This is what the DSM V will be stating:
Gender 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) 
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**
With a disorder of sex development 
Without a disorder of sex development
See also: [15, 16, 19]
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).
In this section we summarize the rationales for the revised posting of May 4, 2011.
*For the adult criteria, we propose, on a preliminary basis, the requirement of only 2 indicators. This is based on a preliminary secondary data analysis of 154 adolescent and adults patients with GID compared to 684 controls (Deogracias et al., 2007; Singh et al., 2010). From a 27-item dimensional measure of gender dysphoria, the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ), we extracted five items that correspond to the proposed A2-A6 indicators (we could not extract a corresponding item for A1). Each item was rated on a 5-point response scale, ranging from Never to Always, with the past 12 months as the time frame. For the current analysis, we coded a symptom as present if the participant endorsed one of the two most extreme response options (frequently or always) and as absent if the participant endorsed one of the three other options (never, rarely, sometimes). This yielded a true positive rate of 94.2% and a false positive rate of 0.7%. Because the wording of the items on the GIDYQ is not identical to the wording of the proposed indicators, further validational work will be required.
**In response to criticisms that the term was stigmatizing, we originally proposed to replace the term “Gender Identity Disorder” with Gender Incongruence. This was accompanied by a re-definition of the condition, revised criteria, eliminating the previous subtype pertaining to sexual attraction, and introducing a new subtype categorization that does not exclude such individuals with a somatic disorder of sex development (DSD). We chose the new term, Gender Incongruence, as descriptive and to avoid a presupposition of the presence of a clinically significant acute distress in all cases as a requirement for the diagnosis. In part, this was based on more general discussions in the DSM-5 Task Force on separating out the distress/impairment criterion and evaluating these parameters as a separate dimensions.
We also debated and discussed the merit of placing this condition in a special category apart from (formerly Axis-I) psychiatric diagnoses to reflect its unusual status as a mental condition treated with cross-sex hormones, gender reassignment surgery, and social and legal transition to the desired gender (particularly with regard to adolescents and adults). We chose not to make any decision between its categorization as a psychiatric or a medical condition and wished to avoid jeopardizing either insurance coverage or treatment access (Drescher, 2010).
On the open APA website, we received many favorable comments about the proposed name change, particularly with regard to the removal of the “Disorder” label from the name of the diagnosis. However, we also received many comments from reviewers of the open APA website as well as from members of the World Professional Association for Transgender Health (WPATH) expressing concerns that the new descriptive term could easily be misread as applying to individuals with gender-atypical behaviors who had no gender-identity problem. Many commentators recommended “gender dysphoria” as a semantically more appropriate term, because it expresses an aversive emotional component. In this regard, it should be noted that the term “gender dysphoria” has a long history in clinical sexology (see Fisk, 1973) and thus is one that is quite familiar to clinicians who specialize in this area. Also, we were not able to find a special placement of the condition in the developing organizational structure of the DSM-5, although it appears the gender diagnoses will be separated from the sexual dysfunctions and paraphilias. Furthermore, as the definition of “mental disorder” in the Introduction of DSM-IV-TR (American Psychiatric Association, 2000, p. xxxi), in addition to “present distress…or disability,” includes “a significantly increased risk of suffering death, pain, disability, or an important loss of freedom,” we added a correspondingly modified B criterion. As this is in line with the empirical evidence, this change permitted us to adopt the “gender dysphoria” term without presupposing the existence of acute or inherent distress at the time of diagnosis.
The addition of this specifier is prompted by the observation that many individuals, after transition, do not meet any more the criteria set for gender dysphoria as defined above; however, they continue to undergo chronic hormone treatment, further gender-confirming surgery, or intermittent psychotherapy/counseling to facilitate the adaptation to life in the desired gender and the social consequences of the transition. Although the concept of “post-transition” is modeled on the concept “in [partial or full] remission” as used for mood disorders, “remission” has implications in terms of symptom reduction that do not apply directly to gender dysphoria, given its unique status as a psychiatric category (see above). Cross-sex hormone treatment of gonadectomized individuals could, of course, be coded as treatment of hypogonadism, but this would not apply to individuals who have not undergone gonadectomy but receive hormone treatments. In the text, we will, however, also mention that the traditional course specifier of “full remission” does apply to many children with the diagnosis of Gender Dysphoria and, perhaps, for a small number of adolescents and adults.
