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Alves Rodrigues C, Marguilho M, Ferreira B, Nascimento S, Nascimento M, Cardoso S, Silva M, Pablo AC, Soares C, Fernandes C, Gonçalves M. Gender Dysphoria: Concepts, Diagnosis and Clinical Management. ACTA MEDICA PORT 2024; 37:379-385. [PMID: 38577868 DOI: 10.20344/amp.21057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/04/2024] [Indexed: 04/06/2024]
Abstract
Gender dysphoria is defined as a condition characterized by mental suffering associated with the incongruence between one's experienced gender and their birth-assigned sex. Gender as a construct and gender dysphoria as a condition in need of multidisciplinary intervention have developed as swiftly as their visibility in society, making it mandatory to promote the literacy and education of all healthcare professionals in this area. This article aims to review information based on scientific evidence on people with gender dysphoria and its clinical approach, while contributing to a safe, inclusive, and non-discriminatory practice of healthcare.
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Affiliation(s)
- Carolina Alves Rodrigues
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Miriam Marguilho
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Bárbara Ferreira
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Sandra Nascimento
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Miguel Nascimento
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Sónia Cardoso
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Mariana Silva
- Serviço de Psiquiatria de Ligação. Hospital São José. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Ana Cristina Pablo
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Catarina Soares
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Carlos Fernandes
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
| | - Marco Gonçalves
- Consulta de Sexologia. Hospital Júlio de Matos. Unidade Local de Saúde São José. Lisboa. Portugal
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Della Casa V, Gubello A, Malmquist A, Mezzalira S, Bonato M, Simonelli A, Gatta M, Miscioscia M. Minority Stress, Self-Awareness, and Coping Strategies during the COVID-19 Pandemic among Italian Transgender Young Adults. Healthcare (Basel) 2024; 12:132. [PMID: 38255021 PMCID: PMC10815491 DOI: 10.3390/healthcare12020132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 12/16/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND The security measures implemented in response to the COVID-19 emergency have caused complex consequences. The aim of the present study is to examine the repercussions of the pandemic on individuals belonging to gender identity minority groups, who have experienced heightened levels of stress in comparison to the general population. METHODS Online interviews with 12 transgender participants who resided in Italy during the pandemic were conducted and subsequently analyzed following the thematic analysis methodology. RESULTS The majority of the participants reported an increase in stress levels primarily attributed to the lack of acceptance and support within their familial environments, obstacles encountered in accessing specialized healthcare services, and a lack of support from the broader LGBTQ+ community. Despite these challenges, several participants developed effective coping strategies and a subset of them also benefited from multiple resilience factors, including familial support and assistance from mental health professionals. CONCLUSIONS The outcomes of the present study indicate that the COVID-19 pandemic, while fostering certain protective factors within this population, has also given rise to new and critical mental health concerns. These findings hold significant implications for professionals working with transgender populations, highlighting the necessity of addressing these emerging mental health issues.
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Affiliation(s)
- Veronica Della Casa
- Department of General Psychology, University of Padova, Via Venezia 12, 35131 Padua, Italy; (V.D.C.); (M.B.)
| | - Alessio Gubello
- DéFaSy, Faculty of Psychology, Educational Sciences and Language and Speech Therapy, Université Libre de Bruxelles, 1050 Brussels, Belgium;
| | - Anna Malmquist
- Department of Behavioural Sciences and Learning, Linkoping University, Campus Valla, I-Huset, 3, 581 83 Linkoping, Sweden;
| | - Selene Mezzalira
- School of Engineering, University of Basilicata, Via Nazario Sauro, 85, 85100 Potenza, Italy;
| | - Marina Bonato
- Department of General Psychology, University of Padova, Via Venezia 12, 35131 Padua, Italy; (V.D.C.); (M.B.)
| | - Alessandra Simonelli
- Department of Developmental Psychology and Socialization, University of Padova, Via Venezia 8, 35131 Padua, Italy;
| | - Michela Gatta
- Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padua, Italy;
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padova, Via Venezia 8, 35131 Padua, Italy;
- Department of Women’s and Children’s Health, University of Padova, Via Giustiniani 3, 35128 Padua, Italy;
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Lampis J, De Simone S, Lasio D, Serri F. The Role of Family Support and Dyadic Adjustment on the Psychological Well-being of Transgender Individuals: An Exploratory Study. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2023:1-17. [PMID: 37363352 PMCID: PMC10166461 DOI: 10.1007/s13178-023-00817-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 06/28/2023]
Abstract
Introduction This study aimed to measure dyadic adjustment, social support, and psychological well-being. Methods A research protocol composed of the Dyadic Adjustment Scale, the Outcome Questionnaire 45.2, and the Multidimensional Scale of Perceived Social Support was administered to a sample of 109 Italian transgender individuals. Results Higher levels of global psychological distress, symptom severity, and interpersonal relationship distress were associated with lower levels of family support and dyadic adjustment. In addition, transgender women and younger transgender individuals reported higher levels of interpersonal relationship distress. Conclusions The results indicate that the support and acceptance of one's partner and family of origin play a crucial role in promoting well-being. It represents an important protective factor with respect to negative psychological health outcomes. Policy Implications The findings emphasize the need to develop specific clinical and social practices for transgender individuals and their families. Building family and partner-centered policies and programs is particularly important to enable transgender individuals to avoid paying the emotional and psychological costs associated with rejection and non-acceptance.
