Question Answer

What are the two main types of elimination Enuresis and Encopresis.
disorders?

What is enuresis? The repeated voiding of urine into bed or clothes.

What is encopresis? The repeated passage of feces into inappropriate places.

What are the diagnostic criteria for enuresis? Repeated voiding of urine into bed or clothes, occurring at least twice a week for at least 3
consecutive months, in a child who is at least 5 years old.

What are the diagnostic criteria for encopresis? Repeated passage of feces into inappropriate places, whether voluntary or involuntary,
occurring at least once a month for at least 3 consecutive months, in a child who is at least 4
years old.

What are elimination disorders? Inappropriate elimination of urine and feces.

At what age are elimination disorders usually first Childhood or adolescence.

diagnosed?

What is enuresis? Enuresis is the involuntary discharge of urine, often referred to as bedwetting.

What is encopresis? Encopresis is the repeated passage of feces into inappropriate places, such as clothing or the
floor.

What are the diagnostic criteria for enuresis? The diagnostic criteria for enuresis include the repeated voiding of urine into bed or clothes,
occurring twice a week for at least 3 consecutive months, and the individual must be at least
5 years old.

What are the diagnostic criteria for encopresis? The diagnostic criteria for encopresis include the repeated passage of feces into
inappropriate places, such as clothing or the floor, occurring at least once a month for at least
3 months, and the individual must be at least 4 years old.

What is the differential diagnosis of elimination The differential diagnosis of elimination disorders includes considering medical conditions,
disorders? such as urinary tract infections or constipation, as well as psychological factors and
environmental stressors.

What is enuresis? The repeated voiding of urine into inappropriate places.

What is the first diagnostic criterion for enuresis? Repeated voiding of urine into bed or clothes, whether involuntary or intentional.

How is the clinical significance of enuresis behavior By a frequency of twice a week for at least 3 consecutive months or the presence of clinically
manifested? significant distress or impairment in social, academic, or other important areas of functioning.

What is the minimum chronological age for the At least 5 years of age (or equivalent developmental level).
diagnosis of the behavior?

What are the exclusions for the behavior not being Physiological effect of a substance or another medical condition.
attributable to?

What does 'nocturnal only' refer to in terms of urine Passage of urine only during nighttime sleep.
passage?

What does 'diurnal only' refer to in terms of urine Passage of urine during waking hours.
passage?

What does 'nocturnal and diurnal' refer to in terms of A combination of the two subtypes above.
urine passage?

What is the specifier for the different subtypes of Specifier.

urine passage?

What conditions exclude the diagnosis of enuresis? Neurogenic bladder, structural conditions, medical conditions causing polyuria or urgency,
and acute urinary tract infection.

When is the diagnosis of enuresis compatible with a If urinary incontinence was regularly present prior to the development of another medical
medical condition? condition or if it persists after the institution of appropriate treatment of the medical condition.

What medications may induce enuresis as a side Antipsychotic medications, diuretics, or other medications that may induce constipation,
effect? polyuria, or alteration in executive functioning.

When should a diagnosis of enuresis not be made in When enuresis occurs as a medication side effect.
isolation?

Under what condition can a diagnosis of enuresis be If urinary incontinence was regularly present prior to treatment with medication.
made despite medication use?
Question Answer

What is encopresis also known as? Fecal incontinence or soiling.

How is encopresis defined? The repeated passing of stool (usually involuntarily) into clothing.

What is the diagnostic criteria A for encopresis? Repeated passage of feces into inappropriate places (e.g., clothing, floor), whether
involuntary or intentional.

How often should at least one event occur for the At least once each month for at least 3 months.
diagnostic criteria B of encopresis?

What is the minimum age requirement for the Chronological age of at least 4 years (or equivalent developmental level).
diagnostic criteria C of encopresis?

What does the behavior not result from? Physiological effects of a substance or another medical condition, except through a
mechanism involving constipation.

When is a diagnosis of encopresis appropriate in the When the mechanism involves constipation that cannot be explained by other medical
presence of another medical condition? conditions.

