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Rafael RDMR, Silva NL, Depret DG, Gonçalves de Souza Santos H, Silva KPD, Catarina Barbachan Moares A, Braga do Espírito Santo T, Caravaca-Morera JA, Wilson EC, Moreira Jalil E, Knupp VMDAO, Veloso VG, Grinsztejn B, Velasque LDS. Childhood Parental Neglect, Abuse and Rejection Among Transgender Women: A Cross-Sectional Study in Rio de Janeiro, Brazil. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241259018. [PMID: 38867520 DOI: 10.1177/08862605241259018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
We aimed to estimate the proportions of childhood parental neglect, abuse, and rejection and to evaluate the co-occurrence of these experiences among transgender women in Rio de Janeiro, Brazil. This was a cross-sectional study with a convenience sample enrolled between July 2019 and March 2020, using an adapted version of the Childhood Trauma Questionnaire. Proportions and corresponding confidence intervals (CI) were calculated. Kendall correlation with Tau-b estimator was used in the bivariate analyses. We gathered data from 139 participants. The most prevalent types of childhood traumas were emotional abuse (60.43%, 95% CI [51.79, 68.62]), physical abuse (57.55%, 95% CI [48.90, 65.89]) and sexual abuse (44.60%, 95% CI [36.18, 53.27]). Severe to extreme physical and emotional abuse occurred among 40.29% (95% CI [32.06, 48.93]) and 5.75% (95% CI [2.51, 11.02]) of participants, respectively. The proportion of parental rejection (eviction) was 32.37% (95% CI [25.04, 40.69]) and occurred with the other forms of abuse, except sexual abuse. Multiple types of childhood abuse, neglect, and parental rejection were observed among transgender women in our sample. The harmful effects of childhood abuse on the mental and physical health of people in the transgender population are of concern, particularly considering the cumulative effect produced by the co-occurrence of such events and their harmful lifetime effects. It is urgently necessary to debate and formulate public policies to ensure the right to gender expression from childhood.
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Affiliation(s)
| | | | - Davi Gomes Depret
- Universidade do Estado do Rio de Janeiro, Brazil
- Rio de Janeiro Municipal Health Secretary, Brazil
| | | | | | | | | | | | - Erin C Wilson
- Center for Public Health Research, San Francisco, CA, United States of America
- University of California, San Francisco, United States of America
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Moncayo Quevedo JE, Pérez-Arizabaleta MDM, Reyes Sevillano WH. Condom use and non-use among transgender women in Colombia: a qualitative analysis based on the IMB model. Rev Saude Publica 2022; 56:84. [PMID: 36169523 PMCID: PMC9529206 DOI: 10.11606/s1518-8787.2022056004145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/03/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Review the reasons for condom use and non-use among transgender women in Colombia based on the information, motivation and behavioral skills (IMB) model. METHOD Qualitative study in which an iterative process analysis was carried out. A focal group participated in person, and in-depth interviews were conducted virtually. RESULTS First study carried out in Colombia on condom use among transgender women under the IMB model. The information component finds that traditional sexual education does not have a positive impact. Regarding motivational aspects, the importance of family support and follow-up and community-based organizations to motivate sexual health care and condom use is highlighted. Regarding behavioral skills, it was found that distrust towards sexual partners and the acquisition of condoms promote their use. CONCLUSIONS It is important to create spaces for sexual education delivered by and for the LGBTIQ population, followed by the medical knowledge of health centers, to have positive impacts on the sexual health of transgender women; studies with sexual partners of transgender women are encouraged in order to know the reasons why they request the non-use of condoms.