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Affiliation(s)
- Jessica Lampis
- Department of Education, Psychology, Philosophy, University of Cagliari, Via Is Mirrionis, 1, 09123 Cagliari, Italy
| | - Silvia De Simone
- Department of Education, Psychology, Philosophy, University of Cagliari, Via Is Mirrionis, 1, 09123 Cagliari, Italy
| | - Diego Lasio
- Department of Education, Psychology, Philosophy, University of Cagliari, Via Is Mirrionis, 1, 09123 Cagliari, Italy
| | - Francesco Serri
- Department of Education, Psychology, Philosophy, University of Cagliari, Via Is Mirrionis, 1, 09123 Cagliari, Italy
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Mezzalira S, Scandurra C, Mezza F, Miscioscia M, Innamorati M, Bochicchio V. Gender Felt Pressure, Affective Domains, and Mental Health Outcomes among Transgender and Gender Diverse (TGD) Children and Adolescents: A Systematic Review with Developmental and Clinical Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:ijerph20010785. [PMID: 36613106 PMCID: PMC9819455 DOI: 10.3390/ijerph20010785] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 05/04/2023]
Abstract
Although capable of mobilizing significant resilience factors to face stigma and discrimination, transgender and gender diverse (TGD) children and adolescents tend to suffer from more adverse mental health outcomes compared to their cisgender counterparts. The minority stressors that this population faces are mainly due to the gender-based pressure to conform to their assigned gender. This systematic review was aimed at assessing the potential mental health issues that affect the TGD population. The literature search was conducted in three databases; namely, Scopus, PubMed, and Web of Science, based on the PRISMA guidelines. The 33 articles included in the systematic review pointed out how TGD children and adolescents experience high levels of anxiety and depression, as well as other emotional and behavioral problems, such as eating disorders and substance use. Resilience factors have been also pointed out, which aid this population in facing these negative mental health outcomes. The literature review highlighted that, on the one hand, TGD individuals appear to exhibit high levels of resilience; nonetheless, health disparities exist for TGD individuals compared with the general population, which are mainly attributable to the societal gender pressure to conform to their assigned gender. Considerations for research and clinical practice are provided.
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Affiliation(s)
- Selene Mezzalira
- Department of Humanities, University of Calabria, 87036 Rende, Italy
| | - Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences, and Dentistry, University of Naples Federico II, 80131 Naples, Italy
| | - Fabrizio Mezza
- SInAPSi Center, University of Naples Federico II, 80133 Naples, Italy
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy
| | - Marco Innamorati
- Department of History, Cultural Heritage, Education, and Society, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenzo Bochicchio
- Department of Humanities, University of Calabria, 87036 Rende, Italy
- Correspondence:
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Rosati F, Lorusso MM, Pistella J, Giovanardi G, Di Giannantonio B, Mirabella M, Williams R, Lingiardi V, Baiocco R. Non-Binary Clients' Experiences of Psychotherapy: Uncomfortable and Affirmative Approaches. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15339. [PMID: 36430057 PMCID: PMC9690436 DOI: 10.3390/ijerph192215339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Non-binary people may face specific challenges in psychological settings. Psychotherapists often display a lack of preparation for non-binary gender identities, resulting in overt or subtle forms of prejudice that compromise the therapeutic alliance. The present study aimed to provide data on non-binary clients' positive and negative experiences within therapeutic relationships. Twenty-five interviews were conducted with non-binary people in the age range of 19-35. Using codebook thematic analysis, the researchers identified three main themes: (1) the self of the psychotherapist, consisting of the impact of the therapist's personal (i.e., sexual identity) and professional (i.e., competence) characteristics on the therapeutic experience; (2) the practice of the psychotherapist, emerging as affirmative (validation and microaffirmations) or negative (gender identity change efforts, manifest aggressions, and microaggressions) approaches toward non-binary identities; (3) the therapeutic relationship, referring to the alliance, rupture, and reparation based on the therapists' openness toward non-binary identities. To provide a safer setting for non-binary clients, psychotherapists should incorporate issues related to gender minority identities in their training, acknowledge clinical errors when they occur and adopt an active predisposition to learn through the client's experience, giving value to their unique contribution.
