Treatment Of Gender Identity Disorder Research Articles

Assessment and Treatment of Gender Dysphoria and Gender Variant Patients: A Primer for Psychiatrists.

Assessment and Treatment of Gender Dysphoria and Gender Variant Patients: A Primer for Psychiatrists.

The case of successful treatment of gender identity disorder of childhood

Gender identity disorder of childhood refers to a rather rare disorders, but according to the literature girls with the disorder in the future may become homosexual or transsexual. The necessary diagnostic criterion for gender identity disorder of childhood is the presence of a constant desire to belong (or the conviction of belonging) to the opposite sex, coupled with a strong denial of the behavior, characteristics and/or clothing specific to the registered sex. Usually the disorder is manifested in the preschool years, but for diagnosing it is necessary that it manifests before the onset of puberty. Both sexes may have a rejection of anatomical structures inherent in his own sex; however, such unusual display is rare.Patient V. came to the appointment with psychiatrist with parents 3 years ago. During the interview reported that she starts to feel the boy at the age of 9 years. This announcement provoked outrage from parents. With the beginning of the critical days began to position herself in a male person. The patient met all diagnostic criteria for gender identity disorder of childhood. The patient underwent a course of systemic therapy combined with nootropics. Currently, patient name is the name of a female, the patient wears women's clothing, identifies herself as a woman. The patient continues to meet with a psychotherapist, is satisfied with the treatment, thoughts on sex change does not express. Thus, in the case of diagnosis of this disorder can become effective systemic therapy in combination with nootropics.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A Systematic Review of the Effects of Hormone Therapy on Psychological Functioning and Quality of Life in Transgender Individuals.

Objectives: To review evidence from prospective cohort studies of the relationship between hormone therapy and changes in psychological functioning and quality of life in transgender individuals accessing hormone therapy over time.Data Sources: MEDLINE, PsycINFO, and PubMed were searched for relevant studies from inception to November 2014. Reference lists of included studies were hand searched.Results: Three uncontrolled prospective cohort studies, enrolling 247 transgender adults (180 male-to-female [MTF], 67 female-to-male [FTM]) initiating hormone therapy for the treatment of gender identity disorder (prior diagnostic term for gender dysphoria), were identified. The studies measured exposure to hormone therapy and subsequent changes in mental health (e.g., depression, anxiety) and quality of life outcomes at follow-up. Two studies showed a significant improvement in psychological functioning at 3–6 months and 12 months compared with baseline after initiating hormone therapy. The third study showed improvements in quality of life outcomes 12 months after initiating hormone therapy for FTM and MTF participants; however, only MTF participants showed a statistically significant increase in general quality of life after initiating hormone therapy.Conclusions: Hormone therapy interventions to improve the mental health and quality of life in transgender people with gender dysphoria have not been evaluated in controlled trials. Low quality evidence suggests that hormone therapy may lead to improvements in psychological functioning. Prospective controlled trials are needed to investigate the effects of hormone therapy on the mental health of transgender people.

Evaluation and management of children and adolescents with gender identification and transgender disorders

Gender identity development is poorly understood but impacted by central nervous system (CNS) factors, genes, gonadal hormones and receptors, genitalia, and social/environmental factors. Gender identity disorder (GID) is the diagnostic term to describe persons discontent with the sex they were assigned at birth and/or the gender roles associated with that sex. It is crucial that the diagnosis be verified as persistent, since gender confusion among those young persists among only a portion. Recent publications do not yet provide an overall perspective but involve observations regarding outcome information, unusual variables, incidence of cross-gender behavior, and CNS differences related to GID and bi-gender descriptions. Approaches to therapy for GID and task force guidelines are noted. Although the concept of gender identity is a relatively new paradigm and remains an area of active and exciting investigation, findings reported here provide items of information for understanding and treatment of GIDs and illustrate the need for further research.

Le concept de trouble de l’identité sexuelle chez l’enfant et l’adolescent. Qu’en savoir ? Que dire ? Que faire ?