**In response to reviewers' criticism, the proposed revision separates the 6 dimensionalized "Informational Questions" from the 6 dimensionalized Severity Questions. The Severity Questions represent dimensionalized versions of the 6 Point A criteria. The Informational Questions were added to collect specific data important for both clinical counseling and research, as they cover broad issues that are relevant for understanding a presenting patient's condition: A statement of the current legal/assigned "sex" or "gender" (Item 1), a rating of the degree of confidence in the subjective validity of that legal/assigned gender (Item 2), a rating of the degree of incongruence between assigned and experienced/expressed gender (Item 3), the degree of the distress, if any, resulting from that incongruence (Item 4), the patient's sexual orientation (Item 5), and the age of onset of a strong desire to live in a gender role different from the one assigned (Item 6). The distress item (4) was added because of the observation that acute distress may vary considerably across patients and the psychosocial contexts in which they experience an incongruence between assigned gender and experienced/expressed gender, as has been noted in the Rationale for adding Criterion B. The patient's sexual orientation and age-of-onset items are included because of the unresolved controversy about the utility and justification of the DSM-IV subtypes, which have been dropped from the DSM-5 criteria set, but will be addressed in the DSM-5 text, because these subtypes may reflect different pathways to gender dysphoria and are important to consider for research purposes.
These were the original notes from the February 2010 posting (with references updated).
1. It is proposed that the name gender identity disorder (GID) be replaced by “Gender Incongruence” (GI) because the latter is a descriptive term that better reflects the core of the problem: an incongruence between, on the one hand, what identity one experiences and/or expresses and, on the other hand, how one is expected to live based on one’s assigned gender (usually at birth) (Meyer-Bahlburg, 2009a; Winters, 2005). In a recent survey that we conducted among consumer organizations for transgendered people (Vance et al., in press), many very clearly indicated their rejection of the GID term because, in their view, it contributes to the stigmatization of their condition.
2. In addition to the proposed name change for the diagnosis (see Endnote 1), there are 6 substantive proposed changes to the DSM-IV descriptive and diagnostic material: (a) we have proposed a change in conceptualization of the defining features by emphasizing the phenomenon of “gender incongruence” in contrast to cross-gender identification per se (Meyer-Bahlburg, 2009a); (b) we have proposed a merging of the A and B clinical indicator criteria in DSM-IV (see Endnotes 10, 13); (c) for the adolescent/adult criteria, we have proposed a more detailed and specific set of polythetic indicators than was the case in DSM-IV (Cohen-Kettenis & Pfäfflin, 2009; Zucker, 2006); (d) for the child criteria, we have proposed that the A1 indicator be necessary (but not sufficient) for the diagnosis of GI (see Endnote 5); (e) we have proposed that the “distress/impairment” criterion not be a prerequisite for the diagnosis of GI (see Endnote 15); and (f) we have proposed that subtyping by sexual attraction (for adolescents/adults) be eliminated (see Endnote 18) but that subtyping by the presence or absence of a co-occurring disorder of sex development (DSD) be introduced (see Endnote 14). As in DSM-IV, we recommend one overarching diagnosis, GI, with separate, developmentally-appropriate criteria sets for children vs. adolescents/adults. The text material will provide updated information on developmental trajectory data for clients who received the GI diagnosis in childhood vs. adolescence or adulthood.
The term “sex” has been replaced by assigned “gender” in order to make the criteria applicable to individuals with a DSD (Meyer-Bahlburg, 2009b). During the course of physical sex differentiation, some aspects of biological sex (e.g., 46,XY genes) may be incongruent with other aspects (e.g., the external genitalia); thus, using the term “sex” would be confusing. The change also makes it possible for individuals who have successfully transitioned to “lose” the diagnosis after satisfactory treatment. This resolves the problem that, in the DSM-IV-TR, there was a lack of an “exit clause,” meaning that individuals once diagnosed with GID will always be considered to have the diagnosis, regardless of whether they have transitioned and are psychosocially adjusted in the identified gender role (Winters, 2008). The diagnosis will also be applicable to transitioned individuals who have regrets, because they did not feel like the other gender after all. For instance, a natal male living in the female role and having regrets experiences an incongruence between the “newly assigned” female gender and the experienced/expressed (still or again male) gender.
