Gender and sex are commonly used as interchangeable terms, but when applied to interchangeable lifestyles, history has shown that there are great boundaries and disparities between individuals that overlap with their biological and social identities. Sex refers to a person's biological state, consisting of internal organs, external genitalia, and chromosomal composition. (American Psychiatric Association, 2013) In contrast, gender refers to gender-normative cultural feelings, thoughts, and behaviors, expectations, and congruent conformity between sex and gender roles (American Psychiatric Association, 2013 ). People who do not fit standard definitions have been classified as having gender identity disorder (GID) or gender variant (GV). Since the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) in 2013, all gender-related diagnoses have been classified under the category Gender Dysphoria (GD) (Zucker, 2009). To gain an in-depth understanding of gender dysphoria, this article will cover the history, criteria, approaches and goals of treatment, as well as cultural and environmental issues related to diagnosis. Description and History of Gender Dysphoria The first introduction of gender-related disorders was in 1980 in the DSM-III, divided into two categories, transsexualism and gender identity disorders of childhood (Kamens, 2011 ). The latter was diagnosed as a child with a “strongly and persistently expressed desire” or “insistence” that he or she was the opposite sex (Zucker, 2009; American Psychiatric Association, 1980). The revised DSM-III-R (1987) categories included: gender identity disorder in adolescence and adulthood nontranssexual (GIDAANT), and not otherwise specified (GI...... middle of the article......meets the Group A criteria for GD but must also meet Group B which specifies that the incongruence felt around issues of gender, identity, sex and orientation is a “clinically significant distress” and impairs several important areas of functioning such as school and education, career and occupation, and social or relational (APA, 2013). in more detail under GD with a disorder of sexual development and adults may also have a post-transition specification or have undergone a legal, permanent or lifestyle change the desired gender and sex (APA, 2013). DSM-V also recognized two categories, other specified gender dysphoria that meets criterion B and only some of the symptoms of criterion A, and unspecified gender dysphoria, used when there is insufficient evidence of the existence of gender dysphoria. a diagnosis of GDM (APA, 2013).