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Guadagnin F, da Silva DC, Schwarz K, Villas Bôas AP, Lobato MIR. The Impact of the COVID-19 Pandemic on the Lives of People With Gender Dysphoria. Front Public Health 2022; 10:878348. [PMID: 35874999 PMCID: PMC9298877 DOI: 10.3389/fpubh.2022.878348] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/14/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To analyze the impact on the psychological and social aspects caused by the COVID-19 pandemic in individuals diagnosed with Gender Dysphoria (GD). METHODS Google Forms inventory was sent via WhatsApp, including qualitative and quantitative questions evaluating three life dimensions denominated as Sociodemographic, Economic, and COVID-19 pandemic. It was applied in two periods: At the beginning of the pandemic (June-2020) (P1) and one year later (June-2021) (P2). The inventory also included questions about economic dimensions before the pandemic for individual comparison purposes (P0). 48 individuals (28 transsexual women, 20 transsexual men) participated in both periods. RESULTS 77.1% (n = 37) lived in Rio Grande do Sul, 50.0% (n = 24) refereed incomplete high school; Monthly Income increased significantly between the periods (P0) and (P1). Emergence aid approval was significantly higher in (P2), 56.3% (n = 27), compared to (P1), 39.6% (n = 19). A statistically significant difference was detected in the feeling of depression in the (P2) among the cases that requested Emergency Aid. CONCLUSION The studied population presented deterioration regarding their condition of social vulnerability in relation to formal employment, access to health services, and mental health.
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Affiliation(s)
| | - Dhiordan Cardoso da Silva
- Department of Psychiatry, Gender Identity Program at Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Karine Schwarz
- Department of Psychiatry, Gender Identity Program at Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
- Postgraduate Program in Medical Sciences: Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Anna Paula Villas Bôas
- Department of Psychiatry, Gender Identity Program at Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Maria Inês Rodrigues Lobato
- Clinical Hospital of Porto Alegre, Porto Alegre, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences at the Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Sun M, Ji H, Chen X, Xu J, Lu J, Yi Y, Pan Y, Wu R, Chen Y, Duan Y, Dou X, Zhou L. The factors influencing the psychological distress of transgender women in Shandong, China: a cross-sectional study. BMC Public Health 2022; 22:955. [PMID: 35549903 PMCID: PMC9101853 DOI: 10.1186/s12889-022-13357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background As a group at high-risk for acquired immune deficiency syndrome (AIDS) infection, the psychological distress of transgender women cannot be ignored while preventing and controlling AIDS risks. Transgender women are a vulnerable group, and their psychological distress deserves attention. The purpose of this study was to evaluate the psychological distress of transgender women and further determine the influences of factors on the psychological distress of transgender women. Methods From March 2021 to August 2021, a cross-sectional survey was conducted in Shandong province, China. Data were collected by a questionnaire designed for transgender women, and the GHQ-12 scale was used to measure their psychological distress. The questionnaire combined sociodemographic characteristics, HIV/AIDS cognition, related behaviors, substance abuse, social support, gender identity and other factors. Univariate logistic regression and multivariate logistic regression models were used to explore the psychological factors of transgender women. Results In this study, the rate of transgender women with psychological distress was 20.08%. Earned monthly income between 10,000–15,000 yuan (OR:0.16, 95% CI:0.06–0.45) and a monthly income greater than 15,000 yuan (OR:0.07, 95% CI:0.01–0.43) were protective factors in the psychology of transgender women. Transgender women who never disclosed sexual orientation and identity (OR: 0.19, 95% CI: 0.06–0.58), who only disclosed their sexual orientation and identity to families or friends (OR: 0.41, 95% CI: 0.18–0.93) were also less likely to have psychological distress. Additionally, transgender women who did not desire to be identified with their sexual orientation and identity (OR: 3.31, 95%CI: 1.08–10.16) and who reported that the Internet did not play an essential role in helping determine sexual orientation (OR: 5.96, 95% CI: 2.91–12.20) were more likely to have psychological distress. Conclusion Transgender women were at risk of psychological distress. Earning more money can help transgender women's psychological health. When formulating measures for transgender women, we should pay attention to enhance social inclusion and social acceptance of their gender identity and sexual orientation. Strengthening the role of the internet in transgender women's confirmation of sexual orientation and improving the social acceptance of transgender women will have a positive impact on the psychological status of transgender women. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13357-9.
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Affiliation(s)
- Meng Sun
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Haoqiang Ji
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Xu Chen
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Jia Xu
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Jiachen Lu
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Yaohui Yi
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Yuanping Pan
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Ruiheng Wu
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Yunting Chen
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Yuxin Duan
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Xiaofeng Dou
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China
| | - Ling Zhou
- School of Public Health, Dalian Medical University, Dalian, 116044, Liaoning, China.