What is considered in the differential diagnosis for Chronic diarrhea, spina bifida, anal stenosis, etc.
fecal incontinence related to other medical
conditions?

What are elimination disorders in children? They are present in children that urinate or defecate in places other than the toilet.

What is the etiology of elimination disorders? The cause or origin of elimination disorders.

What is the most common cause of encopresis? Chronic (long-term) constipation.

What are some reasons for chronic constipation Stress, not drinking enough water, a diet low in fiber, lack of exercise, fear or reluctance to
leading to encopresis? use unfamiliar bathrooms.

How does not drinking enough water contribute to It makes the stools hard and difficult to pass.
encopresis?

What is enuresis commonly known as? Bed-wetting.

What are some risk factors that may increase Unusual stress in children, growing up in a low socioeconomic environment, divorced parents,
enuresis? the addition of a sibling, or a family history of enuresis.

What may put deep sleepers at higher risk of Not being easily aroused.
enuresis?

What are some factors that may contribute to A small bladder, persistent urinary tract infections, and severe stress.
enuresis?

What is voluntary enuresis also known as? Intentional enuresis.

What mental disorders may voluntary enuresis be Behavior disorders or emotional disorders such as anxiety.
associated with?

Is enuresis known to run in families? Yes, it appears to run in families.

Is enuresis considered to be inherited? Yes, it may be inherited, particularly on the father's side.

What is Gender Dysphoria? A condition where a person experiences discomfort or distress due to a mismatch between
their biological sex and gender identity.

What are the diagnostic criteria for Gender A marked incongruence between one's experienced/expressed gender and assigned gender,
Dysphoria? lasting at least six months, and causing clinically significant distress.

What is the differential diagnosis of Gender Conditions such as schizophrenia, other psychotic disorders, and autism spectrum disorder,
Dysphoria? which need to be ruled out before diagnosing Gender Dysphoria.

What factors contribute to the etiology of Gender Biological, psychological, and social factors may contribute to the development of Gender
Dysphoria? Dysphoria.

What is Gender Dysphoria (GD)? The distress a person experiences due to a mismatch between their gender identity and their
sex assigned at birth.

What was the diagnostic label used for Gender Gender Identity Disorder (GID).
Dysphoria until 2013?
Question Answer

When was the diagnostic label for Gender Dysphoria In 2013 with the release of DSM-5.
changed?

Why was the condition renamed from Gender To remove the stigma associated with the term disorder.
Identity Disorder to Gender Dysphoria?

What is the mismatch that causes distress in Gender Between a person's gender identity and their sex assigned at birth.
Dysphoria?

What do the terms 'sex' and 'sexual' refer to? Biological indicators of male and female, understood in the context of reproductive capacity.

What is included in Disorders of Sex Development Historical terms such as hermaphroditism and pseudohermaphroditism, somatic intersex
(DSDs)? conditions, congenital development of ambiguous genitalia, disjunction of internal and
external sex anatomy, incomplete development of sex anatomy, sex chromosome anomalies,
and disorders of gonadal development.

Give examples of somatic intersex conditions. Congenital development of ambiguous genitalia, disjunction of internal and external sex
anatomy, and incomplete development of sex anatomy.

What are some examples of sex chromosome Turner syndrome and Klinefelter syndrome.
anomalies?

What is meant by 'incomplete development of sex Conditions such as gonadal agenesis.

anatomy'?

What is the historical term for Disorders of Sex Hermaphroditism and pseudohermaphroditism.
Development (DSDs)?

What does gender reassignment denote? An official (and sometimes legal) change of gender.

What are gender-affirming treatments? Medical procedures (hormones or surgeries or both) that aim to align an individual's physical
characteristics with their experienced gender.

What does gender-atypical refer to? Somatic features or behaviors that are not typical (in a statistical sense) of individuals with the
same assigned gender in a given society and historical era.

What are alternative nondiagnostic terms for Gender-nonconforming, gender variant, and gender diverse.
gender-atypical?

