CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(10): 545-551
DOI: 10.1055/s-0037-1604134
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Clinical Characteristics in a Sample of Transsexual People

Características clínicas de uma amostra de pessoas transexuais
Maria Rita Lerri
1   Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
,
Adriana Peterson Mariano Salata Romão
1   Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
,
Manoel Antônio dos Santos
2   Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
,
Alain Giami
3   Center for Research in Epidemiology and Population Health (CESP), Institut National de la Santé et de la Recherche Médicale (Iserm) Unit 1018, Team Gender, Sexual and Reproductive Health, Paris, France
,
Rui Alberto Ferriani
1   Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
,
Lúcia Alves da Silva Lara
1   Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

15. August 2016

05. Mai 2017

Publikationsdatum:
07. August 2017 (online)

Abstract

Purpose To assess the clinical characteristics of subjects with gender dysphoria (GD).

Method A cross-sectional study of adults with GD. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Sociodemographic data, clinical data and life habits were recorded.

Results Total of 44 subjects participated in the study: 36 (82%) trans women and 8 (18%) trans men. Forty-three (98%) of the GD patients had anxiety (36 [100%] trans women and 7 [87.5%] trans men), and 36 (82%) had depression (29 [80.5%] trans women and 7 [87.5%] trans men). Suicide had been attempted by 32 (73%) subjects. The rates of depression were lower among the subjects living with partners, parents, or other people than among those living alone (p = 0.03), and it was also lower among the subjects who were married compared to those who were dating or single (p = 0.03).

Conclusion Improving the relationship status may reduce the prevalence of depressive symptoms in GD patients. There was a high rate of attempted suicide in this sample.

Resumo

Objetivo Avaliar as características clínicas de indivíduos com disforia de gênero (DG).

Método Estudo transversal com pessoas transexuais. Os sintomas de ansiedade e depressão foram medidos usando a Escala Hospitalar de Ansiedade e Depressão. Os dados sociodemográficos, os dados clínicos, e os hábitos de vida foram registrados por meio de um questionário.

Resultados Um total de 44 indivíduos participou do estudo: 36 (82%) mulheres trans, e 8 (18%) homens trans. Quarenta e três (98%) destes apresentaram ansiedade, sendo 36 (100%) mulheres trans e 7 (87,5%) homens trans, e 36 (82%) apresentaram depressão, sendo 29 (80,5%) mulheres trans, e 7 (87,5%) homens trans. Um total de 32 (73%) indivíduos já haviam tentado suicídio. Os indivíduos que vivem com parceiros, pais ou outras pessoas tiveram uma menor taxa de depressão do que aqueles que vivem sozinhos (p = 0,03), e os indivíduos que eram casados tiveram uma menor taxa de depressão do que aqueles que estavam namorando ou solteiros (p = 0,03).

Conclusão A melhoria do status de relacionamento pode reduzir a prevalência de sintomas depressivos em pessoas transexuais. Encontrou-se uma alta taxa de tentativas de suicídio nessa amostra.