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Silva DC, Rabelo-da-Ponte FD, Salati LR, Lobato MIR. Heterogeneity in gender dysphoria in a Brazilian sample awaiting gender-affirming surgery: a data-driven analysis. BMC Psychiatry 2022; 22:79. [PMID: 35105327 PMCID: PMC8808968 DOI: 10.1186/s12888-022-03727-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 11/18/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Population heterogeneity and the lack of clinical and sociodemographic information in transgender individuals with gender dysphoria (GD) remains a challenge for specialized services in mental health and surgical procedures. It aimed to identify and describe profiles in a sample waiting for gender-affirming surgery. METHODS A sample of 100 outpatients with GD was assessed through a structured interview, Emotion Regulation Difficulty Scale (DERS), Ruminative Response Scale (RRS), Depression, Anxiety and Stress Scale (DASS-21) and Life Satisfaction scale (SWLS). Cluster analysis was used to identify different profile categories. RESULTS Two subgroups with different profiles were identified: with less clinical severity (LCS) and with high clinical severity (HCS) on emotional dysregulation, acute symptoms of depression, anxiety, stress and association with mental rumination. The HCS cluster had greater vulnerability in terms of psychiatric history, use of psychotropic drugs, HIV positive, child abuse and suicidal behavior. CONCLUSION Different profiles were found regarding the vulnerability to mental health in a sample of transgender people with GD who seek a public hospital service for the same clinical-surgical objective. Longitudinal studies are essential to monitor the impact of these contrasts and to target personalized therapeutic approaches in the prevention of psychiatric disorders.
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Affiliation(s)
- Dhiordan Cardoso Silva
- Transdisciplinary Gender Identity Program, Department of Psychiatry of Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
- Graduate Program in Psychiatry and Behavioral Sciences, Medical School of the Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil.
| | - Francisco Diego Rabelo-da-Ponte
- Graduate Program in Psychiatry and Behavioral Sciences, Medical School of the Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil
- Molecular Psychiatry Laboratory, Department of Psychiatry of Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Leonardo Romeira Salati
- Transdisciplinary Gender Identity Program, Department of Psychiatry of Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maria Inês Rodrigues Lobato
- Transdisciplinary Gender Identity Program, Department of Psychiatry of Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Medical School of the Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil
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Lobato MIR. Editorial: Gender dysphoria: Diagnostic issues, clinical aspects, and health promotion. Front Psychiatry 2022; 13:1000939. [PMID: 36311497 PMCID: PMC9597883 DOI: 10.3389/fpsyt.2022.1000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Maria Inês Rodrigues Lobato
- Serviço de Psiquiatria, Hospital de Clínicas de Porto Alegre-HCPA, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Programa de Pós-Graduação (PPG) Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Coordenadora Programa de Identidade de Gênero-PROTIG, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Real AG, Fontanari AMV, Costa AB, Soll BMB, Bristot G, de Oliveira LF, Kamphorst AM, Schneider MA, Lobato MIR. Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2021; 43:37-46. [PMID: 33681906 PMCID: PMC7932037 DOI: 10.47626/2237-6089-2020-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Gender dysphoria (GD) is characterized by a marked incongruence between experienced gender and one's gender assigned at birth. Transsexual individuals present a higher prevalence of psychiatric disorders when compared to non-transsexual populations, and it has been proposed that minority stress, i.e., discrimination or prejudice, has a relevant impact on these outcomes. Transsexuals also show increased chances of having experienced maltreatment during childhood. Interleukin (IL)-1β, IL-6, IL-10 and tumor necrosis factor-alpha (TNF-α) are inflammatory cytokines that regulate our immune system. Imbalanced levels in such cytokines are linked to history of childhood maltreatment and psychiatric disorders. We compared differences in IL-1β, IL-6, IL-10 and TNF-α levels and exposure to traumatic events in childhood and adulthood in individuals with and without GD (DSM-5). METHODS Cross-sectional controlled study comparing 34 transsexual women and 31 non-transsexual men. They underwent a thorough structured interview, assessing sociodemographic information, mood and anxiety symptoms, childhood maltreatment, explicit discrimination and suicidal ideation. Inflammatory cytokine levels (IL-1β, IL-6, IL-10 and TNF-α) were measured by multiplex immunoassay. RESULTS Individuals with GD experienced more discrimination (p = 0.002) and childhood maltreatment (p = 0.046) than non-transsexual men. Higher suicidal ideation (p < 0.001) and previous suicide attempt (p = 0.001) rates were observed in transsexual women. However, no differences were observed in the levels of any cytokine. CONCLUSIONS These results suggest that transsexual women are more exposed to stressful events from childhood to adulthood than non-transsexual men and that GD per se does not play a role in inflammatory markers.