What does gender identity refer to? An individual's identification as male, female, some category in between (i.e., gender fluid), or
a category other than male or female (i.e., gender neutral).

What does the term 'transgender' refer to? The broad spectrum of individuals whose gender identity is different from their birth-assigned
gender.

What does 'cisgender' describe? Individuals whose gender expression is congruent with their birth-assigned gender (also
nontransgender).

What does the term 'transsexual' historically denote? An individual who seeks, is undergoing, or has undergone a social transition from male to
female or female to male, which in many, but not all, cases also involves a somatic transition
by gender-affirming hormone treatment and surgery.

What are the diagnostic criteria for Gender Dysphoria In boys, a strong preference for cross-dressing or simulating female attire; in girls, a strong
in children related to clothing preferences? preference for wearing only typical masculine clothing and a strong resistance to the wearing
of typical feminine clothing.

What is one of the manifestations of Gender A strong preference for cross-gender roles in make-believe play or fantasy play.
Dysphoria related to make-believe play?

What is one of the manifestations of Gender A strong preference for the toys, games, or activities stereotypically used or engaged in by
Dysphoria related to toys, games, or activities? the other gender.

What is one of the manifestations of Gender A strong preference for playmates of the other gender.
Dysphoria related to playmates?

What is the duration required for the marked At least 6 months.

incongruence between one's experienced/expressed
gender and assigned gender in Gender Dysphoria?

What are the signs of Gender Dysphoria in boys Rejection of typically masculine toys, games, and activities, and avoidance of
(assigned gender)? rough-and-tumble play.

What are the signs of Gender Dysphoria in girls Rejection of typically feminine toys, games, and activities.
Question Answer

(assigned gender)?

What is a sign of Gender Dysphoria related to one's A strong dislike of one's sexual anatomy.
sexual anatomy?

What is a sign of Gender Dysphoria related to A strong desire for the primary and/or secondary sex characteristics that match one's
physical characteristics? experienced gender.

What is necessary for the diagnosis of Gender The condition is associated with clinically significant distress or impairment in social, school,
Dysphoria? or other important areas of functioning.

What is an example of a disorder/difference of sex Congenital adrenal hyperplasia or androgen insensitivity syndrome.
development?

What is a congenital adrenogenital disorder? Congenital adrenal hyperplasia.

What is androgen insensitivity syndrome? A disorder/difference of sex development.

What is the specifier for a disorder/difference of sex E25.0 or E34.50.

development?

What is the diagnostic criteria for Gender Dysphoria At least 6 months' duration.
in terms of duration?

What are the manifestations required for the At least two of the following manifestations.
diagnostic criteria of Gender Dysphoria?

What is the first manifestation required for the A marked incongruence between one's experienced/expressed gender and primary and/or
diagnostic criteria of Gender Dysphoria? secondary sex characteristics.

What is the second manifestation required for the A strong desire to be rid of one's primary and/or secondary sex characteristics.
diagnostic criteria of Gender Dysphoria?

What is the age group for the diagnostic criteria of In adolescents and adults.
Gender Dysphoria?

What is the strong desire for the primary and/or Gender Dysphoria.
secondary sex characteristics of the other gender
called?

What is the strong desire to be of the other gender Gender Dysphoria.

called?

What is the strong desire to be treated as the other Gender Dysphoria.

gender called?

What is the strong conviction that one has the typical Gender Dysphoria.
feelings and reactions of the other gender called?

What is the requirement for the condition to be Gender Dysphoria.

associated with clinically significant distress or
impairment in social, occupational, or other important
areas of functioning?

What are some examples of disorders/differences of Congenital adrenal hyperplasia, androgen insensitivity syndrome.
sex development?

What does 'posttransition' refer to? When the individual has transitioned to full-time living in the experienced gender.

What are some gender-affirming medical procedures Regular gender-affirming hormone treatment, gender reassignment surgery.
or treatment regimens?

Give an example of a gender-affirming medical Breast augmentation surgery and/or vulvovaginoplasty.

procedure for an individual assigned male at birth.

