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Schaeff C. Assigned-Female-at-Birth Trans Masculine and Non-Binary Individuals Differ in Their Body Satisfaction and Desire for Gender Affirming Treatments. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2037-2047. [PMID: 35099654 DOI: 10.1007/s10508-021-02178-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/20/2021] [Accepted: 10/07/2021] [Indexed: 06/14/2023]
Abstract
Many non-binary individuals physically affirm their gender, but the binary/non-binary component of gender identity is rarely reported, and when it is, assigned-male- and assigned-female-at-birth individuals are often grouped together. We compared the experience of assigned-female-at-birth trans masculine and non-binary individuals via an anonymous online survey and found that patterns of overall body satisfaction and strength of intention to modify the body support the idea that the lower engagement in physical affirmation by non-binary individuals reflects less need to undergo body modifications. Trans masculine and non-binary participants who had had at least one gender affirming treatment (GAT) mostly identified as trans and expressed a similar ranking of GAT preferences. In contrast, non-physically affirmed cohorts differed in strength of intention to modify their body, desired GAT and the proportion who identified as trans, with more than a third of non-physically affirmed non-binary individuals not wanting any GAT and a third wanting GAT without testosterone. Several participants who did not want testosterone used female-based identifiers suggesting that some non-binary individuals use GAT to defeminize rather than masculinize their bodies. Individuals' orientation to the binary/non-binary and trans/non-trans dimensions of identity appears connected to their strength of motivation to physically affirm and their preferred outcomes but there is ambiguity in the usage of the terms. We need to explore what these terms mean to a given individual if we are to support them as they make decisions about whether and how to modify their body to affirm their gender.
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Affiliation(s)
- Catherine Schaeff
- Department of Biology, Hall of Science, American University, 4400 Mass. Ave. N.W, Washington, DC, 20016, USA.
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Falck F, Frisén L, Dhejne C, Armuand G. Undergoing pregnancy and childbirth as trans masculine in Sweden: experiencing and dealing with structural discrimination, gender norms and microaggressions in antenatal care, delivery and gender clinics. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2021; 22:42-53. [PMID: 34939070 PMCID: PMC8040690 DOI: 10.1080/26895269.2020.1845905] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND A sterilization requirement to change legal gender was removed from Swedish law in 2013, facilitating pregnancy in trans masculine individuals. The limited number of studies investigating pregnancy and childbirth among trans masculine individuals indicate increased gender dysphoria and negative experiences of pre- and post-natal healthcare, highlighting a need to improve care. Research focusing on Europe or contexts where sterilization to change legal gender was previously required by national law remains minimal. AIMS This study aimed to investigate how trans masculine individuals experience healthcare encounters in connection with pregnancy, delivery and nursing, in a setting where mandatory sterilization to change legal gender was recently removed. METHODS In-depth face-to-face interviews were conducted with 12 trans masculine individuals who attended Swedish prenatal care and delivered a child after the law on legal gender recognition was amended. Thematic content analysis was used. RESULTS Providers in gender clinics, antenatal care and delivery were perceived to regard a masculine gender identity and pregnancy as incompatible. The main categories encompassed expectations and experiences of pregnancy related care and participant responses to it. Participants took charge of their care to ensure that their needs were fulfilled. The quality of care was inconsistent. DISCUSSION A lack of knowledge, narrow gender norms and the legacy of the former legal sterility requirement limited access to diagnostic evaluation of gender dysphoria, information on reproduction and gender-affirming treatment. Medical safety during pregnancy, childbirth and nursing was impeded, gender dysphoria increased, and participants experienced minority stress. Attempts to avoid microaggressions guided healthcare encounters and birth wishes. Navigating healthcare required considerable attention, personal resources and energy, leaving particularly vulnerable individuals at risk of a lower quality of care. The paper concludes with clinical recommendations.