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Affiliation(s)
- André Gonzales Real
- Programa de Identidade de GêneroHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPrograma de Identidade de Gênero (PROTIG), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazilPrograma de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
| | - Anna Martha Vaitses Fontanari
- Programa de Identidade de GêneroHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPrograma de Identidade de Gênero (PROTIG), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazilPrograma de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
| | - Angelo Brandelli Costa
- Departamento de PsicologiaPontifícia Universidade Católica do Rio Grande do SulPorto AlegreRSBrazilDepartamento de Psicologia, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
| | - Bianca Machado Borba Soll
- Programa de Identidade de GêneroHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPrograma de Identidade de Gênero (PROTIG), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazilPrograma de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
| | - Giovana Bristot
- INCT Translacional em MedicinaHospital de Clinicas de Porto AlegreUFRGSPorto AlegreRSBrazil Laboratório de Psiquiatria Molecular, INCT Translacional em Medicina, Hospital de Clinicas de Porto Alegre (HCPA), UFRGS, Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em BioquímicaUFRGSPorto AlegreRSBrazilPrograma de Pós-Graduação em Bioquímica, UFRGS, Porto Alegre, RS, Brazil.
| | - Larissa Fagundes de Oliveira
- INCT Translacional em MedicinaHospital de Clinicas de Porto AlegreUFRGSPorto AlegreRSBrazil Laboratório de Psiquiatria Molecular, INCT Translacional em Medicina, Hospital de Clinicas de Porto Alegre (HCPA), UFRGS, Porto Alegre, RS, Brazil.
| | - Ana Maria Kamphorst
- Programa de Identidade de GêneroHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPrograma de Identidade de Gênero (PROTIG), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Maiko Abel Schneider
- Programa de Identidade de GêneroHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPrograma de Identidade de Gênero (PROTIG), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazilPrograma de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
| | - Maria Inês Rodrigues Lobato
- Programa de Identidade de GêneroHospital de Clínicas de Porto AlegreUniversidade Federal do Rio Grande do SulPorto AlegreRSBrazilPrograma de Identidade de Gênero (PROTIG), Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Programa de Pós-Graduação em Psiquiatria e Ciências do ComportamentoUFRGSPorto AlegreRSBrazilPrograma de Pós-Graduação em Psiquiatria e Ciências do Comportamento, UFRGS, Porto Alegre, RS, Brazil.
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Rich AJ, Scheim AI, Koehoorn M, Poteat T. Non-HIV chronic disease burden among transgender populations globally: A systematic review and narrative synthesis. Prev Med Rep 2020; 20:101259. [PMID: 33335828 PMCID: PMC7732872 DOI: 10.1016/j.pmedr.2020.101259] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/09/2020] [Accepted: 11/15/2020] [Indexed: 01/10/2023] Open
Abstract
Chronic disease is a growing concern for research, policy and clinical care. While the global burden of HIV for transgender populations has been comprehensively covered in recent systematic reviews, the same is not true for the burden of other chronic disease. The objective of this study was to review the literature on non-HIV chronic disease burden for transgender populations worldwide. A systematic review was conducted of Medline, Embase, CINAHL, PsycINFO and LGBT Life bibliographic databases for peer-reviewed scientific studies with non-HIV chronic disease prevalence data for transgender populations published any date up to February 15, 2019 without restriction on country or study design. A total of 93 studies and 665 datapoints were included in this review, comprising 48 distinct chronic disease outcomes in seven groups (cancer, cerebro/cardiovascular conditions, chronic liver and kidney disease, mental health and substance use conditions, metabolic and endocrine disorders, musculoskeletal and brain disorders, respiratory conditions, and unspecified and other conditions). The empirical literature on chronic disease among global transgender populations focuses on mental health morbidity, demonstrating an evidence gap on chronic physical health morbidity, particularly beyond that of sexual health. This review identified important gaps including in age-related conditions, inflammation-related disease and studies designed explicitly to investigate chronic disease burden among transgender populations. There is a need for high quality evidence in this area, including longitudinal population-based studies with appropriate comparison groups, and consistent measurement of both transgender status and chronic conditions.