Give an example of a gender-affirming medical Transmasculine chest surgery and/or phalloplasty or metoidioplasty.
procedure for an individual assigned female at birth.

How should gender dysphoria be distinguished from By the strong desire to be of another gender than the assigned one and by the extent and
simple nonconformity to stereotypical gender role pervasiveness of gender-variant activities and interests.
behavior?

What is the diagnosis of gender dysphoria not meant Nonconformity to stereotypical gender role behavior (e.g., 'tomboyism' in girls, 'girly-boy'
Question Answer

to merely describe? behavior in boys, occasional cross-dressing in adult men).

Why is it important that the clinical diagnosis of To those individuals whose distress and impairment meet the specified criteria.
gender dysphoria be limited to certain individuals?

What is important given the increased openness of That the clinical diagnosis be limited to those individuals whose distress and impairment meet
gender-diverse expressions by individuals across the the specified criteria.
transgender spectrum?

What should the diagnosis of gender dysphoria be The specified criteria of distress and impairment.
based on?

What should be considered in the differential Nonconformity to stereotypical gender role behavior and the extent of gender-variant activities
diagnosis of gender dysphoria? and interests.

Who is diagnosed with Transvestic disorder? Heterosexual or bisexual adolescent and adult males (rarely in females).

What causes distress and/or impairment in Women's clothing generating sexual excitement.
individuals with Transvestic disorder?

What is occasionally accompanied by Transvestic Gender dysphoria.

disorder?

What can an individual with both Transvestic disorder Both Transvestic disorder and gender dysphoria.
and clinically significant gender dysphoria be
diagnosed with?

What is a precursor to the diagnosis of gender Cross-dressing with sexual excitement.

dysphoria in some cases of postpubertal-onset
gender dysphoria in individuals assigned male at
birth who are attracted to women?

What does an individual with body dysmorphic The alteration or removal of a specific body part perceived as abnormally formed.
disorder focus on?

When an individual's presentation meets criteria for Both diagnoses of gender dysphoria and body dysmorphic disorder.
both gender dysphoria and body dysmorphic
disorder, what can be given?

What do individuals with body integrity identity To have a healthy limb amputated to feel more 'complete'.
disorder wish for?

Why can diagnosing gender dysphoria be Due to the concrete and rigid thinking around gender roles and poor understanding of social
challenging in individuals with autism spectrum relationships characteristic of autism.
disorder?

What may rarely occur in schizophrenia related to Delusions of belonging to some other gender.
gender dysphoria?

How can gender-themed delusions in schizophrenia By their bizarre content and by waxing and waning with remissions and exacerbations of
be differentiated from gender dysphoria? psychotic episodes.

What percentage of individuals with schizophrenia Up to 20%.

may experience gender-themed delusions?

Is insistence by an individual with gender dysphoria No, in the absence of psychotic symptoms.
that he or she is another gender considered a
delusion?

What clinical presentation may meet the criteria for Masculinization desire and development of an alternative, nonmale/nonfemale gender
gender dysphoria? identity.

In what cases do some males seek genital surgery For either aesthetic reasons or to remove psychological effects of androgens without
without meeting the criteria for gender dysphoria? changing male identity.

What largely determines gender identity? Biologic factors such as genetic complement and prenatal hormonal milieu.

What do some brain imaging studies show in Functional and anatomic differences consistent with their felt gender identity rather than their
gender-dysphoric people? birth sex.

What influences the formation of a secure, Social factors such as the character of the parents' emotional bond and the relationship each
unconflicted gender identity and gender role? parent has with the child.
Question Answer

What are some conditions associated with rare Genital ambiguity (intersex conditions) or genetic abnormalities like Turner syndrome,
cases of gender dysphoria? Klinefelter syndrome.

In what situations may children become uncertain When sex labeling and rearing are confusing, such as in cases of ambiguous genitals or
about their gender identity or role? genetic syndromes altering genital appearance.

What is the controversial aspect related to the The level of importance of environmental factors.
development of gender dysphoria?