Gender dysphoria
Meaning of gender dysphoria: For the purposes of this Statement of Principles, gender dysphoria: (a) means a disorder of mental health that meets the following criteria (derived from DSM-5): (i) a marked incongruence between one's experienced/expressed gender and assigned gender, of at least 6 months' duration, as manifested by at least two of the following: 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); 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); a strong desire for the primary and/or secondary sex characteristics of the other gender; a strong desire to be of the other gender (or some alternative gender different from one's assigned gender); a strong desire to be treated as the other gender (or some alternative gender different from one's assigned gender); or a strong conviction that one has the typical feelings and reactions of the other ge
Reasonable Hypothesis (RH) — Statement of Principles No. 113 of 2021
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting gender dysphoria or death from gender dysphoria with the circumstances of a person's relevant service:
- (1)experiencing severe childhood abuse before the clinical worsening of gender dysphoria;
Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.
- (2)being subject to a serious physical attack or assault, including rape and sexual molestation, within the 5 years before the clinical worsening of gender dysphoria;
- (3)experiencing a category 2 stressor within the 1 year before the clinical worsening of gender dysphoria;
Note: A category 2 stressor can arise in a variety of circumstances connected with service. Such circumstances can arise during the course of service, as a result of separation from service and the conditions associated with that separation, and in the transition to civilian life in the years following separation.
Note: category 2 stressor is defined in the Schedule 1 - Dictionary.
- (4)inability to obtain appropriate clinical management for gender dysphoria;
Aggravation-only factors: the factors in subsections 8(1) to 8(4) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 114 of 2021
4 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, gender dysphoria or death from gender dysphoria is connected with the circumstances of a person's relevant service:
- (1)experiencing severe childhood abuse before the clinical worsening of gender dysphoria;
Note: severe childhood abuse is defined in the Schedule 1 - Dictionary.
- (2)being subject to a serious physical attack or assault, including rape and sexual molestation, within the 5 years before the clinical worsening of gender dysphoria;
- (3)experiencing a category 2 stressor within the 1 year before the clinical worsening of gender dysphoria;
Note: A category 2 stressor can arise in a variety of circumstances connected with service. Such circumstances can arise during the course of service, as a result of separation from service and the conditions associated with that separation, and in the transition to civilian life in the years following separation.
Note: category 2 stressor is defined in the Schedule 1 - Dictionary.
- (4)inability to obtain appropriate clinical management for gender dysphoria;
Aggravation-only factors: the factors in subsections 8(1) to 8(4) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.