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Affiliation(s)
- Ashleigh J. Rich
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
- Corresponding author.
| | - Ayden I. Scheim
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Mieke Koehoorn
- School of Population & Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Tonia Poteat
- Department of Social Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
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Fontanari AMV, Vilanova F, Schneider MA, Chinazzo I, Soll BM, Schwarz K, Lobato MIR, Brandelli Costa A. Gender Affirmation Is Associated with Transgender and Gender Nonbinary Youth Mental Health Improvement. LGBT Health 2020; 7:237-247. [PMID: 32456545 DOI: 10.1089/lgbt.2019.0046] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: The present study aimed to evaluate the impact of each domain of gender affirmation (social, legal, and medical/surgical) on the mental health of transgender and gender nonbinary youth. Methods: Three hundred fifty transgender boys, transgender girls, and gender nonbinary Brazilian youth, from 16 to 24 years old, answered an online survey. Results: The final sample consisted of 350 youth who participated in this study. A total of 149 (42.64%) youth identified as transgender boys, 85 (24.28%) identified as transgender girls, and 116 (33.14%) identified as gender nonbinary youth. The mean age was 18.61 (95% confidence interval 18.34-18.88) years. Having accessed multiple steps of gender affirmation (social, legal, and medical/surgical) was associated with fewer symptoms of depression and less anxiety. Furthermore, engaging in gender affirmation processes helped youth to develop a sense of pride and positivity about their gender identity and a feeling of being socially accepted. Conclusion: Enabling transgender and gender nonbinary youth to access gender affirmation processes more easily should be considered as a strategy to reduce depression and anxiety symptoms, as well as to improve gender positivity.
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Affiliation(s)
- Anna Martha Vaitses Fontanari
- Postgraduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Vilanova
- Postgraduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maiko Abel Schneider
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Itala Chinazzo
- Postgraduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Bianca Machado Soll
- Postgraduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Karine Schwarz
- Speech Therapy Department, Centro Universitário Metodista IPA, Porto Alegre, Brazil
| | - Maria Inês Rodrigues Lobato
- Postgraduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Angelo Brandelli Costa
- Postgraduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
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Abstract
Transgender or gender dysphoria has been defined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), as distress resulting from the incongruence between one's experienced gender and one's assigned gender, along with a persistent and strong desire to be of another gender, and accompanied by clinically significant distress. Adolescents referred for evaluation often want hormonal therapy and several among them also express a desire for gender reassignment surgery. Furthermore, evidence shows that adolescents and adults with gender dysphoria without a sex development disorder, before gender reassignments, are at increased risk for suicide. For this review, a search of the English language scientific literature was conducted using the PubMed database. This summary discusses the associations and comorbidities of gender dysphoria and reiterates the evidence that its etiology is multifactorial. Transsexualism involves prenatal neuroanatomical changes, has a psychiatric association, and is found to be more prevalent in conjunction with schizophrenia and autism spectrum disorders. Childhood adversities and neglect are also linked to having a transgender identity. Moreover, the evidence favors a genetic predisposition. Likewise, there seems to be a growing concern with regards to the relationship between endocrine disruptors and transsexuals as well as other gender minority populations. More research needs to be done to understand the exact pathways.
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Affiliation(s)
- Fatima Saleem
- Internal medicine, King Edward Medical University Lahore, Pakistan
| | - Syed W Rizvi
- R Endocrinology, New Jersey, Asst. Professor, Internal Medicine and Endocrinology, Umdnj
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