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Affiliation(s)
- Felicitas Falck
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- ANOVA Karolinska University Hospital, Stockholm, Sweden
- Psychiatry Southwest, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Louise Frisén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Dhejne
- ANOVA Karolinska University Hospital, Stockholm, Sweden
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Gabriela Armuand
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
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Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, De Cuypere G, Feldman J, Fraser L, Green J, Knudson G, Meyer WJ, Monstrey S, Adler RK, Brown GR, Devor AH, Ehrbar R, Ettner R, Eyler E, Garofalo R, Karasic DH, Lev AI, Mayer G, Meyer-Bahlburg H, Hall BP, Pfäfflin F, Rachlin K, Robinson B, Schechter LS, Tangpricha V, van Trotsenburg M, Vitale A, Winter S, Whittle S, Wylie KR, Zucker K. Normas de Atención para la salud de personas trans y con variabilidad de género. INT J TRANSGENDERISM 2018. [DOI: 10.1080/15532739.2018.1503902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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4
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Cussino M, Crespi C, Mineccia V, Molo M, Motta G, Veglia F. Sociodemographic characteristics and traumatic experiences in an Italian transgender sample. Int J Transgend 2017. [DOI: 10.1080/15532739.2016.1268082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Martina Cussino
- Department of Psychology, University of Turin, Turin, Italy
- Faculty of Communication Sciences, Institute for Public Communication, University of Lugano, Lugano, Switzerland
| | - Chiara Crespi
- Carlo Molo Onlus Foundation, Turin, Italy
- Division of Endocrinology, Diabetology and Metabolism, Centro Interdipartimentale Disturbi d'Identità di Genere Molinette, City of Health and Science, Turin, Italy
| | - Valentina Mineccia
- Carlo Molo Onlus Foundation, Turin, Italy
- Division of Endocrinology, Diabetology and Metabolism, Centro Interdipartimentale Disturbi d'Identità di Genere Molinette, City of Health and Science, Turin, Italy
| | | | - Giovanna Motta
- Division of Endocrinology, Diabetology and Metabolism, Centro Interdipartimentale Disturbi d'Identità di Genere Molinette, City of Health and Science, Turin, Italy
| | - Fabio Veglia
- Department of Psychology, University of Turin, Turin, Italy
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Abstract
Studies investigating the prevalence of psychiatric disorders among trans individuals have identified elevated rates of psychopathology. Research has also provided conflicting psychiatric outcomes following gender-confirming medical interventions. This review identifies 38 cross-sectional and longitudinal studies describing prevalence rates of psychiatric disorders and psychiatric outcomes, pre- and post-gender-confirming medical interventions, for people with gender dysphoria. It indicates that, although the levels of psychopathology and psychiatric disorders in trans people attending services at the time of assessment are higher than in the cis population, they do improve following gender-confirming medical intervention, in many cases reaching normative values. The main Axis I psychiatric disorders were found to be depression and anxiety disorder. Other major psychiatric disorders, such as schizophrenia and bipolar disorder, were rare and were no more prevalent than in the general population. There was conflicting evidence regarding gender differences: some studies found higher psychopathology in trans women, while others found no differences between gender groups. Although many studies were methodologically weak, and included people at different stages of transition within the same cohort of patients, overall this review indicates that trans people attending transgender health-care services appear to have a higher risk of psychiatric morbidity (that improves following treatment), and thus confirms the vulnerability of this population.
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Affiliation(s)
- Cecilia Dhejne
- a Gender Team, Centre for Andrology and Sexual Medicine and Centre for Psychiatry Research, Department of Clinical Neuroscience , Karolinska Institute and University Hospital , Stockholm , Sweden
| | - Roy Van Vlerken
- b Centre of Expertise on Gender Dysphoria, VU University Medical Centre , Amsterdam , Netherlands
| | - Gunter Heylens
- c Centre for Sexology and Gender, University Hospital , Ghent , Belgium
| | - Jon Arcelus
- d Nottingham Centre for Gender Dysphoria , Nottingham , UK ;,e Division of Psychiatry and Applied Psychology , Faculty of Medicine & Health Sciences, University of Nottingham , Nottingham , UK
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Zeluf G, Dhejne C, Orre C, Nilunger Mannheimer L, Deogan C, Höijer J, Ekéus Thorson A. Health, disability and quality of life among trans people in Sweden-a web-based survey. BMC Public Health 2016; 16:903. [PMID: 27576455 PMCID: PMC5006581 DOI: 10.1186/s12889-016-3560-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022] Open
Abstract
Background Swedish research concerning the general health of trans people is scarce. Despite the diversity of the group, most Swedish research has focused on gender dysphoric people seeking medical help for their gender incongruence, or on outcomes after medical gender-confirming interventions. This paper examines self-rated health, self-reported disability and quality of life among a diverse group of trans people including trans feminine, trans masculine, and gender nonbinary people (identifying with a gender in between male of female, or identify with neither of these genders) as well as people self-identifying as transvestites. Methods Participants were self-selected anonymously to a web-based survey conducted in 2014. Univariable and multivariable regression analyses were performed. Three backward selection regression models were conducted in order to identify significant variables for the outcomes self-rated health, self-reported disability and quality of life. Results Study participants included 796 individuals, between 15 and 94 years of age who live in Sweden. Respondents represented a heterogeneous group with regards to trans experience, with the majority being gender nonbinary (44 %), followed by trans masculine (24 %), trans feminine (19 %) and transvestites (14 %). A fifth of the respondents reported poor self-rated health, 53 % reported a disability and 44 % reported quality of life scores below the median cut-off value of 6 (out of 10). Nonbinary gender identity (adjusted Odds Ratio (aOR) = 2.19; 95 % CI: 1.24, 3.84), negative health care experiences (aOR = 1.92; 95 % CI: 1.26, 2.91) and not accessing legal gender recognition (aOR = 3.06; 95 % CI: 1.64, 5.72) were significant predictors for self-rated health. Being gender nonbinary (aOR = 2.18; 95 % CI: 1.35, 3.54) and history of negative health care experiences (aOR = 2.33; 95 % CI: 1.54, 3.52) were, in addition, associated with self-reported disability. Lastly, not accessing legal gender recognition (aOR = 0.32; 95 % CI: 0.17, 0.61) and history of negative health care experiences (aOR = 0.56; 95 % CI: 0.36, 0.88) were associated with lower quality of life. Conclusions The results of this study demonstrate that the general health of trans respondents is related to vulnerabilities that are unique for trans people in addition to other well-known health determinants.
