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Rawee P, Rosmalen JGM, Kalverdijk L, Burke SM. Development of Gender Non-Contentedness During Adolescence and Early Adulthood. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:1813-1825. [PMID: 38413534 PMCID: PMC11106144 DOI: 10.1007/s10508-024-02817-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/29/2024]
Abstract
Adolescence is an important period for the development of gender identity. We studied the development of gender non-contentedness, i.e., unhappiness with being the gender aligned with one's sex, from early adolescence to young adulthood, and its association with self-concept, behavioral and emotional problems, and adult sexual orientation. Participants were 2772 adolescents (53% male) from the Tracking Adolescents' Individual Lives Survey population and clinical cohort. Data from six waves were included (ages 11-26). Gender non-contentedness was assessed with the item "I wish to be of the opposite sex" from the Youth and Adult Self-Report at all six waves. Behavioral and emotional problems were measured by total scores of these scales at all six waves. Self-concept was assessed at age 11 using the Global Self-Worth and Physical Appearance subscales of the Self-Perception Profile for Children. Sexual orientation was assessed at age 22 by self-report. In early adolescence, 11% of participants reported gender non-contentedness. The prevalence decreased with age and was 4% at the last follow-up (around age 26). Three developmental trajectories of gender non-contentedness were identified: no gender non-contentedness (78%), decreasing gender non-contentedness (19%), and increasing gender non-contentedness (2%). Individuals with an increasing gender non-contentedness more often were female and both an increasing and decreasing trajectory were associated with a lower global self-worth, more behavioral and emotional problems, and a non-heterosexual sexual orientation. Gender non-contentedness, while being relatively common during early adolescence, in general decreases with age and appears to be associated with a poorer self-concept and mental health throughout development.
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Affiliation(s)
- Pien Rawee
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Luuk Kalverdijk
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Sarah M Burke
- Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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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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van der Vaart LR, Verveen A, Bos HM, van Rooij FB, Steensma TD. Differences in self-perception and social gender status in children with gender incongruence. Clin Child Psychol Psychiatry 2022; 27:1077-1090. [PMID: 35532285 PMCID: PMC9574892 DOI: 10.1177/13591045221099394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Gender incongruent children report lower self-perception compared to the norm population. This study explored differences in self-perception between children living in their gender role assigned at birth and children living in their experienced gender role.Method: The self-perception questionnaire was administered to 312 children referred to the Center of Expertise on Gender Dysphoria 'Amsterdam UMC'. Social transition status was determined by parental interviews. 2 (social transition) by 2 (sex assigned at birth) ANCOVA's were conducted.Results: Children living in their assigned gender role reported comparable self-perception to children living in their experienced gender role. Birth assigned girls living in their assigned gender role reported poorer self-perception on 'athletic competence', compared to girls living in their experienced gender role. Birth assigned boys living in their assigned gender role reported poorer on 'scholastic competence' and 'behavioral conduct' compared to boys living in their experienced gender role.Conclusions: Social transition did not show to affect self-perception. Self-perception was poorer for birth assigned boys living in their experienced gender role. For birth assigned girls this was reversed. Future studies should give more insight in the role of social transitions in relation to child development and focus on other aspects related to self-perception.
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Affiliation(s)
- Lindsey R van der Vaart
- Research Institute of Child Development and Education, Faculty of Social and Behavioral Sciences, 1234University of Amsterdam, Amsterdam, The Netherlands
| | - Anouk Verveen
- Department of Medical Psychology, Centre of Expertise on Gender Dyphoria, 1209Amsterdam UMC Locatie VUmc, Amsterdam, the Netherlands
| | - Henny Mw Bos
- Research Institute of Child Development and Education, Faculty of Social and Behavioral Sciences, 1234University of Amsterdam, Amsterdam, The Netherlands
| | - Floor B van Rooij
- Research Institute of Child Development and Education, Faculty of Social and Behavioral Sciences, 1234University of Amsterdam, Amsterdam, The Netherlands
| | - Thomas D Steensma
- Department of Medical Psychology, Centre of Expertise on Gender Dyphoria, 1209Amsterdam UMC Locatie VUmc, Amsterdam, the Netherlands
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Bloom TM, Nguyen TP, Lami F, Pace CC, Poulakis Z, Telfer M, Taylor A, Pang KC, Tollit MA. Measurement tools for gender identity, gender expression, and gender dysphoria in transgender and gender-diverse children and adolescents: a systematic review. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:582-588. [PMID: 34111389 DOI: 10.1016/s2352-4642(21)00098-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 12/01/2022]
Abstract
Increasing numbers of children and adolescents are being referred to gender services for gender-related concerns. Various instruments are used with these patients in clinical care, but their clinical validity, strengths, and limitations have not been systematically reviewed. In this systematic review, we searched MEDLINE, PubMed, and PsycINFO databases for available tools that assess gender identity, gender expression, or gender dysphoria in transgender and gender-diverse (TGD) children and adolescents. We included studies published before Jan 20, 2020, that used tools to assess gender identity, expression, or dysphoria in TGD individuals younger than 18 years. Data were extracted from eligible studies using a standardised form. We found 39 studies that met the inclusion criteria, from which we identified 24 tools. The nature of tools varied considerably and included direct observation, child and adolescent self-report, and parent-report tools. Many methods have only been used with small samples, include outdated content, and lack evaluation of psychometric properties. In summary, a paucity of studies in this area, along with sparse reporting of psychometric properties, made it difficult to compare the relative use of tools, and current tools have substantial limitations. Future research is required to validate existing measures and create more relevant, culturally appropriate tools.