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Affiliation(s)
- Fau Rosati
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Maric Martin Lorusso
- Department of Psychology, Campus Cesena, Alma Mater Studiorum, University of Bologna, 47521 Bologna, Italy
| | - Jessica Pistella
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Guido Giovanardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Bianca Di Giannantonio
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Marta Mirabella
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Riccardo Williams
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Vittorio Lingiardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Roberto Baiocco
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Garro M, Novara C, Di Napoli G, Scandurra C, Bochicchio V, Lavanco G. The Role of Internalized Transphobia, Loneliness, and Social Support in the Psychological Well-Being of a Group of Italian Transgender and Gender Non-Conforming Youths. Healthcare (Basel) 2022; 10:2282. [PMID: 36421606 PMCID: PMC9690355 DOI: 10.3390/healthcare10112282] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/25/2022] [Accepted: 11/08/2022] [Indexed: 11/25/2023] Open
Abstract
Although transgender and gender non-conforming (TGNC) youth represent a highly resilient community capable of successfully overcoming adverse life circumstances, they still face social stigma that negatively impacts their health, being at risk of developing negative feelings toward their own TGNC identity (i.e., internalized transphobia). A poorly investigated dimension in TGNC health research is perceived loneliness. Thus, within the minority stress theory, the present study aimed to investigate the mediating role of loneliness and the moderating role of social support in the relationship between internalized transphobia and psychological well-being among 79 Italian TGNC youths aged 18 to 30-years-old who participated in an online survey. The main results show that loneliness partially mediated the relationship between internalized transphobia and psychological well-being. In addition, social support emerged as a significant moderator, as the impact of internalized transphobia on psychological well-being decreased at moderate and high levels of social support, but not at low levels. The findings have significant implications for clinical practice and psychosocial interventions to reduce the impact of internalized stigma and stress on psychological health.
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Affiliation(s)
- Maria Garro
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Cinzia Novara
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Gaetano Di Napoli
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
| | - Cristiano Scandurra
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, 80138 Naples, Italy
| | - Vincenzo Bochicchio
- Department of Humanistic Studies, University of Calabria, 87036 Rende, Italy
| | - Gioacchino Lavanco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
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Kennis M, Duecker F, T'Sjoen G, Sack AT, Dewitte M. Sexual Self-Concept Discrepancies Mediate the Relation between Gender Dysphoria Sexual Esteem and Sexual Attitudes in Binary Transgender Individuals. JOURNAL OF SEX RESEARCH 2022; 59:524-536. [PMID: 34279141 DOI: 10.1080/00224499.2021.1951643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Sexual responding in transgender people has typically been investigated from a medical and functional perspective. Aligning with the biopsychosocial model, it is however equally important to consider psychological aspects of sexuality in this population. We propose that the Sexual Self-Concept (SSC) theory offers a valuable framework to understand (sexual) wellbeing in transgender people, while Self-Concept Discrepancy (SCD) theory could offer an explanation of the mechanisms underlying negative SSCs related to gender dysphoria. We investigated differences in SSC (consisting of sexual esteem, sexual attitudes, and sexual self-efficacy) in 197 binary transgender and 205 cisgender individuals using an online survey and explored the mediating role of actual/ideal self-discrepancies in explaining the relation between gender dysphoria and SSC. Transgender and cisgender individuals differed significantly in seven out of eight components related to sexual esteem and sexual attitudes. Actual/ideal self-discrepancies mediated the relationship between gender dysphoria and the SSC in transgender individuals for the sexual esteem components related to body perception, conduct, and attractiveness, as well as for sexual anxiety. We found no relation between gender dysphoria and the other SSC components in this group. We conclude that SSC discrepancies could be a valuable treatment target to improve transgender individuals' sexual esteem and sexual attitudes.