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Affiliation(s)
- Galit Zeluf
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
| | - Cecilia Dhejne
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Gender Team, Centre for Andrology and Sexual Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Carolina Orre
- Department of Health and HIV-prevention, The Swedish Federation for LGBTQ Rights (RFSL), Stockholm, Sweden
| | - Louise Nilunger Mannheimer
- Department of Learning Information Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,The Public Health Agency of Sweden, Stockholm, Sweden
| | - Charlotte Deogan
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,The Public Health Agency of Sweden, Stockholm, Sweden
| | - Jonas Höijer
- Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Ekéus Thorson
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Guzmán-Parra J, Sánchez-Álvarez N, de Diego-Otero Y, Pérez-Costillas L, Esteva de Antonio I, Navais-Barranco M, Castro-Zamudio S, Bergero-Miguel T. Sociodemographic Characteristics and Psychological Adjustment Among Transsexuals in Spain. ARCHIVES OF SEXUAL BEHAVIOR 2016; 45:587-596. [PMID: 25994499 DOI: 10.1007/s10508-015-0557-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 04/07/2015] [Accepted: 04/13/2015] [Indexed: 06/04/2023]
Abstract
This study examined the sociodemographic characteristics and the psychological adjustment of transsexuals in Andalusia (Spain), and also analyzed the differences between female-to-male (FtM) and male-to-female (MtF) transsexuals. The sample included 197 transsexuals (101 MtF and 96 FtM) selected from those who visited the Transsexual and Gender Identity Unit at the Carlos Haya Hospital in Malaga between 2011 and 2012. Our analyses indicated that MtF transsexuals were more likely to have lower educational levels, live alone, have worked less frequently throughout their lifetime, and have engaged in prostitution. For FtM transsexuals, there were more frequent references to the mother's psychiatric history and more social avoidance and distress. Multivariate analysis showed that the number of personality dysfunctional traits and unemployment status were associated with depression in the entire sample. The following three conclusions can be made: there are significant differences between MtF and FtM transsexuals (mainly related to sociodemographic variables), depression was high in both groups, and a remarkable percentage of transsexuals have attempted suicide (22.8 %) or have had suicidal thoughts (52.3 %).
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Affiliation(s)
- José Guzmán-Parra
- Mental Health Department, Málaga Plaza Hospital, University Regional Hospital of Málaga, Civil s/n, 29009, Málaga, Spain.
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Málaga, Spain.
- Grupo Andaluz de Investigación Psicosocial, Málaga, Spain.
| | - Nicolás Sánchez-Álvarez
- Mental Health Department, Málaga Plaza Hospital, University Regional Hospital of Málaga, Civil s/n, 29009, Málaga, Spain
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Málaga, Spain
| | - Yolanda de Diego-Otero
- Mental Health Department, Málaga Plaza Hospital, University Regional Hospital of Málaga, Civil s/n, 29009, Málaga, Spain
| | - Lucía Pérez-Costillas
- Mental Health Department, Málaga Plaza Hospital, University Regional Hospital of Málaga, Civil s/n, 29009, Málaga, Spain
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Málaga, Spain
| | | | - Miriam Navais-Barranco
- Mental Health Department, Málaga Plaza Hospital, University Regional Hospital of Málaga, Civil s/n, 29009, Málaga, Spain
| | - Serafina Castro-Zamudio
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Málaga, Spain
| | - Trinidad Bergero-Miguel
- Mental Health Department, Málaga Plaza Hospital, University Regional Hospital of Málaga, Civil s/n, 29009, Málaga, Spain
- Transsexual and Gender Identity Unit, Málaga, Spain
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8
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Simonsen RK, Hald GM, Kristensen E, Giraldi A. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death. Sex Med 2016; 4:e60-8. [PMID: 26944779 PMCID: PMC4822482 DOI: 10.1016/j.esxm.2016.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 01/07/2016] [Accepted: 01/13/2016] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Studies of mortality and somatic well-being after sex-reassignment surgery (SRS) of transsexual individuals are equivocal. Accordingly, the present study investigated mortality and somatic morbidity using a sample of transsexual individuals who comprised 98% (n = 104) of all surgically reassigned transsexual individuals in Denmark. AIMS To investigate somatic morbidity before and after SRS and cause of death and its relation to somatic morbidity after SRS in Danish individuals who underwent SRS from 1978 through 2010. METHODS Somatic morbidity and mortality in 104 sex-reassigned individuals were identified retrospectively by data from the Danish National Health Register and the Cause of Death Register. MAIN OUTCOME MEASURES Somatic morbidity and cause of death. RESULTS Overall, 19.2% of the sample were registered with somatic morbidity before SRS and 23.1% after SRS (P = not significant). In total, 8.6% had somatic morbidity before and after SRS. The most common diagnostic category was cardiovascular disease, affecting 18 individuals, 9 before and 14 after SRS, and 5 of those 14 who were affected after SRS had cardiovascular disease before and after SRS. Ten individuals died after SRS at an average age of 53.5 ± 7.9 years (male to female) and 53.5 ± 7.3 years (female to male). CONCLUSION Of 98% of all Danish transsexuals who officially underwent SRS from 1978 through 2010, one in three had somatic morbidity and approximately 1 in 10 had died. No significant differences in somatic morbidity or mortality were found between male-to-female and female-to-male individuals. Despite the young average age at death and the relatively larger number of individuals with somatic morbidity, the present study design does not allow for determination of casual relations between, for example, specific types of hormonal or surgical treatment received and somatic morbidity and mortality.