3. It has been recommended by the Workgroup to delete the “perceived cultural advantages” proviso. This was also recommended by the DSM-IV Subcommittee on Gender Identity Disorders (Bradley et al., 1991). There is no reason to “impute” one causal explanation for GI at the expense of others (Zucker, 1992, 2009).
4. The 6 month duration was introduced to make at least a minimal distinction between very transient and persistent GI. The duration criterion was decided upon by clinical consensus. However, there is no clear empirical literature supporting this particular period (e.g., 3 months vs. 6 months or 6 months vs. 12 months). There was, however, consensus among the group that a lower-bound duration of 6 months would be unlikely to yield false positives.
13. In the DSM-IV, there are two sets of clinical indicators (Criteria A and B). This distinction is not supported by factor analytic studies. The existing studies suggest that the concept of GI is best captured by one underlying dimension (Cohen-Kettenis & van Goozen, 1997; Deogracias et al., 2007; Green, 1987; Johnson et al., 2004; Singh et al., 2010).
14. There is considerable evidence individuals with a DSD experience GI and may wish to change from their assigned gender; the percentage of such individuals who experience GI is syndrome-dependent (Cohen-Kettenis, 2005; Dessens, Slijper, & Drop, 2005; Mazur, 2005; Meyer-Bahlburg, 1994, 2005, 2009a, 2009b). From a phenomenologic perspective, DSD individuals with GI have both similarities and differences to individuals with GI with no known DSD. Developmental trajectories also have similarities and differences. The presence of a DSD is suggestive of a specific causal mechanism that may not be present in individuals without a diagnosable DSD.
15. It is our recommendation that the GI diagnosis be given on the basis of the A criterion alone and that distress and/or impairment (the D criterion in DSM-IV) be evaluated separately and independently. This definitional issue remains under discussion in the DSM-V Task Force for all psychiatric disorders and may have to be revisited pending the outcome of that discussion. Although there are studies showing that adolescents and adults with the DSM-IV diagnosis of GID function poorly, this type of impairment is by no means a universal finding. In some studies, for example, adolescents or adults with GID were found to generally function psychologically in the non-clinical range (Cohen-Kettenis & Pfäfflin, 2009; Meyer-Bahlburg, 2009a). Moreover, increased psychiatric problems in transsexuals appear to be preceded by increased experiences of stigma (Nuttbrock et al., 2009). Postulating “inherent distress” in case one desires to be rid of body parts that do not fit one’s identity is, in the absence of data, also questionable (Meyer-Bahlburg, 2009a).
16. Although the DSM-IV diagnosis of GID encompasses more than transsexualism, it is still often used as an equivalent to transsexualism (Sohn & Bosinski, 2007). For instance, a man can meet the two core criteria if he only believes he has the typical feelings of a woman and does not feel at ease with the male gender role. The same holds for a woman who just frequently passes as a man (e.g., in terms of first name, clothing, and/or haircut) and does not feel comfortable living as a conventional woman. Someone having a GID diagnosis based on these subcriteria clearly differs from a person who identifies completely with the other gender, can only relax when permanently living in the other gender role, has a strong aversion against the sex characteristics of his/her body, and wants to adjust his/her body as much as technically possible in the direction of the desired sex. Those who are distressed by having problems with just one of the two criteria (e.g., feeling uncomfortable living as a conventional man or woman) will have a GIDNOS diagnosis. This is highly confusing for clinicians. It perpetuates the search for the “true transsexual” only, in order to identify the right candidates for hormone and surgical treatment instead of facilitating clinicians to assess the type and severity of any type of GI and offer appropriate treatment. Furthermore, in the DSM-IV, gender identity and gender role were described as a dichotomy (either male or female) rather than a multi-category concept or spectrum (Bockting, 2008; Bornstein, 1994; Drescher, 2010; Ekins & King, 2006; Lev, 2007; Røn, 2002). The current formulation makes more explicit that a conceptualization of GI acknowledging the wide variation of conditions will make it less likely that only one type of treatment is connected to the diagnosis. Taking the above regarding the avoidance of male-female dichotomies into account, in the new formulation, the focus is on the discrepancy between experienced/expressed gender (which can be either male, female, in-between or otherwise) and assigned gender (in most societies male or female) rather than cross-gender identification and same-gender aversion (Cohen-Kettenis & Pfäfflin, 2009).
