Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent (gender dysphoria) due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder. Controversy surrounding the pathologization and treatment of a transgender identity and associated behaviors, particularly in children, has been evident in the literature since the 1980s. The majority of major medical associations such as the American Psychological Association, Substance Abuse and Mental Health Services Administration, and the World Professional Association for Transgender Health consider attempts to change a person's gender identity to be conversion therapy. The practice is considered unethical, pathologizing, and seriously harmful to transgender youth. Researchers also argue that therapeutic interventions that aim to alter a child's gender identity rely on the assumption that an adult transgender identity is undesirable, challenging this assumption along with the lack of clinical data to support outcomes and efficacy. Proponents of the older therapeutic approach to intervention argue that therapeutic intervention helps children be more comfortable in their bodies, have better peer relations and therefore better self-esteem, that research indicates there exist forms of distress associated directly with children's gender variance, and that treatment can prevent adult GD. More modern therapeutic interventions do not seek to change a child's gender identity, but are instead focused on creating a supportive and safe environment for the child to explore their gender identity and gender expression. Classification Children with persistent gender dysphoria are characterized by more extreme gender dysphoria in childhood than children with desisting gender dysphoria. Some (but not all) gender variant youth will want or need to transition, which may involve social transition (changing dress, name, pronoun), and, for older youth and adolescents, medical transition (hormone therapy or surgery). DSM-5 (2013) In May 2013, the American Psychiatric Association published the DSM-5 update to the Diagnostic and Statistical Manual of Mental Disorders, in which the GIDC diagnosis was removed and replaced with gender dysphoria, for the first time in its own distinct chapter. Subtyping by sexual orientation was deleted. The diagnosis for children was separated from that for adults. The