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Affiliation(s)
| | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ellids Kristensen
- Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark
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9
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Abstract
Gender dysphoria (GD), a term that denotes persistent discomfort with one's biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities.
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Affiliation(s)
- Kenneth J Zucker
- Gender Identity Clinic, Child, Youth, and Family Services, Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R8, Canada;
| | - Anne A Lawrence
- Department of Psychology, University of Lethbridge, Lethbridge, Alberta T1K 3M4, Canada
| | - Baudewijntje P C Kreukels
- Department of Medical Psychology, VU University Medical Center and EMGO Institute for Health and Care Research, Amsterdam 1081 HV, The Netherlands
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Smith ES, Junger J, Derntl B, Habel U. The transsexual brain – A review of findings on the neural basis of transsexualism. Neurosci Biobehav Rev 2015; 59:251-66. [DOI: 10.1016/j.neubiorev.2015.09.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 09/18/2015] [Accepted: 09/20/2015] [Indexed: 12/30/2022]
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Alavi K, Eftekhar M, Jalali Nadoushan AH. Comparison of Masculine and Feminine Gender Roles in Iranian Patients with Gender Identity Disorder. Sex Med 2015; 3:261-8. [PMID: 26797060 PMCID: PMC4721038 DOI: 10.1002/sm2.79] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Gender identity disorders (GID) are heterogeneous disorders that may be influenced by culture and social norms. Aim The aim of this study was to determine masculine and feminine gender roles in a group of Iranian patients with GID and compare these roles with two control groups. Methods Twelve male‐to‐female (MF) and 27 female‐to‐male (FM) individuals with GID referred to Tehran Psychiatric Institute in Tehran, I. R. Iran were evaluated by self‐report inventories and were compared with two groups of healthy controls (81 men and 89 women). Diagnoses were established based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM‐IV) criteria. Data analysis was done using analysis of variance and chi‐squared test. Main Outcome Measures Masculine and feminine gender roles were assessed by two questionnaires: (i) Gender‐Masculine (GM) and Gender‐Feminine (GF) scales derived from the Minnesota Multiphasic Inventory‐2 (MMPI‐2); (ii) Bem Sex Role Inventory (BSRI). Results In the scales of masculinity, MF‐GID individuals scored as male controls, but lower than female controls. FM‐GID individuals scored similar to female controls and higher than male controls. In femininity scales, MF‐GID individuals and control women seemed similar, and both scored higher than the other groups. FM‐GID persons were considered less feminine than both controls in the GF scale of MMPI‐2, but not in the BSRI. In both scales, FM‐GID persons had higher scores than control women and MF‐GID individuals. Conclusion Iranian FM‐GID individuals were less feminine than normal men. However, MF‐GID individuals were similar to normal women or more feminine. Cultural considerations remain to be investigated. Alavi K, Eftekhar M and Jalali Nadoushan AH. Comparison of masculine and feminine gender roles in Iranian patients with gender identity disorder. Sex Med 2015;3:261–268.
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Affiliation(s)
- Kaveh Alavi
- Mental Health Research CenterDepartment of PsychiatryIran University of Medical SciencesTehranIran
| | - Mehrdad Eftekhar
- Mental Health Research CenterDepartment of PsychiatryIran University of Medical SciencesTehranIran
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Simonsen R, Hald GM, Giraldi A, Kristensen E. Sociodemographic Study of Danish Individuals Diagnosed with Transsexualism. Sex Med 2015; 3:109-17. [PMID: 26185676 PMCID: PMC4498828 DOI: 10.1002/sm2.48] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Male-to-female (MtF) and female-to-male (FtM) individuals with transsexualism (International Classification of Diseases-10) may differ in core clinical and sociodemographic variables such as age, sexual orientation, marriage and parenthood, school, educational level, and employment. Assessing and understanding the implication of such differences may be a key to developing appropriate and effective treatment and intervention strategies for this group. However, research in the area remains sparse and is often on small populations, making the generalization of results from current studies on individuals diagnosed with transsexualism difficult. Aims (i) To describe and assess key sociodemographic and treatment-related differences between MtF and FtM individuals in a Danish population of individuals diagnosed with transsexualism; (ii) to assess possible implications of such difference, if any, for clinical treatment initiatives for individuals diagnosed with transsexualism. Methods Follow-up of 108 individuals who had permission to undergo sex reassignment surgery (SRS, meaning castration and genital plastic surgery) over a 30-year period from 1978 to 2008 through the Gender Identity Unit in Copenhagen, Denmark. The individuals were identified through Social Security numbers. Clinical and sociodemographic data from medical records were collected. Results The sex ratio was 1.16:1 (MtF : FtM). Mean age at first referral was 26.9 (standard deviation [SD] 8.8) years for FtM and 30.2 (SD 9.7) for MtF individuals. Compared with MtF, FtM had a significantly lower onset age (before 12 years of age) and lower age when permission for SRS was granted. Further, FtM individuals were significantly more often gynephilic (sexually attracted to females) during research period and less likely to start self-initiated hormonal sex reassignment (SR) (treatment with cross-sex hormones). The MtF and FtM groups did not differ in years of school, educational level, employment, or engagement in marriage and cohabitation. Conclusions As approximately half of MtF started cross-sex hormonal SR without attending a gender unit, future treatment needs to focus on this group of MtF individuals in order to accommodate the medical risks of self-initiated hormonal treatment.Earlier intervention with adolescents appears necessary since three-quarters of FtM individuals before age 12 had problems with their assigned sex. For both MtF and FtM, we found problems in areas of school, education, and employment and recommend further help in these core areas.