 
  • References

  • 1 Drescher J. Queer diagnoses revisited: The past and future of homosexuality and gender diagnoses in DSM and ICD. Int Rev Psychiatry 2015; 27 (05) 386-395
  • 2 American Pasychiatric Association. Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5a ed. Porto Alegre: Artes Médicas; 2014
  • 3 Giami A, Beaubatie E. Gender identification and sex reassignment surgery in the trans population: a survey study in France. Arch Sex Behav 2014; 43 (08) 1491-1501
  • 4 Meyer III WJ. Comorbidity of gender identity disorders. Am J Psychiatry 2004; 161 (05) 934-935 , author reply 935
  • 5 Selvaggi G, Bellringer J. Gender reassignment surgery: an overview. Nat Rev Urol 2011; 8 (05) 274-282
  • 6 Lobato MI, Koff WJ, Crestana T. , et al. Using the Defensive Style Questionnaire to evaluate the impact of sex reassignment surgery on defensive mechanisms in transsexual patients. Rev Bras Psiquiatr 2009; 31 (04) 303-306
  • 7 Lobato MI, Schestatsky G, Schestatsky S, Henriques AA, Ghisolfi ES, Kegel S. Transexualismo: uma revisão. J Bras Psiquiatr 2001; 50 (11/12): 379-388
  • 8 Cohen-Kettenis PT, Gooren LJ. Transsexualism: a review of etiology, diagnosis and treatment. J Psychosom Res 1999; 46 (04) 315-333
  • 9 Bazargan M, Galvan F. Perceived discrimination and depression among low-income Latina male-to-female transgender women. BMC Public Health 2012; 12: 663
  • 10 Nemoto T, Bödeker B, Iwamoto M. Social support, exposure to violence and transphobia, and correlates of depression among male-to-female transgender women with a history of sex work. Am J Public Health 2011; 101 (10) 1980-1988
  • 11 Spizzichino L, Zaccarelli M, Rezza G, Ippolito G, Antinori A, Gattari P. HIV infection among foreign transsexual sex workers in Rome: prevalence, behavior patterns, and seroconversion rates. Sex Transm Dis 2001; 28 (07) 405-411
  • 12 Newcomb ME, Heinz AJ, Mustanski B. Examining risk and protective factors for alcohol use in lesbian, gay, bisexual, and transgender youth: a longitudinal multilevel analysis. J Stud Alcohol Drugs 2012; 73 (05) 783-793
  • 13 Giami A, Le Bail J. HIV infection and STI in the trans population: a critical review. Rev Epidemiol Sante Publique 2011; 59 (04) 259-268
  • 14 Sanchez NF, Sanchez JP, Danoff A. Health care utilization, barriers to care, and hormone usage among male-to-female transgender persons in New York City. Am J Public Health 2009; 99 (04) 713-719
  • 15 De Cuypere G, T'Sjoen G, Beerten R. , et al. Sexual and physical health after sex reassignment surgery. Arch Sex Behav 2005; 34 (06) 679-690
  • 16 Derogatis LR, Meyer JK, Vazquez N. A psychological profile of the transsexual. I. The male. J Nerv Ment Dis 1978; 166 (04) 234-254
  • 17 Guzmán-Parra J, Sánchez-Álvarez N, de Diego-Otero Y. , et al. Sociodemographic characteristics and psychological adjustment among transsexuals in Spain. Arch Sex Behav 2016; 45 (03) 587-596
  • 18 Grossman AH, D'Augelli AR. Transgender youth and life-threatening behaviors. Suicide Life Threat Behav 2007; 37 (05) 527-537
  • 19 Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67 (06) 361-370
  • 20 Cox DR. The analysis of binary data. London: Methuen; 1970
  • 21 Merryfeather L. A personal epistemology: towards gender diversity. Nurs Philos 2011; 12 (02) 139-149
  • 22 van Kesteren PJ, Gooren LJ, Megens JA. An epidemiological and demographic study of transsexuals in The Netherlands. Arch Sex Behav 1996; 25 (06) 589-600
  • 23 Duisin D, Nikolić-Balkoski G, Batinić B. Sociodemographic profile of transsexual patients. Psychiatr Danub 2009; 21 (02) 220-223
  • 24 Vujovic S, Popovic S, Sbutega-Milosevic G, Djordjevic M, Gooren L. Transsexualism in Serbia: a twenty-year follow-up study. J Sex Med 2009; 6 (04) 1018-1023
  • 25 Ross B. Outdoor brothel culture: the un/making of a transsexual stroll in Vancouver's West End, 1975–1984. J Hist Sociol 2012; 25 (01) 126-150