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Affiliation(s)
- Mathilde Kennis
- Department of Clinical Psychological Science, Maastricht University
- Department of Cognitive Neuroscience, Maastricht University
- Maastricht Brain Imaging Center, Maastricht University
| | - Felix Duecker
- Department of Cognitive Neuroscience, Maastricht University
- Maastricht Brain Imaging Center, Maastricht University
| | - Guy T'Sjoen
- Department of Endocrinology, Ghent University Hospital
- Center for Sexology and Gender, Ghent University Hospital
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Maastricht University
- Maastricht Brain Imaging Center, Maastricht University
- Department of Psychiatry and Neuropsychology, Maastricht University
- Center for Integrative Neuroscience, Maastricht University
| | - Marieke Dewitte
- Department of Clinical Psychological Science, Maastricht University
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Smith G, Robertson N, Cotton S. Transgender and gender non-conforming people’s adaptive coping responses to minority stress: A framework synthesis. NORDIC PSYCHOLOGY 2021. [DOI: 10.1080/19012276.2021.1989708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Greg Smith
- School of Psychology, University of Leicester, Leicester, UK
| | | | - Sue Cotton
- Northamptonshire Healthcare NHS Trust, Gender Identity Clinic, Daventry, UK
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Giovanardi G, Fortunato A, Mirabella M, Speranza AM, Lingiardi V. Gender Diverse Children and Adolescents in Italy: A Qualitative Study on Specialized Centers' Model of Care and Network. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249536. [PMID: 33352745 PMCID: PMC7766564 DOI: 10.3390/ijerph17249536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 12/09/2020] [Accepted: 12/17/2020] [Indexed: 12/30/2022]
Abstract
In recent years, Italy, similar to many other countries, has witnessed an increase in children and adolescents presenting gender incongruence. This trend has led to the development and implementation of specialized centers providing care and support for these youths and their families. The present study aimed at investigating the functioning of agencies specialized in working with transgender and gender non-conforming youths in the Italian territory. Professionals in these agencies were interviewed about their perspectives on their agency's functioning, networks with other services, and work with trans* youths and their families. A semi-structured interview was developed and administered to professionals in specialized centers and associations dedicated to trans * youths, and deductive thematic analysis was applied to the transcripts. Eight professionals were interviewed: six working in specialized centers and two working in associations. The qualitative analyses of transcripts revealed four main themes, pertaining to service referrals, assessment protocols and intervention models, psychological support for youths and families, and agency shortcomings. The study explored the functioning of Italian agencies specialized in caring for transgender and gender non-conforming youths, from the perspective of professionals working in these agencies. While several positive aspects of the work emerged, the study highlighted a lack of uniformity across the Italian territory and the need for better networks between agencies and other medical professionals.
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Cooper K, Russell A, Mandy W, Butler C. The phenomenology of gender dysphoria in adults: A systematic review and meta-synthesis. Clin Psychol Rev 2020; 80:101875. [PMID: 32629301 PMCID: PMC7441311 DOI: 10.1016/j.cpr.2020.101875] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/29/2020] [Accepted: 05/31/2020] [Indexed: 12/31/2022]
Abstract
Gender dysphoria is distress due to a discrepancy between one's assigned gender and gender identity. Adults who wish to access gender clinics are assessed to ensure they meet the diagnostic criteria for gender dysphoria. Therefore, the definition of gender dysphoria has a significant impact on the lives of individuals who wish to undergo physical gender transition. This systematic review aimed to identify and synthesize all existing qualitative research literature about the lived experience of gender dysphoria in adults. A pre-planned systematic search identified 1491 papers, with 20 of those meeting full inclusion criteria, and a quality assessment of each paper was conducted. Data pertaining to the lived experience of gender dysphoria were extracted from each paper and a meta-ethnographic synthesis was conducted. Four overarching concepts were identified; distress due to dissonance of assigned and experienced gender; interface of assigned gender, gender identity and society; social consequences of gender identity; internal processing of rejection, and transphobia. A key finding was the reciprocal relationship between an individual's feelings about their gender and societal responses to transgender people. Other subthemes contributing to distress were misgendering, mismatch between gender identity and societal expectations, and hypervigilance for transphobia. A systematic review of all papers on the lived experience of gender dysphoria Twenty papers with 1606 participants were included in a meta-ethnographic synthesis. Distress was due to gender and sex incongruence, as well as social factors. Results give new insights into the relationships between factors causing distress.