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Affiliation(s)
- Thea M Bloom
- Department of Adolescent Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Thomas P Nguyen
- Mental Health, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Francesca Lami
- Department of Adolescent Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Carmen C Pace
- Department of Adolescent Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Zeffie Poulakis
- Department of Adolescent Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Michelle Telfer
- Department of Adolescent Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Amelia Taylor
- Tavistock and Portman NHS Foundation Trust, Gender Identity Development Service, London, UK
| | - Kenneth C Pang
- Department of Adolescent Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
| | - Michelle A Tollit
- Department of Adolescent Medicine, The Royal Children's Hospital, Melbourne, VIC, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, VIC, Australia; Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
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Geist C, Greenberg KB, Luikenaar RAC, Mihalopoulos NL. Pediatric Research and Health Care for Transgender and Gender Diverse Adolescents and Young Adults: Improving (Biopsychosocial) Health Outcomes. Acad Pediatr 2021; 21:32-42. [PMID: 32980544 DOI: 10.1016/j.acap.2020.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 09/03/2020] [Accepted: 09/21/2020] [Indexed: 01/18/2023]
Abstract
Adolescent and young adult (AYA) transgender health care and research have expanded rapidly in the United States and abroad, but the effects of gender-affirming social, hormonal, or surgical care on overall health remain unclear. Gender diverse identities, also termed nonbinary, have often been neglected in favor of (male/female) binary identities, even in the context of transgender health care and research. No high quality studies have assessed how gender-affirming medical care impact health inequities in transgender and gender diverse (TG/GD) adults, much less in AYAs, despite the fact that that TG/GD adults have higher than average morbidity and mortality across a host of health concerns, from human immunodeficiency virus infection to thromboembolism, and that reported depression with suicidal ideation is >10 times higher in TG/GD adults than in the general population. TG/GD youth have related but different needs from TG/GD adults. TG/GD AYA are embedded in family and schools, where stigma may be difficult to escape; mental health during adolescence has areas of increased risk as well as resilience; and the effects of early hormonal and surgical interventions on long-term health are insufficiently studied. Because of this, an inclusive and proactive approach to addressing the needs of TG/GD AYA by pediatric clinicians, researchers, and educators is particularly crucial. This article focuses on what is known and unknown about clinical practice, research, and education related to TG/GD health. We highlight the role of gender affirmation by clinicians as they care and advocate for TG/GD AYAs; the potential challenges of hormonal treatment for peripubertal youth; and short- and long-term effects on physical and reproductive health of medical or surgical interventions. We also discuss how social context influences knowledge gaps and the health-relevant risks faced by TG/GD AYA. The challenges are formidable, but opportunities await: high priority research questions to explore, educational gaps to be filled, and advocacy that needs the voices of pediatricians to promote policies to facilitate positive health outcomes for TG/GD AYA.
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Affiliation(s)
- Claudia Geist
- Division of Gender Studies, Department of Sociology (C Geist), University of Utah, Salt Lake City, Utah
| | - Katherine B Greenberg
- Departments of Pediatrics and Obstetrics/Gynecology (KB Greenberg), University of Rochester, Rochester, NY
| | | | - Nicole L Mihalopoulos
- Department of Pediatrics (NL Mihalopoulos), University of Utah, Salt Lake City, Utah.