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Affiliation(s)
- Rikke Simonsen
- Psychiatric Center Copenhagen, Sexological Clinic, GIUUC Copenhagen, Denmark ; Department of Clinical Medicine, University of Copenhagen Denmark
| | | | - Annamaria Giraldi
- Psychiatric Center Copenhagen, Sexological Clinic, GIUUC Copenhagen, Denmark ; Department of Clinical Medicine, University of Copenhagen Denmark
| | - Ellids Kristensen
- Psychiatric Center Copenhagen, Sexological Clinic, GIUUC Copenhagen, Denmark ; Department of Clinical Medicine, University of Copenhagen Denmark
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Karpel L, Gardel B, Revol M, Brémont-Weil C, Ayoubi JM, Cordier B. Bien-être psychosocial postopératoire de 207 transsexuels. ANNALES MEDICO-PSYCHOLOGIQUES 2015. [DOI: 10.1016/j.amp.2012.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Capetillo-Ventura N, Jalil-Pérez S, Motilla-Negrete K. Gender dysphoria: An overview. MEDICINA UNIVERSITARIA 2015. [DOI: 10.1016/j.rmu.2014.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Claes L, Bouman WP, Witcomb G, Thurston M, Fernandez‐Aranda F, Arcelus J. Non‐Suicidal Self‐Injury in Trans People: Associations with Psychological Symptoms, Victimization, Interpersonal Functioning, and Perceived Social Support. J Sex Med 2015; 12:168-79. [DOI: 10.1111/jsm.12711] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Heylens G, Elaut E, Kreukels BPC, Paap MCS, Cerwenka S, Richter-Appelt H, Cohen-Kettenis PT, Haraldsen IR, De Cuypere G. Psychiatric characteristics in transsexual individuals: multicentre study in four European countries. Br J Psychiatry 2014; 204:151-6. [PMID: 23869030 DOI: 10.1192/bjp.bp.112.121954] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Research into the relationship between gender identity disorder and psychiatric problems has shown contradictory results. AIMS To investigate psychiatric problems in adults fulfilling DSM-IV-TR criteria for a diagnosis of gender identity disorder. METHOD Data were collected within the European Network for the Investigation of Gender Incongruence using the Mini International Neuropsychiatric Interview - Plus and the Structured Clinical Interview for DSM-IV Axis II Disorders (n = 305). RESULTS In 38% of the individuals with gender identity disorder a current DSM-IV-TR Axis I diagnosis was found, mainly affective disorders and anxiety disorders. Furthermore, almost 70% had a current and lifetime diagnosis. All four countries showed a similar prevalence, except for affective and anxiety disorders, and no difference was found between individuals with early-onset and late-onset disorder. An Axis II diagnosis was found in 15% of all individuals with gender identity disorder, which is comparable to the general population. CONCLUSIONS People with gender identity disorder show more psychiatric problems than the general population; mostly affective and anxiety problems are found.
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Affiliation(s)
- Gunter Heylens
- Gunter Heylens, MD, Els Elaut, MSc, Department of Sexology and Gender Problems, University Hospital Ghent, Belgium; Baudewijntje P. C. Kreukels, PhD, Department of Medical Psychology, VU University Hospital, Amsterdam, The Netherlands; Muirne C. S. Paap, PhD, Department of Research Methodology, Measurement and Data Analysis, Behavioural Sciences, Susanne Cerwenka, Mr.Sc, Hertha Richter-Appelt, PhD, Department of Sex Research and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Germany; Peggy T. Cohen-Kettenis, PhD, Department of Medical Psychology, VU University Hospital Amsterdam, The Netherlands; Ira R. Haraldsen, MD, PhD, Department of Neuropsychiatry and Psychosomatic Medicine, Rikshospitalet Oslo, Norway; Griet De Cuypere, MD, PhD, Department of Sexology and Gender Problems, University Hospital Ghent, Belgium
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Guzman-Parra J, Paulino-Matos P, de Diego-Otero Y, Perez-Costillas L, Villena-Jimena A, Garcia-Encinas MA, Bergero-Miguel T. Substance use and social anxiety in transsexual individuals. J Dual Diagn 2014; 10:162-7. [PMID: 25392291 DOI: 10.1080/15504263.2014.930658] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study examined social anxiety and use of cannabis and cocaine among transsexuals. METHODS A total of 379 transsexuals seeking treatment or consultation participated in this study, providing data on sociodemographics, substance use, and anxiety. Analyses were based on (a) lifetime but not current use versus never used and (b) current use only versus no current use (lifetime only or never used). RESULTS Lifetime only cannabis users (n = 72, 19%) and lifetime only cocaine users (n = 36, 9.8%) were older, had more victimization, and received more mental health treatment that those who never used. Current cannabis users (n = 47, 12.4%) had higher scores on fear of negative evaluation and social avoidance than those not currently using (p <.01). Multivariate analysis showed that social avoidance and fear of negative evaluation were associated with current cannabis use (p <.05), but not cocaine. Further, being single was associated with current cannabis use, after controlling for social avoidance and fear of negative evaluation (p <.05). CONCLUSIONS Transsexuals' levels of anxiety and cannabis/cocaine use are comparable to those in the general population. Cannabis may be used to control anxiety and can have detrimental clinical implications for transsexuals.