There has been an explosion of public interest and concern about children and adolescents who show an interest in changing their gender. And it is an emerging problem for pediatricians, which brings many inquiries about what to do? Both the diagnosis and treatment of gender identity disorder are controversial. But there are a new early treatment using puberty blocking hormones.

Hormone treatment of gender identity disorder in a cohort of children and adolescents

Medical Journal of AustraliaVolume 197, Issue 5 p. 273-274 Letter Hormone treatment of gender identity disorder in a cohort of children and adolescents Zoë Hyde, Corresponding Author Zoë Hyde Research Associate zoe@sexologyresearch.org Department of Sexology, Curtin University, Perth, WA.Correspondence: zoe@sexologyresearch.orgSearch for more papers by this author Zoë Hyde, Corresponding Author Zoë Hyde Research Associate zoe@sexologyresearch.org Department of Sexology, Curtin University, Perth, WA.Correspondence: zoe@sexologyresearch.orgSearch for more papers by this author First published: 03 September 2012 https://doi.org/10.5694/mja12.10911Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume197, Issue5September 2012Pages 273-274 RelatedInformation

Hormone treatment of gender identity disorder in a cohort of children and adolescents

Hormone treatment of gender identity disorder in a cohort of children and adolescents

Hormone treatment of gender identity disorder in a cohort of children and adolescents

Hormone treatment of gender identity disorder in a cohort of children and adolescents

Treatment of Gender Identity Disorder

Treatment of Gender Identity Disorder

Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder

Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA. The literature on treatment of gender dysphoria in individuals with disorders of sex development was also assessed. The completed report was accepted by the BOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as the primary outcome measure, current evidence was judged sufficient to support recommendations for adults in the form of an evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variant minors, and the rights of persons of any age who are gender variant, transgender or transsexual.

Hormone treatment of gender identity disorder in a cohort of children and adolescents

To describe the experience of hormone treatment of gender identity disorder (GID) in children and adolescents within a specialist clinic. Cohort study by medical record review of children aged 0-17 years referred during 2003-2011 for management at the GID clinic in a tertiary paediatric referral centre - the Royal Children's Hospital, Melbourne, Victoria. Clinical characteristics of the patient population, hormone treatment provided, frequency of referrals with time. Thirty-nine children and adolescents were referred for gender dysphoria. Seventeen individuals were pubertal with persistent GID, and were considered eligible for hormone treatment. Seven patients, comprising three biological males and four biological females, had legally endorsed hormone treatment. In this group, gender dysphoria was first noted at 3-6 years of age. Hormone treatment with GnRH analogue to suppress pubertal progression (phase 1) was given at 10-16 years of age. Treatment with cross-sex hormones (phase 2) was given at 15.6-16 years. One patient purchased cross-sex hormone treatment overseas. One patient received oestrogen and progesterone for menstrual suppression before phase 1. The annual frequency of new referrals increased continuously over the study period. Hormone treatment for pubertal suppression and subsequent gender transition needs to be individualised within stringent protocols in multidisciplinary specialist units.

Status of sex reassignment surgery for gender identity disorder in Japan

An incongruence between one's physiological sex and the gender identity that is one's basic sense of self as a man or a woman is known as gender identity disorder. In general, the conditions of physiological men having female gender identity and physiological women having male gender identity are called male-to-female and female-to-male gender identity disorder, respectively. Although the precise pathogenesis of gender identity disorder remains unclear, the prevalence of gender identity disorder is quite high, with the rates calculated for male-to-female to be 1:25,000 and female-to-male to be 1:12,000 in Hokkaido, Japan. The diagnosis and treatment of gender identity disorder in Japan are based on the Diagnostic and Therapeutic Guidelines for Patients with Gender Identity Disorder, 4th edition. Although gender identity disorder was previously thought to be a psychiatric condition, it is extremely difficult to assign gender identity to physiological sex by psychiatric and psychological treatments. To adapt the figure of the body to the native gender identity, physical treatments such as administration of cross-sex steroids and sex reassignment surgery are considered. However, there are very few institutions that routinely carry out sex reassignment surgery in Japan, even though it is mandatory for changing sex on the census register at the present time. Sex reassignment surgery for male-to-female and female-to-male patients includes orchiectomy, penectomy, clitoroplasty, vaginoplasty and vulvoplasty, and hysterectomy, ovariectomy, metoidioplasty and phalloplasty, respectively. To provide accurate information about physical treatment for patients with gender identity disorder, even urologists who are not actively involved in the diagnosis and treatment of gender identity disorder should understand the fundamental aspects and contemporary problems of gender identity disorder.

