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Gender dysphoria: recognition and assessment

  • Kate Eden, Kevan Wylie and Emily Watson
Summary

The role of the mental health professional, and of the psychiatrist in particular, is evolving and changing. As the recognition of transsexualism and gender identity disorder expands across the transgender spectrum, it has been recommended that gender dysphoria should replace existing diagnostic terminology. Patient-focused care is evolving and this article considers the limitations of current healthcare settings and how the mental health professional can support patients undergoing the real-life experience. Differentiation from other mental health conditions that may present as gender dysphoria is outlined, as well as specific clinical situations.

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Copyright
Corresponding author
Dr Kevan Wylie, Porterbrook Clinic, Nether Edge Hospital, Sheffield S11 9BF, UK. Email: k.r.wylie@sheffield.ac.uk
Footnotes
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The treatment of gender dysphoria is discussed on pp. 12–16 and 17–24, this issue.

Declaration of Interest

None.

Footnotes
References
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Abramowitz, SI (1986) Psychosocial outcomes of sex reassignment surgery. Journal of Consulting and Clinical Psychology 54: 183–9.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). APA.
Bakker, A, Kesteren, PJM, Gooren, LJG et al (1993) The prevalence of transsexualism in the Netherlands. Acta Psychiatrica Scandinavica 87: 237–8.
Blancard, R (1991) Clinical observations and systematic studies of autogynephilia. Journal of Sex & Marital Therapy 17: 235–51.
Bockting, W, Knudson, G, Goldberg, J (2007) Counseling and mental health care for transgender adults and loved ones. International Journal of Transgenderism 9: 3582.
Bockting, W, Coleman, E, Benner, A (2008) Select symposium abstracts from WPATH 20th Biennial Symposium, Chicago, Illinois, USA-September 2007. International Journal of Transgenderism 10: 173219.
Bockting, W (2009) Are gender identity disorders mental disorders? Recommendations for revision of the World Professional Association for Transgender Health's Standards of Care. International Journal of Transgenderism 11: 5362.
Bower, H (2001) The gender identity disorder in the DSM-IV classification. A critical evaluation. Australian and New Zealand Journal of Psychiatry 35: 18.
Buhrich, N, McConaghy, N (1978) Parental relationships during childhood in homosexuality, transvestism and transsexualism. Australian and New Zealand Journal of Psychiatry 12: 103–8.
Campo, J, Nijman, H, Evers, C et al (2001) Genderidentiteitsstoornissen als bijverschijnsel van psychose, in het bijzonder schizofrenie [Gender identity disorders as a symptom of psychosis, schizophrenia in particular]. Nederlands Tijdschrift voor Geneeskunde 145: 1876–80.
Campo, J, Nijman, H, Merckelbach, H et al (2003) Psychiatric comorbidity of gender identity disorders: a survey among Dutch psychiatrists. American Journal of Psychiatry 160: 1332–6.
Carroll, R, Leiblum, S (2007) Gender Dysphoria and Transgender Experiences: Principles and Practice of Sex Therapy. Guilford Press.
Clements-Nolle, K, Marx, R, Katz, M (2006) Attempted suicide among transgender persons: the influence of gender-based discrimination and victimization. Journal of Homosexuality 51: 5369.
Cohen-Kettenis, P, Arrindell, W (1990) Perceived parental rearing style, parental divorce and transsexualism: a controlled study. Psychological Medicine 20: 613–20.
Cohen-Kettenis, PT, Gooren, LJ (1999) Transsexualism: a review of etiology, diagnosis and treatment. Journal of Psychosomatic Research 46: 315–33.
Cole, C, O'Boyle, M, Emory, L et al (1997) Comorbidity of gender dysphoria and other major psychiatric diagnoses. Archives of Sexual Behavior 26: 1326.
Decuypere, G, Elaut, E, Heylens, G et al (2006) Long-term follow-up. Psychosocial outcome of Belgian transsexuals after sex reassignment surgery. Sexologies 15: 126–33.
Eliason, M (2000) Substance abuse counselor's attitudes regarding lesbian, gay, bisexual, and transgendered clients. Journal of Substance Abuse 12: 311–28.
Feldman, J, Goldberg, J (2007) Transgender primary medical care. International Journal of Transgenderism 9: 334.
Gehring, D, Knudson, G (2005) Prevalence of childhood trauma in a clinical population of transsexual people. International Journal of Transgenderism 8: 2330.
Gittleson, NL, Levine, S (1966) Subjective ideas of sexual change in male schizophrenics. British Journal of Psychiatry 112: 779–82.