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Affiliation(s)
- Jose Guzman-Parra
- a Mental Health Department , University General Hospital of Malaga , Malaga , Spain
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Auer MK, Höhne N, Bazarra-Castro MÁ, Pfister H, Fuss J, Stalla GK, Sievers C, Ising M. Psychopathological profiles in transsexuals and the challenge of their special status among the sexes. PLoS One 2013; 8:e78469. [PMID: 24194937 PMCID: PMC3808537 DOI: 10.1371/journal.pone.0078469] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 09/11/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Investigating psychopathological profiles of transsexuals raises a very basic methodological question: are control groups, which represent the biological or the phenotypic sex, most suited for an optimal evaluation of psychopathology of transsexuals? METHOD Male-to-female (MtF) (n=52) and female-to-male transsexuals (FtM) (n=32), receiving cross-sex hormone treatment, were compared with age matched healthy subjects of the same genetic sex (n=178) and with the same phenotypic sex (n=178) by means of the Symptom Check List-90-Revisited instrument (SCL-90-R). We performed analyses of covariance (ANCOVA) to test for group and sex effects. Furthermore, we used a profile analysis to determine if psychopathological symptom profiles of transsexuals more closely resemble genotypic sex or phenotypic sex controls. RESULTS Transsexual patients reported more symptoms of psychopathological distress than did healthy control subjects in all subscales of the SCL-90-R (all p<0.001), regardless of whether they were compared with phenotype or genotype matched controls. Depressive symptoms were more pronounced in MtF than in FtM (SCL-90-R score 0.85 vs. 0.45, p = 0.001). We could demonstrate that FtM primarily reflect the psychopathological profile of biological males rather than that of biological females (r = 0.945), while MtF showed a slightly higher profile similarity with biological females than with biological males (r = 0.698 vs. r = 0.685). CONCLUSION Our findings suggest that phenotypic sex matched controls are potentially more appropriate for comparison with the psychopathology of transsexual patients than are genetic sex matched controls.
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Affiliation(s)
- Matthias K. Auer
- Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Nina Höhne
- Department Molecular Psychology, Max Planck Institute of Psychiatry, Munich, Germany
| | - María Ángeles Bazarra-Castro
- Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Hildegard Pfister
- Department Molecular Psychology, Max Planck Institute of Psychiatry, Munich, Germany
| | - Johannes Fuss
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/University of Heidelberg, Mannheim, Germany
| | - Günter K. Stalla
- Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Caroline Sievers
- Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Marcus Ising
- Department Molecular Psychology, Max Planck Institute of Psychiatry, Munich, Germany
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Fisher AD, Bandini E, Casale H, Ferruccio N, Meriggiola MC, Gualerzi A, Manieri C, Jannini E, Mannucci E, Monami M, Stomaci N, Delle Rose A, Susini T, Ricca V, Maggi M. Sociodemographic and Clinical Features of Gender Identity Disorder: An Italian Multicentric Evaluation. J Sex Med 2013; 10:408-19. [DOI: 10.1111/j.1743-6109.2012.03006.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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[Surgical gender reassignment in the elderly]. Urologe A 2012; 51:1414-8. [PMID: 23053037 DOI: 10.1007/s00120-012-3023-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Gender reassignment surgery (GRS) from male to female is increasingly being requested by older female patients. RESULTS To the best of our knowledge this study has for the first time investigated the correlation between the age of patients and perioperative and postoperative complications. The presented data show that an age-related limitation for this intervention due to perioperative and postoperative complications is not justified. CONCLUSION Health status and capability for self-sufficiency as well as physical and psychological limitations must be individually considered in order to achieve a successful postoperative course and a subjective satisfaction of patients.
