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Determines if patient meets ICD-10 criteria for transsexualism. Triggered when a clinician uses ICD-10 for diagnostic purposes in gender identity assessment.
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For a person with confirmed islet autoantibodies (early-stage type 1 diabetes), state the numerical progression risk to Stage 3 T1D by stage and age, set the age-stratified monitoring frequency (metabolic and HbA1c), apply the ≥10% longitudinal HbA1c rise → OGTT rule, and give the standard risk-modifier and communication framing. Use when a clinician asks how often should I monitor this Stage 1 child, what's the risk of this teenager progressing to insulin, adult with GAD positive what's the 5-year risk, my patient's HbA1c has risen 12% is that important, single autoantibody how often to retest, or how to counsel a family about progression risk. Grounded in Phillip et al. Diabetologia 2024 international staging and monitoring consensus, cross-referenced with Hussain et al 2026 IDF Europe roadmap.
Order and confirm islet autoantibody screening for early-stage type 1 diabetes — which antibodies to test (GAD65, IAA, IA2, ZnT8), sample types (capillary dried blood spot, venous), the mandatory two-sample two-method confirmation protocol, and how to interpret a positive, negative, or single-antibody result. Use when a clinician asks how to screen for early T1D, which islet autoantibodies to order, how to confirm a positive T1D antibody screen, is one autoantibody enough for T1D diagnosis, GAD antibody positive what next, or is running a general population or family-history T1D screening program. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
Classify a person with a positive islet autoantibody screen into a specific stage of type 1 diabetes (At Risk / Stage 1 / Stage 2a / Stage 2b / Stage 3a / Stage 3b / Stage 4) using the international consensus staging framework based on autoantibody count and glycaemic status. Use when a clinician asks how to stage a positive autoantibody screen, what stage of T1D is this, is this early-stage T1D, does this child need insulin yet, is this presymptomatic T1D, does this qualify for teplizumab, or presents a person with any combination of islet autoantibodies + glucose data. Applies across paediatric and adult populations. Grounded in Hussain et al 2026 (Diabetes, Obesity and Metabolism, IDF Europe consensus, DOI 10.1111/dom.70569).
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| name | es-assess-transsexualism-icd10 |
| description | Determines if patient meets ICD-10 criteria for transsexualism. Triggered when a clinician uses ICD-10 for diagnostic purposes in gender identity assessment. |
Collect: patient's expressed desire to live and be accepted as a member of the opposite sex, wish to make body congruent via surgery/hormone treatments; duration of transsexual identity; presence of comorbid mental disorders, genetic conditions, DSD, or chromosomal abnormalities.
Does the patient have a persistent desire to live and be accepted as a member of the opposite sex, accompanied by the wish to make the body as congruent as possible through surgery and hormone treatments?
Has the transsexual identity been present persistently for at least 2 years?
Is the disorder not a symptom of another mental disorder, genetic, DSD, or chromosomal abnormality?
Do not confuse with DSM-5 gender dysphoria; ensure persistence is continuous, not intermittent; rule out body dysmorphic disorder, psychotic disorders, or DSD/chromosomal conditions that may mimic gender incongruence; avoid diagnosing if criteria are met only during transient phases of identity exploration.
A 28-year-old assigned male at birth reports a 3‑year history of desiring to live as female, wishes to start hormone therapy and undergo surgery, denies any other mental illness, and has no known DSD or chromosomal abnormality → meets all three ICD-10 criteria for transsexualism.
Source: Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons, Endocrine Society, 2017, doi:10.1210/jc.2017-01658