Gittleson, NL, Dawson-Butterworth, K (1967) Subjective ideas of sexual change in female schizophrenics. British Journal of Psychiatry 113: 491–4.
Haberman, M, Hollingsworth, F, Falek, A et al (1975) Gender identity confusion, schizophrenia and a 47 XYY karyotype: a case report. Psychoneuroendocrinology 1: 207–9.
Hoenig, J, Kenna, JC (1974) The prevalence of transsexualism in England and Wales. British Journal of Psychiatry 124: 181–90.
Lawrence, AA (2008) Shame and narcissistic rage in autogynephilic transsexualism. Archives of Sexual Behaviour 37: 457–61.
Lev, A (2009) The ten tasks of the mental health provider. Recommendations for revision of the World Professional Association for Transgender Health's Standards of Care. International Journal of Transgenderism 11: 7499.
Levine, SB (1980) Psychiatric diagnosis of patients requesting sex reassignment surgery. Journal of Sex & Marital Therapy 6: 164–73.
Lobato, M, Koff, W, Schestatsky, S et al (2008) Clinical characteristics, psychiatric comorbidities and sociodemographic profile of transsexual patients from an outpatient clinic in Brazil. International Journal of Transgenderism 10: 6977.
Meyer, W, Bockting, W, Cohen-Kettenis, P et al (2002) The Harry Benjamin International Gender Dysphoria Association's Standards of Care for Gender Identity Disorders, Sixth Version. Journal of Psychology & Human Sexuality 13: 130.
Pfafflin, F, Ettner, R, Monstrey, S et al (2007) Mental Health Issues. Principles of Transgender Medicine and Surgery. Haworth Press.
Schott, R (1995) The childhood and family dynamics of transvestites. Archives of Sexual Behavior 24: 309–27.
Smith, Y, van Goozen, S, Kuiper, A et al (2005) Sex reassignment: Outcomes and predictors of treatment for adolescent and adult transsexuals. Psychological Medicine 35: 8999.
Tsoi, WF (1988) The prevalence of transsexualism in Singapore. Acta Psychiatrica Scandinavica 78: 501–4.
Veale, J, Clarke, D, Lomax, T (2010) Biological and psychosocial correlates of adult gender-variant identities: a review. Personality and Individual Differences 48: 357–66.
Whittle, S, Turner, L, Al-Alami, M (2007) Engendered Penalties: Transgender and Transsexual People's Experiences of Inequality and Discrimination. Press for Change.
World Health Organization (1992) The ICD-10 Classification of Diseases, Clinical Descriptions and Diagnostic Guidelines. WHO.
World Professional Association for Transgender Health (2011) Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (7th version). WPATH (www.wpath.org).
Wylie, K, Eden, K, Watson, E (2012) Gender dysphoria: treatment and outcomes. Advances in Psychiatric Treatment 18: 1216.
Zhou, JN, Hofman, MA, Gooren, LJ et al (1995) A sex difference in the human brain and its relation to transsexuality. Nature 378: 6870.
Zucker, K, Lawrence, A (2009) Epidemiology of gender identity disorder. Recommendations for the Standards of Care of the World Professional Association for Transgender Health. International Journal of Transgenderism 11: 818.
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BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
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Gender dysphoria: recognition and assessment

  • Kate Eden, Kevan Wylie and Emily Watson
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eLetters

Mind-Brain Divide and the Classification of Gender Dysphoria

C F Johansson, ST4 Psychiatry
02 February 2012

Eden et al (2012) present an informative overview of gender dysphoria. Trainee Psychiatrist, in general, do not have much exposure to this field.

With regard to the debate as to whether gender dysphoria should be classified as a mental illness opponents 'support the theory that gender dysphoria arises from "biological causes" (my quotations) and should therefore be classified as a medical, as opposed to mental illness'. Evidence to possible genetic factors and brain anatomy differences are pointed to.

The above argument is based on the false divide between mind and brain, so called 'Descartian Dualism'. There is a great deal of evidence for genetic factors and anatomical anomalies in Schizophrenia yet this does not take away from the fact the Schizophrenia is a mental illness.

The role of Psychiatry lies in understanding the complex interplay ofneurobiological, psychological and social factors on mental life; it seemsto me that from this perspective the Psychiatrist does have an important role to play in the understanding and management of gender dysphoria.

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Conflict of interest: None declared

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