Abstract
Gender confirming treatment has proven to relief gender dysphoria as a symptom and to improve psychological functioning in transgender persons. Nevertheless, small percentage shows regret after their surgical treatment. Risk factors for regret are the presence of psychiatric problems, dissatisfaction with the results of surgery and poor socializing. In Belgium, euthanasia can be applied for in a situation of constant and unbearable mental or physical suffering. In recent years, three patients applied for euthanasia in the Gender clinic of the University Hospital Ghent, Belgium. We report on one case of a trans-woman applying for euthanasia and discuss on implications for assessment and treatment.
Highlights
According to DSM-5, persons with gender dysphoria suffer from a marked incongruence between their experienced/expressed gender and assigned gender [1]
Gender confirming treatment is considered to be the first choice of treatment in terms of effect on gender dysphoria and psychological functioning [2]
Due to the legal framework that allows patients to obtain euthanasia for psychiatric reasons, one hypothesis could be that some transgender persons in Belgium apply for euthanasia instead of committing suicide
Summary
According to DSM-5, persons with gender dysphoria suffer from a marked incongruence between their experienced/expressed gender and assigned gender [1]. Compared to the general population, mental health problems (e.g. depression and anxiety) are found more frequently in persons with gender dysphoria applying for treatment [4]. This is partial due to long-lasting stigmatization and discrimination. The goal of this article is twofold: first, to shed light on the specific situation in Belgium regarding the possibility to apply for and undergo euthanasia in situations of constant and unbearable physical or mental suffering in general and applied on a case of a patient with gender dysphoria and to discuss on the implications of these findings on the assessment and treatment of transgender persons. Patient was still convinced to continue with the procedure, but had to make several arrangements (e.g. financial)
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