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Boskey ER, Johnson JA, Harrison C, Marron JM, Abecassis L, Scobie-Carroll A, Willard J, Diamond DA, Taghinia AH, Ganor O. Ethical Issues Considered When Establishing a Pediatrics Gender Surgery Center. Pediatrics 2019; 143:peds.2018-3053. [PMID: 31085738 DOI: 10.1542/peds.2018-3053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 11/24/2022] Open
Abstract
As part of establishing a gender surgery center at a pediatric academic hospital, we undertook a process of identifying key ethical, legal, and contextual issues through collaboration among clinical providers, review by hospital leadership, discussions with key staff and hospital support services, consultation with the hospital's ethics committee, outreach to other institutions providing transgender health care, and meetings with hospital legal counsel. This process allowed the center to identify key issues, formulate approaches to resolving those issues, and develop policies and procedures addressing stakeholder concerns. Key issues identified during the process included the appropriateness of providing gender-affirming surgeries to adolescents and adults, given the hospital's mission and emphasis on pediatric services; the need for education on the clinical basis for offered procedures; methods for obtaining adequate informed consent and assent; the lower and upper acceptable age limits for various procedures; the role of psychological assessments in determining surgical eligibility; the need for coordinated, multidisciplinary patient care; and the importance of addressing historical access inequities affecting transgender patients. The process also facilitated the development of policies addressing the identified issues, articulation of a guiding mission statement, institution of ongoing educational opportunities for hospital staff, beginning outreach to the community, and guidance as to future avenues of research and policy development. Given the sensitive nature of the center's services and the significant clinical, ethical, and legal issues involved, we recommend such a process when a establishing a program for gender surgery in a pediatric institution.
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Affiliation(s)
- Elizabeth R Boskey
- Center for Gender Surgery, Boston Children's Hospital, Boston, Massachusetts; and
| | | | | | - Jonathan M Marron
- Ethics Advisory Committee.,Office of Ethics, and.,Division of Hematology/Oncology.,Center for Bioethics, Harvard Medical School, Harvard University, Boston, Massachusetts
| | | | | | - Julian Willard
- Center for Bioethics, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - David A Diamond
- Center for Gender Surgery, Boston Children's Hospital, Boston, Massachusetts; and
| | - Amir H Taghinia
- Center for Gender Surgery, Boston Children's Hospital, Boston, Massachusetts; and
| | - Oren Ganor
- Center for Gender Surgery, Boston Children's Hospital, Boston, Massachusetts; and
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7
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Alberse AME, de Vries AL, Elzinga WS, Steensma TD. Self-perception of transgender clinic referred gender diverse children and adolescents. Clin Child Psychol Psychiatry 2019; 24:388-401. [PMID: 30672324 PMCID: PMC6460680 DOI: 10.1177/1359104518825279] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Transgender children and adolescents show high rates of co-occurring psychopathology, which might be related to low self-confidence. Earlier research showed that compared to the norm population, transgender clinic-referred children have lower self-perception on two domains: physical appearance and global self-worth. This study aimed to compare self-perception in a sample of transgender clinic-referred children and adolescents with their standardization samples and to examine differences between these two groups. To measure self-esteem, the Self-Perception Profile for Children was administered to 305 referred children (162 assigned males at birth (AMABs) and 143 assigned females at birth (AFABs), mean age = 9.05 ( SD, 1.47), range = 5.9-13.00 years), and the Self-Perception Profile for Adolescents was administered to 369 referred adolescents (118 AMABs and 251 AFABs, mean age = 15.27 ( SD, 1.80), range = 10.73-18.03 years). To measure the severity of gender dysphoria, the parents of the children completed the Gender Identity Questionnaire and the adolescents completed the Utrecht Gender Dysphoria Scale. Referred children and adolescents had a significantly lower self-concept compared to the normative population, whereby referred adolescents felt less competent compared to referred children. Compared to their peers, childhood referred AFABs perceived themselves even better on scholastic and athletic competence and social acceptance. With regard to gender differences, referred AFABs generally showed a better self-perception compared to referred AMABs. The lower self-perception of transgender clinic-referred children and adolescents compared to same age peers deserves clinical attention and interventions aimed at, for example, improving social and physical self-worth.
