The discussion of gender issues can be complex. Initially, it is important to differentiate between the terms sexual orientation, gender identity and gender role.

Sexual orientation refers to an individual’s pattern of physical and emotional arousal toward other persons. Gender identity is one’s knowledge of oneself being male or female. Gender role is one’s outward expression of maleness or femaleness.

Gender Identity Disorder (GID) is the current diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This diagnosis specifies criteria for adolescents and adults, and for children typically under age 12.

In the United States, the American Psychiatric Association permits a diagnosis of gender identity disorder if the four diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text-Revised (DSM-IV-TR) are met. The criteria are:

1. Long-standing and strong identification with another gender
2. Long-standing disquiet about the sex assigned or a sense of incongruity in the gender-assigned role of that sex
3. The diagnosis is not made if the individual also has physical intersex characteristics.
4. Significant clinical discomfort or impairment at work, social situations, or other important life areas.

Treatment for Gender Identity Disorder includes gender affirmation, a process in which mental health and medical providers provide treatments to affirm the patient's gender identity, including counseling, medical hormonal therapy to acquire the characteristics of the desired gender, and sometimes surgical treatment as well.

The current diagnostic term "Gender Identity Disorder" is view by some as being pejorative and negative as it can suggest that people who are Transgender may have a pathologic problem and need "fixing." They have offered the term "Gender Incongruence" as a potential replacement diagnostic term, but this has yet to be adopted into the upcoming 5th edition of the DSM.

For further information about transgender health and care, please see the Transgender Health website at http://www.transgendercare.com/

For further information about LGBT health in general or finding a provider who offers Transgender-specific health services, please visit the Gay Lesbian Medical Association website at www.glma.org.

Though your last paragraph suggests the answer to my upcoming questions, I still would like to specifically ask them. Does homosexual behavior in the post pubescent years and beyond directly relate to the condition of non-gender congruent status in childhood? If not, is there any relationship or similarities? if the transition is present, is it equally seen in male and female individuals? ..Maurice.

I am aware of at least one researcher who has looked at the genetic basis for sexual development and gender development, Dr. Eric Vilain, a neuroscientist at the University of Calfornia in Los Angeles. He has co-authored several papers related to gender issues of gay men and male to female transsexual individuals.

I think that ethical issues would certainly arise in research as LGBT people are a vulnerable population who historically have not always been on the receiving end of beneficience via information dissemination at the end of various studies. Judicious review of consent and safety processes should be performed for research involving any vulnerable population.

Here is a link to Dr. Vilain's faculty website:

http://faculty.neuroscience.ucla.edu/institution/personnel?personnel_id=9435

There also appear to be other individuals and agencies interested in transgender research, but not necessarily on the etiology of transsexualism. Some of these sites include:

The International Foundation for Gender Education and Transgender Tapestry - http://www.ifge.org/Topic22.phtml

Vancouver Coastal Health - http://transhealth.vch.ca/services/research.html