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Psychiatric characteristics in transsexual individuals: multicentre study in four European countries

  • Gunter Heylens (a1), Els Elaut (a1), Baudewijntje P. C. Kreukels (a2), Muirne C. S. Paap (a3), Susanne Cerwenka (a4), Hertha Richter-Appelt (a4), Peggy T. Cohen-Kettenis (a5), Ira R. Haraldsen (a6) and Griet De Cuypere (a1)...
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-IVTR 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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Copyright
Corresponding author
Gunter Heylens, Department of Sexology and Gender Problems, University Hospital Ghent De Pintelaan 185, 9000 Ghent, Belgium. Email: gunter.heylens@uzgent.be
Footnotes
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See editorial, pp. 96–97, this issue.

Declaration of interest

None.

Footnotes
References
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1 Verschoor, AM, Poortinga, J. Psychosocial differences between Dutch male and female transsexuals. Arch Sex Behav 1988; 17: 173–8.
2 De Cuypere, G, Jannes, C, Rubens, R. Psychosocial functioning of transsexuals in Belgium. Acta Psychiatr Scand 1995; 91: 180–4.
3 A, Campo JM, Nijman, H, Merckelbach, H, Evers, C. Psychiatric comorbidity of gender identity disorders: a survey among Dutch psychiatrists. Am J Psychiatry 2003; 160: 1332–6.
4 Hepp, U, Kraemer, B, Schnyder, U, Miller, N, Delsignore, A. Psychiatric comorbidity in gender identity disorder. J Psychosom Res 2005; 58: 259–61.
5 Cole, CM, O'Boyle, M, Emory, LE, Meyer, WJ. Comorbidity of gender dysphoria and other major psychiatric diagnoses. Arch Sex Behav 1997; 26: 1326.
6 Haraldsen, IR, Dahl, AA. Symptom profiles of gender dysphoric patients of transsexual type compared to patients with personality disorders and healthy adults. Acta Psychiatr Scand 2000; 102: 276–81.
7 Gomez-Gil, E, Trilla, A, Salamero, M, Godas, T, Valdes, M. Sociodemographic, clinical, and psychiatric characteristics of transsexuals from Spain. Arch Sex Behav 2009; 38: 378–92.
8 Hoshiai, M, Matsumoto, Y, Sato, T, Ohnishi, M, Okabe, N, Kishimoto, Y, et al. Psychosomatic comorbidity among patients with gender identity disorder. Psychiatry Clin Neurosci 2010; 64: 514–9.
9 Landen, M, Walinder, J, Lundstrom, B. Clinical characteristics of a total cohort of female and male applicants for sex reassignment: a descriptive study. Acta Psychiatr Scand 1998; 97: 198–4.
10 Bodlund, O, Kullgren, G, Sundbom, E, Hojerback, T. Personality traits and disorders among transsexuals. Acta Psychiatr Scand 1993; 88: 322–7.
11 Meyer-Bahlburg, HFL. From mental disorder to iatrogenic hypogonadism: dilemmas in conceptualising gender identity variants as psychiatric conditions. Arch Sex Behav 2010; 39: 461–76.
12 De Cuypere, G, Vercruysse, H. Eligibility and readiness criteria for sex reassignment surgery: recommendations for revision of the WPATH standards of care. Int J Transgender 2011; 11: 194205.
13 Dhejne, C, Lichtenstein, P, Boman, M, Johansson, ALV, Langstrom, N, Landen, M. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PloS ONE 2011; 6: 18.
14 Nieder, TO, Herff, M, Cerwenka, S, Preuss, WF, Cohen-Kettenis, PT, De, Cuypere G, et al. Age of onset and sexual orientation in transsexual males and females. J Sex Med 2011; 8: 783–91.
15 Smith, YLS, van, Goozen SHM, Kuiper, AJ, Cohen-Kettenis, PT. Transsexual subtypes: clinical and theoretical significance. Psychiatry Res 2005; 137: 151–60.
16 Lothstein, LM. Psychological testing with transsexuals: a 30-year review. J Pers Assess 1984; 48: 500–7.
17 Kreukels, BP, Haraldsen, IR, De Cuypere, G, Richter-Appelt, H, Gijs, L, Cohen-Kettenis, PT. A European network for the investigation of gender incongruence: the ENIGI initiative. Eur Psychiatry 2012; 27: 445–50.
