scholarly journals Gender Dysphoria in Psychiatric Practice: Understanding the Clinical Ambiguity and Management

2021 ◽  
pp. 263183182110170
Author(s):  
Vyjayanthi N. Venkataramu ◽  
Debanjan Banerjee
Keyword(s):  
Gender Identity ◽  
Mental Health Professionals ◽  
Family Environment ◽  
Gender Dysphoria ◽  
Treatment Guidelines ◽  
Gender Nonconformity ◽  
Critical Element ◽  
Sex And Gender ◽  
Post Traumatic Stress ◽  
And Gender

There have been several myths and misconceptions about the dichotomous understanding of sex and gender. While sex is biologically determined, gender and gender identity depend on childhood experiences, upbringing, social expectations, beliefs, family environment, and peer interactions and is socially constructed. Gender dysphoria (GD) is the extreme distress experienced by an individual because of a mismatch between their gender identity and the sex assigned at birth. GD has been an ambiguous category in psychiatry, initially termed as “gender identity disorder” till Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5) considered removal of the term “disorder” to reduce the stigma associated. The critical element in GD is “clinically significant distress” that differentiates it from gender nonconformity. Individuals with GD identify themselves as transgender and frequently are victims of coercive social norms, discrimination, and stigma. This leads to delay in expression of distress, psychiatric mismanagement, and high comorbidity of depression, anxiety, post-traumatic stress, self-harm, and suicidality. Though management involves a holistic multidisciplinary approach including psychotherapy, social support, and gender-reassignment treatments (medical/surgical), there has been considerable debate and ambiguity related to the same. With this background, the article critics the understanding of GD, focuses on the WPATH SOC-7 treatment guidelines, and highlights the role of mental health professionals for better care.

scholarly journals Case Report: Doubts and Pre-occupations About Being Transgender: Questioning One's Gender Identity or a Case of Obsessive-Compulsive Disorder?

2021 ◽  
Vol 12 ◽  
Author(s):  
Elias Aboujaoude ◽  
Vladan Starcevic
Keyword(s):  
Gender Identity ◽  
Obsessive Compulsive Disorder ◽  
Mental Health Professionals ◽  
Sex And Gender ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Biological Sex ◽  
Gender Minorities ◽  
Gender Based ◽  
And Gender

We report the case of a biological female with gender identity-related doubts that were misconstrued as suggesting obsessive-compulsive disorder (OCD). The patient's parent seemed to favor an OCD explanation for the gender-based self-questioning over acceptance of possible transgender identity. We discuss what OCD is and what it is not in the context of gender identity-based doubt; analogy with the better studied sexual orientation-related OCD; cultural flashpoints around sex and gender that can become the object of OCD; how confusion about biological sex, assigned gender and gender identity can lead to clinical harm; and the role of mental health professionals in fighting the stigma faced by gender minorities.

Disability and quality of life in patients with low back pain: Focus on sex and gender: A cross-sectional study

2021 ◽  
pp. 1-8
Author(s):  
Yen-Mou Lu ◽  
Chung-Hwan Chen ◽  
Yi-Jing Lue
Keyword(s):  
Quality Of Life ◽  
Low Back Pain ◽  
Back Pain ◽  
Gender Identity ◽  
Gender Role ◽  
Low Back ◽  
Sex And Gender ◽  
Cross Sectional ◽  
And Gender

BACKGROUND: Sex and gender affect responses to pain, but little is known about disability and quality of life. OBJECTIVES: To investigate the effects of sex and gender on disability and health-related quality of life (HRQOL) in patients with low back pain. METHODS: Ninety-three patients with low back pain were included in this cross-sectional survey study. Disability, HRQOL and gender identity were respectively assessed with the Oswestry Disability Index, Short Form-36 and Bem Sex Role Inventory. The participants were classified into four gender role orientations (masculinity, femininity, androgyny and undifferentiated). One-way analysis of variance was used to analyze both the sex and the gender role orientation. RESULTS: Females had higher disability than males (p< 0.05), but in gender identity, no significant difference was found. Seven domains of HRQOL were lower than the healthy norms. Males experienced greater impacts than females on vitality and mental health (p< 0.05). For gender identity, five domains of HRQOL had significant differences (p< 0.05). Masculinity orientation had the least impact on four domains (p< 0.05), while undifferentiated orientation had the largest impact on all domains. CONCLUSION: Sex and gender effects can be used to analyze disability and HRQOL in patients with low back pain. Females have higher disability, while HRQOL is greatly influenced by different gender role orientations.

scholarly journals Can evolutionary thinking shed light on gender diversity?

