogue and behavioral strategies. Medication management, on the other hand, is a medical approach where a mental health professional prescribes, monitors, and adjusts psychiatric medication to treat mental health conditions to address your physiological symptoms. Often, a combination of talk therapy and medication management is beneficial.

Does this replace my need for a therapist?

Our providers are here to address your concerns and offer support, but it’s important to note that they are not meant to replace a licensed therapist. Evidence suggests that for many mental health conditions, a combination of medication and psychotherapy is the most effective approach.

How does online psychiatry work?

Virtual psychiatry works just like in-person psychiatry, except instead of sitting in a doctor’s office, you’ll talk to your provider during live video appointments.

What should I expect during a mental health assessment or evaluation?

You’ll connect 1:1 with your new provider to discuss your needs. If appropriate, they’ll prescribe medication and send it to your pharmacy of choice. Regular check-ins will help you track how you’re feeling and any side effects, and your provider will make any needed adjustments.

How do I prepare for my first appointment? How long are typical appointments?

Before your scheduled appointment, you’ll receive new patient forms, which you’ll need to complete in advance. We will also ask for your insurance information, a valid form of identification, a list of any of your current medications, and any relevant medical records or previous psychiatric evaluations.

Typical appointment times vary depending on the nature of your visit and your treatment plan. Initial consultations usually last around 60 minutes, during which you'll have an in-depth discussion with your provider. Follow-up appointments are typically shorter, ranging from 15 to 30 minutes, but this may be adjusted based on your specific needs and progress.

What should I do in case of an emergency or crisis?

If you’re having a medical or mental health emergency, call 911.

Call or text 833-773-2445 for 24/7 Crisis and Mental Health Support from the Massachusetts Behavioral Health Help Line.

How do I schedule an appointment?

To schedule an appointment, please fill out our Appointment Request Form. Someone from the Monomoy Health team will contact you for more information and to help schedule your first appointment. We look forward to working with you!

Do you offer virtual/online appointments?

Yes, we offer virtual appointments. That means you can meet with your provider from the comfort of your home. We recommend choosing a well-lit and quiet space for your meeting.

Are my appointments and information confidential?

Yes. We adhere to the highest standards of privacy and confidentiality to ensure that your personal and medical information is safe, and privacy is a top priority in our practice. For more information, please download our HIPAA policy.