18 Paap, MCS, Kreukels, BPC, Cohen-Kettenis, PT, Richter-Appelt, H, De, Cuypere G, Haraldsen, IR. Assessing the utility of diagnostic criteria: a multisite study on gender identity disorder. J Sex Med 2011; 8: 180–90.
19 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th edn, Text Revision) (DSM-IV-TR). APA, 2000.
20 Cohen-Kettenis, P, Van Goozen, SH. Sex reassignment of adolescent transsexuals: a follow-up study. J Am Acad Child Adolesc Psychiatry 1997; 36: 263–71.
21 Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998; 59 (suppl 20): 2233.
22 First, MB, Gibbon, M, Spitzer, RL, Williams, JBW, Benjamin, L. Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). American Psychiatric Press, 1997.
23 Bruffaerts, R, Bonnewyn, A, Van Oyen, H, Demarest, S, Demyttenaere, K. Prevalence of pure and comorbid mental disorders in Belgium. Rev Med Liege 2003; 58: 741–50.
24 Jacobi, F, Wittchen, HU, Holting, C, Hofler, M, Pfister, H, Muller, N, et al. Prevalence, comorbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med 2004; 34: 597611.
25 De Graaf, R, Ten Have, C, van, Gool S, van, Dorsselaer S. Prevalence of mental disorders, and trends from 1996 to 2009; results from NEMESIS-2. Tijdschr Psychiatr 2012; 54: 2738.
26 Kringlen, E, Torgersen, S, Cramer, V. A Norwegian psychiatric epidemiological study. Am J Psychiatry 2001; 158: 1091–8.
27 Mate-Kole, C, Freschi, M, Robin, A. Aspects of psychiatric symptoms at different stages in the treatment of transsexualism. Br J Psychiatry 1988; 152: 550–3.
28 Mate-Kole, C, Freschi, M, Robin, A. A controlled study of psychological and social change after surgical gender reassignment in selected male transsexuals. Br J Psychiatry 1990; 157: 261–4.
29 Gomez-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.
30 Newfield, E, Hart, S, Dibble, S, Kohler, L. Female-to-male transsgender quality of life. Qual Life Res 2006; 15: 1447–57.
31 Terada, S, Matsumoto, Y, Sato, T, Okabe, N, Kishimoto, Y, Uchitomi, Y. Suicidal ideation among patients with gender identity disorder. Psychiatry Res 2011; 190: 159–62.
32 Haas, AP, Eliason, M, Mays, VM, Mathy, RM, Cochran, SD, D'Augelli, AR, et al. Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. J Homosex 2011; 58: 1051.
33 Liu, RT, Mustanski, B. Suicidal ideation and self-harm in lesbian, gay, bisexual and transgender youth. Am J Prev Med 2012; 42: 221–8.
34 Alonso, J, Angermeyer, MC, Bernert, S, Bruffaerts, R, Brugha, TS, Bryson, H, et al. Prevalence of mental disorders in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD). Acta Psychiatr Scand Suppl 2004; 420: 21–7.
35 Miach, PP, Berah, EF, Butcher, JN, Rouse, S. Utility of the MMPI-2 in assessing gender dysphoric patients. J Pers Assess 2000; 75: 268–79.
36 Madeddu, F, Prunas, A, Hartmann, D. Prevalence of Axis II disorders in a sample of clients undertaking psychiatric evaluation for sex reassignment surgery. Psychiatr Q 2009; 80: 261–7.
37 Maier, W, Lichtermann, D, Klinger, T, Heun, R, Hallmayer, J. Prevalences of personality disorder (DSM-III-R) in the community. J Pers Disord 1992; 6: 187–96.
38 Torgersen, S, Kringlen, E, Cramer, V. The prevalence of personality disorders in a community sample. Arch Gen Psychiatry 2001; 58: 590–6.
40 Landelijke Stuurgroep Multidisciplinaire Richtlijnontwikkeling in de GGZ. Multidisciplinaire Richtlijn Persoonlijkheidsstoornissen 2008. Trimbos Institute, 2008.
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Psychiatric characteristics in transsexual individuals: multicentre study in four European countries

  • Gunter Heylens (a1), Els Elaut (a1), Baudewijntje P. C. Kreukels (a2), Muirne C. S. Paap (a3), Susanne Cerwenka (a4), Hertha Richter-Appelt (a4), Peggy T. Cohen-Kettenis (a5), Ira R. Haraldsen (a6) and Griet De Cuypere (a1)...
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