In the revision in the DSM-V, there has been some changes:
Quote from: DSM-VGender Dysphoria (in Adolescents or Adults)**
A. A marked incongruence between one's experienced/expressed gender and assigned gender, of at least 6 months duration, as manifested by 2* or more of the following indicators: [2, 3, 4]**
1. a marked incongruence between one's experienced/expressed gender and primary and/or secondary sex characteristics (or, in young adolescents, the anticipated secondary sex characteristics) [13, 16]
2. a strong desire to be rid of one's primary and/or secondary sex characteristics because of a marked incongruence with one's experienced/expressed gender (or, in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics) [17]
3. a strong desire for the primary and/or secondary sex characteristics of the other gender
4. a strong desire to be of the other gender (or some alternative gender different from one's assigned gender)
5. a strong desire to be treated as the other gender (or some alternative gender different from one's assigned gender)
6. a strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one's assigned gender)
B. The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning, or with a significantly increased risk of suffering, such as distress or disability**
Subtypes
With a disorder of sex development [14]
Without a disorder of sex development
See also: [15, 16, 19]
Specifier**
Post-transition, i.e., the individual has transitioned to full-time living in the desired gender (with or without legalization of gender change) and has undergone (or is undergoing) at least one cross-sex medical procedure or treatment regimen, namely, regular cross-sex hormone treatment or gender reassignment surgery confirming the desired gender (e.g., penectomy, vaginoplasty in a natal male, mastectomy, phalloplasty in a natal female).
However, many therapists and psychologists use an 'Informed Consent" approach.