Committee Opinion No. 512

Transgender individuals face harassment, discrimination, and rejection within our society. Lack of awareness, knowledge, and sensitivity in health care communities eventually leads to inadequate access to, underutilization of, and disparities within the health care system for this population. Although the care for these patients is often managed by a specialty team, obstetrician–gynecologists should be prepared to assist or refer transgender individuals with routine treatment and screening as well as hormonal and surgical therapies. The American College of Obstetricians and Gynecologists opposes discrimination on the basis of gender identity and urges public and private health insurance plans to cover the treatment of gender identity disorder.

Sliding doors: should treatment of gender identity disorder and other body modifications be privately funded?

Gender Identity Disorder (GID) is regarded as a mental illness and included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). It will also appear in the DSM-V, due to be published in 2013. The classification of GID as a mental illness is contentious. But what would happen to sufferers if it were removed from the diagnostic manuals? Would people lose their entitlement to funded medical care, or to reimbursement under insurance schemes? On what basis should medical treatment for GID be provided? What are the moral arguments for and against funded or reimbursed medical care for GID? This paper starts out with a fiction: GID is removed from the diagnostic manuals. Then the paper splits in two, as in happened in the Howitt's 1998 film Sliding Doors. The two scenarios run parallel. In one, it is argued that GID is on a par with other body modifications, such as cosmetic and racial surgery, and that, for ethical reasons, treatment for GID should be privately negotiated by applicants and professionals and privately paid for. In the other scenario, it is argued that the comparison between GID and other body modifications is misleading. Whether or not medical treatment should be funded or reimbursed is independent of whether GID is on a par with other forms of body dissatisfaction.

Trans-Action Fees: Public Insurance, Medical Necessity, and Sex Reassignment Surgery

Due to a general lack of understanding regarding transgender persons, this group of individuals is put at particular risk of discrimination in the area of law and medicine. The question of public insurance coverage for medical treatment of gender identity disorder is one of the most pressing issues in this field. This paper will provide an overview of transgenderism and treatments of gender identity disorder in order to assess the medical necessity of sex reassignment surgery and other procedures provided to transgender persons. While Medicaid guidelines do allow for the denial of medically necessary services, these denied services must fit certain criteria. Specific cases in which state insurance coverage was permitted or denied to transgender Medicaid patients will be examined in order to assess the overall ethicality of Medicaid policy towards transgender persons.

Gender Identity Disorders in Childhood and Adolescence

While debates continue as to whether or not a diagnosis of gender identity disorder (GID) is wanted or needed by today's adult transsexual, there is increasing concern both in academic and lay literature regarding the diagnosis of children and adolescents with GID. This paper critically evaluates the diagnosis, assessment, and treatment of GID in children and adolescents in light of published controversies, evidence, and arguments in psychological, psychiatric, and lay discourse since the release of the DSM-IV. In the years since GID's first inclusion in the DSM-III, growing criticisms weigh heavily against the diagnosis of GID in children and adolescents. This analysis urges a re-evaluation of the GID diagnosis for children and, to a lesser extent, adolescents. Overall, there is deepening discomfort with pathologizing children and youth for extreme gender variance. Since this is a highly contentious diagnosis-with little established reliability and validity, and problematic assessment and treatment approaches-researchers and clinicians need to establish that GID is validly diagnosed with nonbiased assessments and treated effectively in accordance with current Standards.