  • 26 Brasil. Governo Federal [Internet]. Governo diz que nova classe média tem renda entre R$ 291 e R$ 1.019 familiar per capita. 2012 [cited 2015 Feb 19]. Available from: < http://www.brasil.gov.br/economia-e-emprego/2012/05/governo-diz-que-nova-classe-media-tem-renda-entre-r-291-e-r-1.019-familiar-per-capita >
  • 27 Blosnich JR, Brown GR, Shipherd Phd JC, Kauth M, Piegari RI, Bossarte RM. Prevalence of gender identity disorder and suicide risk among transgender veterans utilizing veterans health administration care. Am J Public Health 2013; 103 (10) e27-e32
  • 28 Perez-Brumer A, Hatzenbuehler ML, Oldenburg CE, Bockting W. Individual- and structural-level risk factors for suicide attempts among transgender adults. Behav Med 2015; 41 (03) 164-171
  • 29 Moody C, Smith NG. Suicide protective factors among trans adults. Arch Sex Behav 2013; 42 (05) 739-752
  • 30 Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics 2009; 123 (01) 346-352
  • 31 Heylens G, Elaut E, Kreukels BP. , et al. Psychiatric characteristics in transsexual individuals: multicentre study in four European countries. Br J Psychiatry 2014; 204 (02) 151-156
  • 32 Steiner BW, Bernstein SM. Female-to-male transsexuals and their partners. Can J Psychiatry 1981; 26 (03) 178-182
  • 33 Kraemer B, Hobi S, Rufer M, Hepp U, Büchi S, Schnyder U. [Partner relationship and sexuality of female-to-male transsexuals]. Psychother Psychosom Med Psychol 2010; 60 (01) 25-30
  • 34 Kabiru CW, Elung'ata P, Mojola SA, Beguy D. Adverse life events and delinquent behavior among Kenyan adolescents: a cross-sectional study on the protective role of parental monitoring, religiosity, and self-esteem. Child Adolesc Psychiatry Ment Health 2014; 8: 24
  • 35 Ramirez-Valles J, Garcia D, Campbell RT, Diaz RM, Heckathorn DD. HIV infection, sexual risk behavior, and substance use among Latino gay and bisexual men and transgender persons. Am J Public Health 2008; 98 (06) 1036-1042
  • 36 Díaz RM, Heckert AL, Sánchez J. Reasons for stimulant use among Latino gay men in San Francisco: a comparison between methamphetamine and cocaine users. J Urban Health 2005; 82 (01) (Suppl. 01) i71-i78
  • 37 MacDonald T, Noel-Weiss J, West D. , et al. Transmasculine individuals' experiences with lactation, chestfeeding, and gender identity: a qualitative study. BMC Pregnancy Childbirth 2016; 16: 106
  • 38 Kuper LE, Nussbaum R, Mustanski B. Exploring the diversity of gender and sexual orientation identities in an online sample of transgender individuals. J Sex Res 2012; 49 (2-3): 244-254
  • 39 Asscheman H, Giltay EJ, Megens JA, de Ronde WP, van Trotsenburg MA, Gooren LJ. A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones. Eur J Endocrinol 2011; 164 (04) 635-642
  • 40 Asscheman H, Gooren LJ, Eklund PL. Mortality and morbidity in transsexual patients with cross-gender hormone treatment. Metabolism 1989; 38 (09) 869-873
  • 41 Wierckx K, Mueller S, Weyers S. , et al. Long-term evaluation of cross-sex hormone treatment in transsexual persons. J Sex Med 2012; 9 (10) 2641-2651
  • 42 Leinung MC, Urizar MF, Patel N, Sood SC. Endocrine treatment of transsexual persons: extensive personal experience. Endocr Pract 2013; 19 (04) 644-650
  • 43 Colizzi M, Costa R, Todarello O. Transsexual patients' psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: results from a longitudinal study. Psychoneuroendocrinology 2014; 39: 65-73
  • 44 Heylens G, Verroken C, De Cock S, T'Sjoen G, De Cuypere G. Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with a gender identity disorder. J Sex Med 2014; 11 (01) 119-126
  • 45 Prado Cortez FC, Boer DP, Baltieri DA. A psychosocial study of male-to-female transgendered and male hustler sex workers in São Paulo, Brazil. Arch Sex Behav 2011; 40 (06) 1223-1231
  • 46 Costa EM, Mendonca BB. Clinical management of transsexual subjects. Arq Bras Endocrinol Metabol 2014; 58 (02) 188-196