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Affiliation(s)
- Anne-Marie E Alberse
- 1 Center of Expertise on Gender Dysphoria, VU University Medical Center, The Netherlands.,2 Department of Child and Adolescent Psychiatry, VU University Medical Center, The Netherlands
| | - Annelou Lc de Vries
- 1 Center of Expertise on Gender Dysphoria, VU University Medical Center, The Netherlands.,2 Department of Child and Adolescent Psychiatry, VU University Medical Center, The Netherlands
| | - Wieteke S Elzinga
- 1 Center of Expertise on Gender Dysphoria, VU University Medical Center, The Netherlands.,2 Department of Child and Adolescent Psychiatry, VU University Medical Center, The Netherlands
| | - Thomas D Steensma
- 1 Center of Expertise on Gender Dysphoria, VU University Medical Center, The Netherlands.,3 Department of Medical Psychology, VU University Medical Center, The Netherlands
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Durwood L, McLaughlin KA, Olson KR. Mental Health and Self-Worth in Socially Transitioned Transgender Youth. J Am Acad Child Adolesc Psychiatry 2017; 56:116-123.e2. [PMID: 28117057 PMCID: PMC5302003 DOI: 10.1016/j.jaac.2016.10.016] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 09/25/2016] [Accepted: 11/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Social transitions are increasingly common for transgender children. A social transition involves a child presenting to other people as a member of the "opposite" gender in all contexts (e.g., wearing clothes and using pronouns of that gender). Little is known about the well-being of socially transitioned transgender children. This study examined self-reported depression, anxiety, and self-worth in socially transitioned transgender children compared with 2 control groups: age- and gender-matched controls and siblings of transgender children. METHOD As part of a longitudinal study (TransYouth Project), children (9-14 years old) and their parents completed measurements of depression and anxiety (n = 63 transgender children, n = 63 controls, n = 38 siblings). Children (6-14 years old; n = 116 transgender children, n = 122 controls, n = 72 siblings) also reported on their self-worth. Mental health and self-worth were compared across groups. RESULTS Transgender children reported depression and self-worth that did not differ from their matched-control or sibling peers (p = .311), and they reported marginally higher anxiety (p = .076). Compared with national averages, transgender children showed typical rates of depression (p = .290) and marginally higher rates of anxiety (p = .096). Parents similarly reported that their transgender children experienced more anxiety than children in the control groups (p = .002) and rated their transgender children as having equivalent levels of depression (p = .728). CONCLUSION These findings are in striking contrast to previous work with gender-nonconforming children who had not socially transitioned, which found very high rates of depression and anxiety. These findings lessen concerns from previous work that parents of socially transitioned children could be systematically underreporting mental health problems.
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Abstract
BACKGROUND Gender reassignment surgery (GRS) can lead to discrimination. This transition makes great demands on the individual and also affects the social environment. OBJECTIVES To evaluate the social support of male-to-female (MtF) transgender people. MATERIALS AND METHODS Group A comprised 254 consecutive MtF transsexuals, who received a penile inversion vaginoplasty between 2004 and 2010. These women were surveyed retrospectively. Group B comprised 144 consecutive MtF transsexuals who presented for preoperative counselling. These patients were asked to answer the survey in advance of the planned GRS. RESULTS The return rate was 46.9 % (A) and 95.1 % (B). In both groups, approximately two-thirds lived with their parents or children at ease. About 13.4 % (A) and 16.9 % (B) estimated the relationship towards their parents and one- seventh (A) or one-sixth (B) woman rated their relationship towards their children as poor. The acceptance of the parents regarding GRS was 65.6 % (A) and 77.1 % (B). In total 20 % (A) and 9.2 % (B) did not, however, accept GRS in their children. The acceptance of children regarding GRS was 64.9 % (A) and 71.1 % (B) with 10.8 % (A) and 6.7 % (B) who did not approve the decision. DISCUSSION Social support is an important resource in the context of gender reassignment surgery. Understanding can help to improve the situation for transsexuals and to reduce consecutive healthcare utilisation.
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Saketopoulou A. Il lutto del corpo come "roccia basilare" nel trattamento psicoanalitico di transessuali. PSICOTERAPIA E SCIENZE UMANE 2015. [DOI: 10.3280/pu2015-001001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Saketopoulou A. Mourning the body as bedrock: developmental considerations in treating transsexual patients analytically. J Am Psychoanal Assoc 2014; 62:773-806. [PMID: 25277869 DOI: 10.1177/0003065114553102] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This paper introduces the concept of massive gender trauma, a clinical syndrome arising at the onerous intersection of the misgendering of transgender patients and the subjective, anguished experience of the natal body. Analysts have become increasingly aware in recent years of the complex interactions between psyche, soma, and culture. Consequently, the field is increasingly hospitable to considering the psychic risks inherent in misgendering. However, patients' body dysphoria is often left unaddressed even by analysts who seek to work within their analysands' gendered experience. Through a detailed, in-depth account of work with a five-year-old trans girl (female-identified, male-bodied), the developmental implications of the natal body's not becoming sufficiently mentalized in the course of treatment are tracked and explored. Attention to unconscious fantasy and its transformations shows the importance of helping transgender patients whose bodies are a source of suffering to be able to psychically represent their pain as a critical step in the process of a psychologically healthy transition.
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de Vries ALC, Kreukels BPC, Steensma TD, McGuire JK. Gender Identity Development: A Biopsychosocial Perspective. GENDER DYSPHORIA AND DISORDERS OF SEX DEVELOPMENT 2014. [DOI: 10.1007/978-1-4614-7441-8_3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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