Gender dysphoria describes the psychological distress caused by identifying with the sex opposite to the one assigned at birth. In recent years, much progress has been made in characterizing the needs of transgender persons wishing to transition to their preferred gender, thus helping to optimize care. This critical review of the literature examines their common mental health issues, several individual risk factors for psychiatric comorbidity, and current research on the underlying neurobiology. Prevalence rates of persons identifying as transgender and seeking help with transition have been rising steeply since 2000 across Western countries; the current U.S. estimate is 0.6%. Anxiety and depression are frequently observed both before and after transition, although there is some decrease afterward. Recent research has identified autistic traits in some transgender persons. Forty percent of transgender persons endorse suicidality, and the rate of self-injurious behavior and suicide are markedly higher than in the general population. Individual factors contributing to mental health in transgender persons include community attitudes, societal acceptance, and posttransition physical attractiveness. Neurobiologically, whereas structural MRI data are thus far inconsistent, functional MRI evidence in trans persons suggests changes in some brain areas concerned with olfaction and voice perception consistent with sexual identification, but here too, a definitive picture has yet to emerge. Mental health clinicians, together with other health specialists, have an increasing role in the assessment and treatment of gender dysphoria in transgender individuals.

性别不安描述了因与出生时性别相反而引起的心理困扰。近年来，在表征希望过渡到其偏好性别的跨性别者的需求方面取得了很大进展，从而有助于优化护理。这篇对文献的批判性评论考察了他们的常见心理健康问题，精神病合并症的若干个人危险因素以及有关基础神经生物学的最新研究。自2000年以来，在西方国家，被识别为跨性别者并寻求过渡帮助的人的患病率急剧上升；目前美国的估计值为0.6％。过渡之前和之后都经常观察到焦虑和抑郁，尽管此后有所减轻。最近的研究已经确定了一些跨性别者的自闭症特征。40％的跨性别者支持自杀，自残行为和自杀率明显高于一般人群。影响跨性别者心理健康的个人因素包括社区态度，社会接受度和过渡后的身体吸引力。从神经生物学的角度来看，尽管结构MRI数据迄今仍不一致，但跨性别者的功能性MRI证据表明，与嗅觉和声音感知有关的某些大脑区域发生了与性别认同相符的变化，但在这里，确切的情况尚未出现。精神卫生临床医生以及其他卫生专家，