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Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J, Fraser L, Green J, Knudson G, Meyer WJ, Monstrey S, Adler RK, Brown GR, Devor AH, Ehrbar R, Ettner R, Eyler E, Garofalo R, Karasic DH, Lev AI, Mayer G, Meyer-Bahlburg H, Hall BP, Pfaefflin F, Rachlin K, Robinson B, Schechter LS, Tangpricha V, van Trotsenburg M, Vitale A, Winter S, Whittle S, Wylie KR, Zucker K. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. Int J Transgend 2012. [DOI: 10.1080/15532739.2011.700873] [Citation(s) in RCA: 993] [Impact Index Per Article: 82.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Pimenoff V, Pfäfflin F. Transsexualism: Treatment Outcome of Compliant and Noncompliant Patients. Int J Transgend 2011. [DOI: 10.1080/15532739.2011.618399] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Simon L, Zsolt U, Fogd D, Czobor P. Dysfunctional core beliefs, perceived parenting behavior and psychopathology in gender identity disorder: A comparison of male-to-female, female-to-male transsexual and nontranssexual control subjects. J Behav Ther Exp Psychiatry 2011; 42:38-45. [PMID: 21074005 DOI: 10.1016/j.jbtep.2010.08.004] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2010] [Revised: 08/19/2010] [Accepted: 08/23/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND Research into the association between Gender Identity Disorder (GID) and psychological disturbances as well as on its relation with parenting experiences yielded mixed results, with different patterns for Male-to-Female (MF) and Female-to-Male (FM) transsexual subjects. We investigated vulnerability markers of maladjustment and their possible origins in MF and FM transsexuals by examining maladaptive core beliefs and parenting behaviors thought to be specifically related to them. METHODS Dysfunctional core beliefs, parenting experiences and psychiatric symptoms were assessed by the Young Schema Questionnaire indexing 19 Early Maladaptive Schemas (EMS), the Young Parenting Inventory and the Symptom Checklist-90-R, respectively, in 30 MF, 17 FM transsexual and 114 control subjects (43 males, 114 females). RESULTS Subjects with GID demonstrated a level of psychiatric distress comparable to that of controls. They did display elevated scores, however, on multiple EMSs compared to nontranssexual subjects, indicating feelings of isolation, emotional deprivation and an urge to meet others' needs, with MF transsexuals conceptualizing themselves also as more vulnerable and deficient than controls. Parenting experiences of transsexual subjects were characterised by increased maternal dominance, emotional abuse and neglect compared to controls, with males being exposed to a disengaged maternal style and more paternal emotional neglect and criticism. Both MF and FM transsexuals were made felt that in areas of achievement they will inevitably fail. CONCLUSIONS There is no evidence of elevated levels of psychiatric symptoms in GID, but potential predisposing factors, particularly in MF transsexuals, are present; these may originate from the more intense rejection they experience.
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Affiliation(s)
- Lajos Simon
- Semmelweis University, Department of Psychiatry and Psychotherapy 1083 Budapest, Balassa u.6., Hungary.
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24
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Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PLoS One 2011; 6:e16885. [PMID: 21364939 PMCID: PMC3043071 DOI: 10.1371/journal.pone.0016885] [Citation(s) in RCA: 278] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 01/09/2011] [Indexed: 01/09/2023] Open
Abstract
CONTEXT The treatment for transsexualism is sex reassignment, including hormonal treatment and surgery aimed at making the person's body as congruent with the opposite sex as possible. There is a dearth of long term, follow-up studies after sex reassignment. OBJECTIVE To estimate mortality, morbidity, and criminal rate after surgical sex reassignment of transsexual persons. DESIGN A population-based matched cohort study. SETTING Sweden, 1973-2003. PARTICIPANTS All 324 sex-reassigned persons (191 male-to-females, 133 female-to-males) in Sweden, 1973-2003. Random population controls (10:1) were matched by birth year and birth sex or reassigned (final) sex, respectively. MAIN OUTCOME MEASURES Hazard ratios (HR) with 95% confidence intervals (CI) for mortality and psychiatric morbidity were obtained with Cox regression models, which were adjusted for immigrant status and psychiatric morbidity prior to sex reassignment (adjusted HR [aHR]). RESULTS The overall mortality for sex-reassigned persons was higher during follow-up (aHR 2.8; 95% CI 1.8-4.3) than for controls of the same birth sex, particularly death from suicide (aHR 19.1; 95% CI 5.8-62.9). Sex-reassigned persons also had an increased risk for suicide attempts (aHR 4.9; 95% CI 2.9-8.5) and psychiatric inpatient care (aHR 2.8; 95% CI 2.0-3.9). Comparisons with controls matched on reassigned sex yielded similar results. Female-to-males, but not male-to-females, had a higher risk for criminal convictions than their respective birth sex controls. CONCLUSIONS Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population. Our findings suggest that sex reassignment, although alleviating gender dysphoria, may not suffice as treatment for transsexualism, and should inspire improved psychiatric and somatic care after sex reassignment for this patient group.
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Flor-Henry P. EEG analysis of male to female transsexuals: discriminant function and source analysis. Clin EEG Neurosci 2010; 41:219-22. [PMID: 21077575 DOI: 10.1177/155005941004100410] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A small series of consecutive, unmedicated male to female transsexuals were studied before hormonal treatment and prior to reassignment surgery. Quantitative EEG and LORETA source localization in the Eyes Open and Eyes Closed conditions were carried out, and they were compared to sinistral/ambilateral male and female controls, as the transsexual group was overwhelmingly sinistral. Discriminant function analysis and source localization showed that the transsexual group was similar to female heterosexual controls, with increased sources in the right hemisphere in the fast frequencies.
