Abstract
Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however, medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinically competent, and culturally attuned care to gender-variant patients, including those who identify as transgender or transsexual or meet criteria for the diagnosis of Gender Dysphoria (GD) as defined by The Diagnostic and Statistical Manual of Mental Disorders (5th edition). The article will also be helpful for other mental health professionals. The following areas are addressed: evolution of diagnostic nosology, epidemiology, gender development, and mental health assessment, differential diagnosis, treatment, and referral for gender-affirming somatic treatments of adults with GD.
Highlights
Individuals who would likely be considered transgender today are evident throughout the historical record.[1]The historical and sociocultural conceptualizations of gender variance, and their evolution within mental health professions over the past century and a half are reviewed elsewhere.[2]Nineteenth and 20th century theories of gender variance and views of appropriate treatment were pathologizing and highly stigmatizing to transgender people.[2]
While mainstream psychiatry is more affirming of gender variance, transgender individuals often are aware of the history in this area and many are likely to have encountered providers who adhere to outdated stigmatizing theories and approaches to treatment.[3]
Transgender, nonbinary, and gender questioning people are sufficiently common that even psychiatrists whose practice does not focus on gender are likely to encounter patients who have transitioned gender, are planning or considering transition, or are questioning their gender identity
Summary
Individuals who would likely be considered transgender today are evident throughout the historical record.[1]The historical and sociocultural conceptualizations of gender variance, and their evolution within mental health professions over the past century and a half are reviewed elsewhere.[2]Nineteenth and 20th century theories of gender variance and views of appropriate treatment were pathologizing and highly stigmatizing to transgender people.[2]. Individuals who would likely be considered transgender today are evident throughout the historical record.[1]. The historical and sociocultural conceptualizations of gender variance, and their evolution within mental health professions over the past century and a half are reviewed elsewhere.[2]. Nineteenth and 20th century theories of gender variance and views of appropriate treatment were pathologizing and highly stigmatizing to transgender people.[2] While mainstream psychiatry is more affirming of gender variance, transgender individuals often are aware of the history in this area and many are likely to have encountered providers who adhere to outdated stigmatizing theories and approaches to treatment.[3] Today’s mental health professionals should, be familiar with the history in this area as it is not unusual for gendervariant patients to have apprehensions about seeking mental healthcare or to raise questions about their providers’ views and approach to treatment considering that history.
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