17. In referring to secondary sex characteristics, anticipation of the development of secondary sex characteristics has been added for young adolescents. Adolescents increasingly show up at gender identity clinics requesting gender reassignment, before the first signs of puberty are visible (Delemarre-van de Waal & Cohen-Kettenis, 2006; Zucker & Cohen-Kettenis, 2008).
18. In contemporary clinical practice, sexual orientation per se plays only a minor role in treatment protocols or decisions. Also, changes as to the preferred gender of sex partner occur during or after treatment (DeCuypere, Janes, & Rubens, 2005; Lawrence, 2005; Schroder & Carroll, 1999). It can be difficult to assess sexual orientation in individuals with a GI diagnosis, as they preoperatively might give incorrect information in order to be approved for hormonal and surgical treatment (Lawrence, 1999). Because sexual orientation subtyping is of interest to researchers in the field, it is recommended that reference to it be addressed in the text, but not as a specifier. It should also be assessed as a dimensional construct.
19. The subworkgroup has had extensive discussion about the placement of GI in the nomenclature for DSM-V, as the meta-structure of the entire manual is under review. The subworkgroup questions the rationale for the current DSM-IV chapter Sexual and Gender Identity Disorders, which contains three major classes of diagnoses: sexual dysfunctions, paraphilias, and gender identity disorders (see Meyer-Bahlburg, 2009a). Various alternative options to the current placement are under consideration.
For Adolescents and Adults
Dimensional Assessment for Gender Dysphoria in Adolescents or Adults
Questions A1-A6 are the dimensional metrics for the corresponding categorical criteria.
Instructions: Please circle the letter next to the statement that applies to you the best.
For Questions A1-A6, please circle the letter next to the statement that applies to you the best.
A1. Over the past 6 months, how intense was your discomfort because your primary and/or secondary sex characteristics do not match your gender identity?
e. Very Strong
A2. Over the past 6 months, how intense was your desire to be rid of your primary and/or secondary sex characteristics because they do not match your gender identity?
e. Very Strong
A3. Over the past 6 months, how intense was your desire for the primary and/or secondary sex characteristics of the other gender?
e. Very Strong
A4. Over the past 6 months, how intense was your desire to be of the other gender (or some gender different from your assigned gender)?
e. Very Strong
A5. Over the past 6 months, how intense was your desire to be treated as the other gender (or some gender different from your assigned gender)?
e. Very Strong
A6. Over the past 6 months, how intense was your conviction that you have the typical feelings and reactions of the other gender (or some gender different from your assigned gender)?
e. Very Strong
Please complete the following questions:
1. My current legal sex or gender (e.g., as listed under "sex" on my passport or driver's license, also called "assigned" gender) is:
c. Other (describe): _________________
2. My confidence that I really am what my legal "sex" states (namely, a girl/woman or boy/man) is:
e. Very Strong
3. The way that I experience and express my true gender compared to my legal sex or gender is:
a. Not at all different
b. Mildly different
c. Moderately different
d. Strongly different
e. Very Strongly different
4. How old were you when you first had the strong desire to be, or to live in the gender role, of the other gender (or some gender different from your assigned gender)?
a. Age 5 years or younger
b. Between 6 and 9 years
c. Between 10 and 12 years
d. Between 13 and 17 years
e. Age 18 years or older
f. Does not apply
5. I am distressed by feeling different from my legal sex or gender:
a. Not at all
e. Very Strongly
6. Over the past 6 months, how would you describe your sexual attraction to other people?
a. Sexually attracted to males
b. Sexually attracted to females
c. Sexually attracted to both males and females
d. Sexually attracted to neither males or females
e. Other (please describe): _______________