The generation of today is increasingly challenging conventional gender stereotypes. A massive poll done in the USA revealed that 50% of millennials believe that gender is actually a spectrum. 
To them, gender identity is about finding a balance of how they present and express themselves in terms of the masculine and the feminine. Therefore, it makes more sense to see gender as a spectrum so that their position on that spectrum of masculine to feminine changes depending on how they feel at any given time. 
This growing wave of gender fluidity has raised crucial questions about what it means to identify one's self within the constructs of sexuality. It has also challenged the earlier definition of sexuality itself.
In Singapore, gender fluidity is not often talked about. However, the Institute of Mental Health (IMH) has started offering psychiatric treatment and psychological counselling for those with gender dysphoria. 
Gender dysphoria refers to the distress a person experiences as a result of the sex and gender they were assigned at birth. This leads to them feeling very disconnected between their sense of self and body. ould gender dysphoria simply be a phase?
Psychiatrist, Dr Ng Beng Yeong, delved further into this topic on DxD. Here's what he had to share.
Gender dysphoria is only diagnosed after 6 months of observation
According to Dr Ng, gender dysphoria can only be diagnosed after careful observation of the individual over time. For it to qualify, signs must be imminent for at least 6 months or more.
In any case, differentiating between real gender dysphoria and a mere phase can be challenging, to say the least, which is why psychiatrists are very cautious with their assessments.
The diagnosis focuses on the patient's reaction to gender roles
As a basis, the integral diagnosis of gender dysphoria revolves heavily around the person's reaction to his or her physical anatomy as well as the societal gender role that has been prescribed from birth.
A prominent feature of gender dysphoria is incongruence
Incongruence (the perception that something doesn't fit) between a person's expressed gender and sex characteristics is a major feature in distinguishing gender dysphoria.
Essentially, there is a strong desire for sex characteristics of the opposite gender. Couple this with a substantial period of time and that leads to a strong indication that the condition exists. 
It's harder to diagnose gender dysphoria in children
Sex characteristics in children and adolescents are still in their developmental stage so it can be challenging to anticipate the reactions of younger patients.
This age group is most susceptible to potential misdiagnosis or delayed diagnosis with regards to any condition that they are experiencing. 
Alternatively, there could be an underlying disorder
Clinically, psychiatrists strive to distinguish gender dysphoria from any underlying psychotic disorders before coming to any conclusions.
Frighteningly, Dr Ng has come across patients suffering from psychosis who, in their acutely psychotic state, would hear voices (auditory hallucinations) advising them to undergo a sex change operation.
Once the voices subside, the patient is once again comfortable with his/her gender and so gender dysphoria is ruled out.
Crossdressers are also taken into consideration
In some instances, people who crossdress to obtain sexual gratification may also be ruled out as having gender dysphoria.
Usually, these people are comfortable with their genders and therefore do not qualify as having the condition.
Most cases of gender dysphoria start from childhood
Many of us have already established a good idea of our own gender and this happened at a very young age.
In fact, by age 3, we begin to develop our own ideas about gender and how it's perceived from our own experiences. 
Many people only begin seeking help in adulthood
Though gender dysphoria begins to take form at a very early age, many people don't seek help until they are fully grown adults.
Probing further into their discomfort, Dr Ng discovered that they felt trapped in the wrong body and they realised it when they were only a few years old.
Social pressures often cause patients to hide their condition
Often, people with gender dysphoria tend to attempt to deal with the issue themselves or suppress it, deciding to not seek professional help due to the fear of embarrassing their family or friends.
It is only at a much later stage that they give up and eventually seek help once they are too tired of suppressing their preferences.
Psychiatrists look for signs from past experiences
During assessments, psychiatrists usually ask patients sets of questions such as whether they enjoyed playing with friends of the same or opposite gender as well as what kinds of toys they played with. A history of cross-dressing may also be a relevant indication.
Seek help if you feel confused and lost
Ultimately, suffering in silence is not the way forward when it comes to psychological matters. Gender dysphoria, like other conditions, needs to be dealt with as early as possible.
The longer people wait, the worse the condition will become and this can cause a lot of distress in the long run. Get advice and assistance from medical professionals that have the experience to guide you through this complex topic.
Article medically reviewed by Dr Ng Beng Yeong.