Gender Identity Disorders in Childhood and Adolescence

While debates continue as to whether or not a diagnosis of gender identity disorder (GID) is wanted or needed by today's adult transsexual, there is increasing concern both in academic and lay literature regarding the diagnosis of children and adolescents with GID. This paper critically evaluates the diagnosis, assessment, and treatment of GID in children and adolescents in light of published controversies, evidence, and arguments in psychological, psychiatric, and lay discourse since the release of the DSM-IV. In the years since GID's first inclusion in the DSM-III, growing criticisms weigh heavily against the diagnosis of GID in children and adolescents. This analysis urges a re-evaluation of the GID diagnosis for children and, to a lesser extent, adolescents. Overall, there is deepening discomfort with pathologizing children and youth for extreme gender variance. In the very least, since this is a highly contentious diagnosis, with little established reliability and validity, and problematic a...

Gender Identity Disorder: General Overview and Surgical Treatment for Vaginoplasty in Male-to-Female Transsexuals

After studying this article, the participant should be able to discuss: 1. The terminology related to male-to-female gender dysphoria. 2. The different theories regarding cause, epidemiology, and treatment of gender dysphoria. 3. The surgical goals of sex reassignment surgery in male-to-female transsexualism. 4. The surgical techniques available for sex reassignment surgery in male-to-female transsexualism. Gender identity disorder (previously "transsexualism") is the term used for individuals who show a strong and persistent cross-gender identification and a persistent discomfort with their anatomical sex, as manifested by a preoccupation with getting rid of one's sex characteristics, or the belief of being born in the wrong sex. Since 1978, the Harry Benjamin International Gender Dysphoria Association (in honor of Dr. Harry Benjamin, one of the first physicians who made many clinicians aware of the potential benefits of sex reassignment surgery) has played a major role in the research and treatment of gender identity disorder, publishing the Standards of Care for Gender Dysphoric Persons. The authors performed an overview of the terminology related to male-to-female gender identity disorder; the different theories regarding cause, epidemiology, and treatment; the goals expected; and the surgical technique available for sex reassignment surgery in male-to-female transsexualism. Surgical techniques available for sex reassignment surgery in male-to-female transsexualism, with advantages and disadvantages offered by each technique, are reviewed. Other feminizing nongenital operative interventions are also examined. This review describes recent etiopathogenetic theories and actual guidelines on the treatment of the gender identity disorder in male-to-female transsexuals; the penile-scrotal skin flap technique is considered the state of the art for vaginoplasty in male-to-female transsexuals, whereas other techniques (rectosigmoid flap, local flaps, and isolated skin grafts) should be considered only in secondary cases. As techniques in vaginoplasty become more refined, more emphasis is being placed on aesthetic outcomes by both surgeons and patients.

Comorbidity of Asperger syndrome and gender identity disorder

The case of a 35-year-old biological woman with Asperger syndrome (AS) and gender identity disorder (GID) fulfilling DSM-IV criteria is reported. Against the background of recently emerging theories of cognitive male pattern underlying autism we present additional psychological assessments in order to discuss any possible interaction or discrimination between AS and GID. Whilst we explain GID as a secondary feature of AS, we examine the assumption of the necessity of treating GID in AS as a primary GID in accordance with international standards. We consider the treatment of GID as compelling, particularly because curative therapy for AS is lacking and with GID treatment in this vein, the patient gains psychosocial improvement.

“Qué joto bonita!”: Transgender Negotiations of Sex and Ethnicity

SUMMARY Recent transgender literature has been sharply critical of existing medical models of the psychosexual development of transsexuals and of the treatment of Gender Identity Disorder. Transgender authors have pointed out that subjects have deliberately falsified their reports in order to conform to medical and psychiatric models for the sake of gaining access to services. In newer transsexual narratives, gender and sexual orientation development appear far more fluid and ambiguous over the life span. This paper reviews the nosological history of gender atypicality, from nineteenth century “sexual inversion” to transvestitism and transsexualism, examining how deviations of gender identity, gender role, sexual object, and sexual aim were often collapsed together. These imbrications continue to persist in both the medical and popular literature on transsexualism. A topic that has especially been neglected is the relationship of ethnicity to the development of gender and sexual identity. Presented is cas...