lieve play or persistent fantasies of being the other sex,
(4) intense desire to participate in the stereotypical games and pastimes of the other sex,
(5) strong preference for playmates of the other sex.
In adolescence, the disorder is associated with symptoms such as a stated desire to be the opposite sex, tendencies to frequently pass as the other sex, a desire to live or be treated as the other sex, and/or the conviction that one has the typical feelings and reactions of the other sex. There is also persistent discomfort with one's own sex or a sense of inappropriateness in terms of evidencing the behaviors associated with the gender role of one's sex. In adolescent girls, this is associated with symptoms such as preoccupation with getting rid of primary and secondary sex characteristics (e.g., request for hormones, surgery, or other procedures to physically alter sexual characteristics to simulate the other sex) or belief that he or she was born the wrong sex. In addition, the disturbance is also associated with causing clinically significant distress or impairment in social, occupational, or other important areas of functioning.
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