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Gómez-Gil E, Trilla A, Salamero M, Godás T, Valdés M. Sociodemographic, clinical, and psychiatric characteristics of transsexuals from Spain. ARCHIVES OF SEXUAL BEHAVIOR 2009; 38:378-92. [PMID: 18288600 DOI: 10.1007/s10508-007-9307-8] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2006] [Revised: 06/13/2007] [Accepted: 08/04/2007] [Indexed: 05/21/2023]
Abstract
The aim of this study was to examine the characteristics of transsexuals from Spain. A total of 252 consecutive applicants for sex reassignment were evaluated using a standardized semistructured clinical interview and the Mini International Neuropsychiatric Interview (Spanish Version 5.0.0) to record demographic, clinical, and psychiatric data. Transsexualism was diagnosed in 230 patients, with a male to female (MF)/female to male (FM) ratio of 2.2:1. Transsexual patients frequently had low employment status, lived with their parents, and mainly had a sexual orientation toward same-sex partners. The most frequent psychiatric diagnoses were adjustment disorder and social phobia in both groups, and alcohol and substance-related disorders in the MF group. MF transsexuals were older than FM transsexuals when requesting sex reassignment, but did not differ in age when starting hormonal therapy (often on their own); fewer MFs were in employment requiring high educational qualification, more were non-Spanish natives, and more had previous and current histories of alcohol and substance abuse or dependence. The basic characteristics of transsexuals from Spain were similar to those of other European countries, except for the higher proportion of patients living with their parents and the higher proportion of MFs who reported same-sex sexual orientation compared with previous studies.
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Affiliation(s)
- Esther Gómez-Gil
- Department of Psychiatry, Institute of Neurosciences, Hospital Clínic, University of Barcelona, Villarroel 170, Barcelona, Spain.
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Zucker KJ, Lawrence AA. Epidemiology of Gender Identity Disorder: Recommendations for theStandards of Careof the World Professional Association for Transgender Health. Int J Transgend 2009. [DOI: 10.1080/15532730902799946] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Gómez-Gil E, Vidal-Hagemeijer A, Salamero M. MMPI–2 Characteristics of Transsexuals Requesting Sex Reassignment: Comparison of Patients in Prehormonal and Presurgical Phases. J Pers Assess 2008; 90:368-74. [DOI: 10.1080/00223890802108022] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Esther Gómez-Gil
- a Institute Clinic of Neurosciences, Department of Psychiatry , University of Barcelona, Hospital Clinic , Barcelona , Spain
| | - Angela Vidal-Hagemeijer
- a Institute Clinic of Neurosciences, Department of Psychiatry , University of Barcelona, Hospital Clinic , Barcelona , Spain
| | - Manel Salamero
- a Institute Clinic of Neurosciences, Department of Psychiatry , University of Barcelona, Hospital Clinic , Barcelona , Spain
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29
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Affiliation(s)
- Andy Levy
- University Research Centre for Neuroendocrinology, Bristol University, Jenner Yard, Bristol, BS2 8HW, UK.
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30
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Baetens P, Camus M, Devroey P. Should requests for donor insemination on social grounds be expanded to transsexuals? Reprod Biomed Online 2003; 6:281-6. [PMID: 12735859 DOI: 10.1016/s1472-6483(10)61846-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Donor insemination may provide an answer to transsexuals with female partners who have a wish for a child. Although the follow-up on children born in the context of these families is non-existent and the follow-up on transsexuals after sex reassignment surgery (SRS) is limited, fertility centres might consider accepting the requests of transsexuals with a female partner. Between 1997 and 2001, nine couples presented themselves at the Centre for Reproductive Medicine of the Dutch-speaking Brussels Free University, of whom five couples were accepted. Nevertheless, some caution is called for because transsexualism is socially not accepted. Moreover, transsexualism is still considered to be psychiatric condition. The following recommendations should be taken in consideration. Treatment should be limited to female-to-male transsexuals with a female partner. A multidisciplinary team of specialists should carry out the diagnosis for gender identity. Developmental problems of the gender-disordered child might interfere with socio-economic, psychological and emotional stability in adulthood. The period of sex reassignment should be nearly completed.
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Affiliation(s)
- P Baetens
- Centre for Reproductive Medicine, University Hospital, Dutch-speaking Brussels Free University, Laarbeeklaan 101, B-1090 Brussels.
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Abstract
The objective of this study was to evaluate the features and calculate the frequency of sex-reassigned subjects who had applied for reversal to their biological sex, and to compare these with non-regretful subjects. An inception cohort was retrospectively identified consisting of all subjects with gender identity disorder who were approved for sex reassignment in Sweden during the period 1972-1992. The period of time that elapsed between the application and this evaluation ranged from 4 to 24 years. The total cohort consisted of 218 subjects. The results showed that 3.8% of the patients who were sex reassigned during 1972-1992 regretted the measures taken. The cohort was subdivided according to the presence or absence of regret of sex reassignment, and the two groups were compared. The results of logistic regression analysis indicated that two factors predicted regret of sex reassignment, namely lack of support from the patient's family, and the patient belonging to the non-core group of transsexuals. In conclusion, the results show that the outcome of sex reassignment has improved over the years. However, the identified risk factors indicate the need for substantial efforts to support the families and close friends of candidates for sex reassignment.
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Affiliation(s)
- M Landén
- Institute of Clinical Neuroscience, Department of Psychiatry and Neurochemistry, Göteborg University, Sweden
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