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Affiliation(s)
- Kate Cooper
- Centre for Applied Autism Research, Department of Psychology, University of Bath, BA2 7AY, UK.
| | - Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, University of Bath, BA2 7AY, UK
| | - William Mandy
- UCL Research Department of Clinical, Educational, and Health Psychology, Gower Street, London WC1E 6BT, UK
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Abstract
Bisexual people are a strongly stigmatized population experiencing health disparities caused by social stigmatization. The predominant framework helping to understand these health disparities and the impact of stigma on mental health of social groups belonging to a sexual minority identity constitutes the minority stress theory. In Italy, studies assessing this model in bisexual populations are very limited. Within this framework, the current study aimed at assessing in 381 Italian bisexual individuals (62 men and 319 women) the effects of anti-bisexual discrimination, proximal stressors (i.e., anticipated binegativity, internalized binegativity, and outness), and resilience on psychological distress. The results suggested that only anti-bisexual discrimination and internalized binegativity were positively associated with psychological distress, and that resilience was negatively associated with mental health issues. Furthermore, the results suggested that internalized binegativity mediated the relationship between anti-bisexual discrimination and mental health problems. No moderating effect of resilience was found. This is the first study to have thoroughly applied minority stress in Italian bisexual people, providing Italian clinicians and researchers with an outline of the associations between minority stress, stigma, resilience, and psychological distress within this population.
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12
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Scandurra C, Dolce P, Vitelli R, Esposito G, Testa RJ, Balsam KF, Bochicchio V. Mentalizing stigma: Reflective functioning as a protective factor against depression and anxiety in transgender and gender-nonconforming people. J Clin Psychol 2020; 76:1613-1630. [PMID: 32222104 DOI: 10.1002/jclp.22951] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The current study examined the role of internalized transphobia (IT) as a mediator between gender-related rejection and mental health, and reflective functioning (or mentalization) as a resilience factor moderating the relationship between both rejection and IT with mental health. METHOD This online study included 203 Italian transgender and gender-nonconforming (TGNC) individuals ranged in age from 18 to 66 years old (M = 30.70; standard deviation = 10.79). Moderated-mediation analysis was performed using a structural equation modeling approach. RESULTS Both rejection and IT were positively associated with mental health, and IT mediated the relationship between rejection and mental health. Mentalization moderated the relationship between rejection and IT with mental health. The indirect effect of rejection on mental health through IT was moderated by mentalization. CONCLUSIONS Findings highlight psychological paths that may inform individual- and group-level mentalization-based interventions to reduce minority stress in TGNC individuals.
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Affiliation(s)
- Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Napoli, Italy
| | - Roberto Vitelli
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Napoli, Italy
| | - Giovanna Esposito
- Department of Humanistic Studies, University of Naples Federico II, Napoli, Italy
| | - Rylan J Testa
- Center for LGBTQ Evidence-Based Applied Research (CLEAR), Palo Alto University, El Cerrito, California
| | - Kimberly F Balsam
- Department of Psychology, Center for LGBTQ Evidence-Based Applied Research (CLEAR), Palo Alto University, Palo Alto, California
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13
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Anzani A, De Panfilis C, Scandurra C, Prunas A. Personality Disorders and Personality Profiles in a Sample of Transgender Individuals Requesting Gender-Affirming Treatments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1521. [PMID: 32120872 PMCID: PMC7084367 DOI: 10.3390/ijerph17051521] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/24/2020] [Accepted: 02/25/2020] [Indexed: 11/16/2022]
Abstract
The study aims to explore the personality patterns of a group of transgender individuals who accessed an Italian gender clinic to undergo gender affirming treatments, by evaluating both dimensional personality domains proposed by the Alternative Model of Personality Disorders and categorical DSM-IV personality disorder (PD) diagnoses. Eighty-seven participants (40 transgender women and 47 transgender men) completed the Personality Inventory for DSM-5 and the Structured Clinical Interview for DSM-IV Axis II personality disorders. Scores obtained were compared to those of the normative samples of cisgender women and men. Results indicated that transgender women scored lower than cisgender women on two main domains (Negative Affectivity and Psychoticism) and on seven facets. As for transgender men, lower scores than cisgender men were found on Antagonism and on five facets. Transgender men scored higher than cisgender men on Depressivity. Nearly 50% of participants showed at least one PD diagnosis, with no gender differences in prevalence. Borderline PD was the most frequent diagnosis in the overall sample. Self-report measures provide a less maladaptive profile of personality functioning than the clinician-based categorical assessment. Results are interpreted in the light of the Minority Stress Model and support the need for a multi-method assessment of personality in medicalized transgender people.
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Affiliation(s)
- Annalisa Anzani
- Department of Psychology, University of Milano–Bicocca, 20126 Milan, Italy;
- CREST, Centro per lo studio e la terapia dei disturbi di personalità, 20145 Milan, Italy
| | - Chiara De Panfilis
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy;
| | - Cristiano Scandurra
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 80131 Naples, Italy;
| | - Antonio Prunas
- Department of Psychology, University of Milano–Bicocca, 20126 Milan, Italy;
- CREST, Centro per lo studio e la terapia dei disturbi di personalità, 20145 Milan, Italy
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