2019 ◽  
Vol 25 (6) ◽  
pp. 351-362 ◽  
Author(s):  
Bernadette Wren ◽  
John Launer ◽  
Michael J. Reiss ◽  
Annie Swanepoel ◽  
Graham Music
Keyword(s):  
Gender Identity ◽  
Gender Diversity ◽  
Medical Intervention ◽  
List Type ◽  
Sex And Gender ◽  
Medical Interventions ◽  
The Core ◽  
Causal Pathways ◽  
And Gender ◽  
Shed Light

SUMMARYIssues of sexual reproduction lie at the core of evolutionary thinking, which often places an emphasis on how individuals attempt to maximise the number of successful offspring that they can produce. At first sight, it may therefore appear that individuals who opt for gender-affirming medical interventions are acting in ways that are evolutionarily disadvantageous. However, there are persuasive hypotheses that might make sense of such choices in evolutionary terms and we explore these here. It is premature to claim knowledge of the extent to which evolutionary arguments can usefully be applied to issues of gender identity, although worth reflecting on the extent to which nature tends towards diversity in matters of sex and gender. The importance of acknowledging and respecting different views in this domain, as well as recognising both the uncertainty and likely multiplicity of causal pathways, has implications for clinicians. We make some suggestions about how clinicians might best respond when faced with requests from patients in this area.LEARNING OBJECTIVESAfter reading this article you will be able to:•understand evolutionary arguments about diversity in human gender identity•identify strengths and weaknesses in evolutionary arguments applied to transgender issues•appreciate the range and diversity of gender experience and gender expression among people who present to specialist gender services, as well as the likely complexities of their reasons for requesting medical intervention.

scholarly journals Community attitudes on genetic research of gender identity, sexual orientation, and mental health

2019 ◽  
Author(s):  
Taylor R. Thomas ◽  
Dabney Hofammann ◽  
Brooke G. McKenna ◽  
Anna I.R. van der Miesen ◽  
Mark A. Stokes ◽  
...  
Keyword(s):  
Mental Health ◽  
Sexual Orientation ◽  
Gender Identity ◽  
Genetic Research ◽  
Mental Health Research ◽  
Sex And Gender ◽  
Willingness To Participate ◽  
Biological Basis ◽  
And Gender ◽  
New Research

ABSTRACTBiological sex is an important factor in mental health, and a non-binary view of how variation in sex and gender influence mental health represents a new research frontier that may yield new insights. The recent acceleration of research into sexual orientation, gender identity, and mental health has generally been conducted without sufficient understanding of the opinions of sexual and gender minorities (SGM) toward this research. We surveyed 768 individuals, with an enrichment of LGBTQ+ stakeholders, for their opinions regarding genetic research of SGM and mental health. We found that the key predictors of attitudes toward genetic research specifically on SGM are 1) general attitudes toward genetic and mental health research 2) tolerance of SGM and associated behaviors 3) non-cisgender stakeholder status and 4) age of the respondent. Non-heterosexual stakeholder status was significantly associated with increased willingness to participate in genetic research if a biological basis for gender identity were discovered. We also found that non-stakeholders with a low tolerance for SGM indicated their SGM views would be positively updated if science showed a biological basis for their behaviors and identities. These findings represent an important first step in understanding and engaging the LGBTQ+ stakeholder community in the context of genetic research.

An adolescent requesting to pause puberty

2021 ◽  
pp. 203-212
Author(s):  
Cordelia Y. Ross ◽  
Alex S. Keuroghlian
Keyword(s):  
Gender Identity ◽  
Hormone Therapy ◽  
Gender Dysphoria ◽  
Social Stigma ◽  
Developmental History ◽  
Psychiatric Assessment ◽  
Gender Expression ◽  
Gender Affirmation ◽  
History Of ◽  
And Gender

Gender dysphoria occurs when a patient has distress associated with incongruence between a person’s experienced gender and the gender traditionally associated with their sex assigned at birth. This must occur for at least six months. The psychiatric assessment of a patient with gender dysphoria should include exploration of the child’s developmental history of gender-expansive identification and expression; sources of distress relating to familial, community, and social stigma; and ways to help families adopt an accepting and nurturing response. Gender affirmation can include psychological, social, legal, and biological interventions. The goal of psychotherapy is to help a person explore, discover, and affirm their gender identity. Social affirmation may include changing names, pronouns, and gender expression. Legal gender affirmation may take place through a name or gender marker change on official documents. Biological affirmation may include pubertal suppression for younger adolescents, gender-affirming hormone therapy, and/or gender-affirming surgery.

Gender Identity without Gender Prescriptions

1998 ◽  
pp. 104-111
Author(s):  
Janet C. Wesselius
Keyword(s):  
Twentieth Century ◽  
Gender Identity ◽  
A Priori ◽  
Social Practices ◽  
Sex And Gender ◽  
Feminist Politics ◽  
Emancipatory Politics ◽  
And Gender ◽  
Gender Categories ◽  
Susan Bordo

The feminist philosopher Susan Bordo suggests that the dilemma of twentieth-century feminism is the tension between a gender identity that both mobilizes a liberatory politics on behalf of women and that results in gender prescriptions which excludes many women. This tension seems especially acute in feminist debates about essentialism/deconstructionism. Concentrating on the shared sex of women may run the risk of embracing an essentialism that ignores the differences among women, whereas emphasizing the constructed natures of sex and gender categories seems to threaten the very project of a feminist politics. I will analyze the possibility of dismantling gender prescriptions while retaining a gender identity that can be the beginning for an emancipatory politics. Perhaps feminists need not rely on a reified essentialism that elides the differences of race, class, etc., if we begin with our social practices of classification rather than with a priori generalizations about the nature of women.

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