Abstract
Since 2014, the Gender Identity Program (PROTIG) of Hospital de Clínicas de Porto Alegre (HCPA) has been assisting transgender youth seeking gender-affirmative treatment offered at a public health-care service specializing in gender in southern Brazil. This article aims to analyze sociodemographic and clinical data regarding the diagnoses of gender dysphoria and gender incongruence, psychiatric comorbidities, and clinical aspects of a sample of transgender youths seeking health care in the gender identity program. The research protocol consisted of a survey of the data collected in the global psychological evaluation performed at the health-care service for youths diagnosed with gender incongruence and their caretakers. Participating in this research were 24 transgender youths between 8 and 16 years old with diagnostic overlap of gender dysphoria [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)] and gender incongruence [International Classification of Diseases, 11th Revision (ICD-11)] and 34 of their caregivers. Of the young people, 45.8% were positive for some psychiatric comorbidity throughout their lives, with almost half (45.4%) having two or more psychiatric comorbidities in addition to gender dysphoria. The mental health professionals comprising affirmation care teams face the challenge of adapting the care protocols to the uniqueness of each demand by developing individualized forms to promote healthy development. This can be done by focusing not only on medical and physical interventions for gender affirmation but also on the promotion of mental health and general emotional well-being. Thus, the gender affirmation model, which advocates for global assessment and personalized guidance, proved to be adequate. Nevertheless, access to multidisciplinary health services specializing in gender is essential for promoting the general well-being of the population of transgender youth.
Highlights
In recent years, there has been an increase in the seeking of assessment at specialized services for gender identity for youths who self-define as transgender people, requiring actions that promote the qualification of professionals focusing on this age group and technical protocols aiming at assistance standardization [1,2,3]
Because it is an approach that values the uniqueness of each experience and the context in which the young person is inserted, affirmative gender practice involves careful assessment and considers family dynamics, psychological profiles, the presence of diagnostic criteria for gender dysphoria (GD)/gender incongruence (GI), possible secondary gains, and the occurrence of clinical and/or psychiatric comorbidities [6]
All of the participants had the diagnosis of GI (ICD-11)
Summary
There has been an increase in the seeking of assessment at specialized services for gender identity for youths who self-define as transgender people, requiring actions that promote the qualification of professionals focusing on this age group and technical protocols aiming at assistance standardization [1,2,3]. The term transgender is a popular expression to include a broad spectrum of gender expressions (gender variance or gender non-conformity) that have been identified in our current society, while cisgender conceptualizes people who do not have a gender identity variant of the sex designated at birth. These expressions are not scientific terms and do not appear in any current diagnostic manual [4]. Despite being a relatively new approach and still lacking scientific research, it is not limited to assessing whether young people should start the medical genderaffirmative treatments available for them but focuses on the global assessment of development [8]
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