Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria

Soll, Bianca Machado Borba; Robles-García, Rebeca; Costa, Ângelo Brandelli; Mori, D.; Mueller, Andressa; Vaitses-Fontanari, Anna M.; Silva, Dhiordan Cardoso da; Schwarz, Karine; Abel-Schneider, Maiko; Saadeh, Alexandre; Lobato, Maria Inês Rodrigues

doi:10.1590/1516-4446-2016-2224

Cited by 13 publications

(11 citation statements)

References 20 publications

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“…For this interview, a questionnaire used in the Brazilian field study for the ICD-11 (WHO) was applied, which overlapped the diagnostic criteria for GI (ICD-11-2018) with the diagnostic criteria of DG (DSM-5-2013) ( 26 , 29 , 30 ). The survey instrument, based on participants' reports, evaluated a particular period of time, that is, when they first became consciously aware that they might be trans (incongruence between one's experienced gender and assigned sex).…”

Section: Methodsmentioning

confidence: 99%

“…Even though there is a regulation of health services, there are many social barriers to this population for accessing these health-care services. Specialized health services remain extremely limited, and the wait for access to the health system in Brazil is long: 9 years on average ( 26 ). Therefore, it is very important for people to have access to health services and vulnerability prevention.…”

Section: Introductionmentioning

confidence: 99%

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Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil

et al. 2021

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Since 2014, the Gender Identity Program (PROTIG) of Hospital de Clínicas de Porto Alegre (HCPA) has been assisting transgender youth seeking gender-affirmative treatment offered at a public health-care service specializing in gender in southern Brazil. This article aims to analyze sociodemographic and clinical data regarding the diagnoses of gender dysphoria and gender incongruence, psychiatric comorbidities, and clinical aspects of a sample of transgender youths seeking health care in the gender identity program. The research protocol consisted of a survey of the data collected in the global psychological evaluation performed at the health-care service for youths diagnosed with gender incongruence and their caretakers. Participating in this research were 24 transgender youths between 8 and 16 years old with diagnostic overlap of gender dysphoria [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)] and gender incongruence [International Classification of Diseases, 11th Revision (ICD-11)] and 34 of their caregivers. Of the young people, 45.8% were positive for some psychiatric comorbidity throughout their lives, with almost half (45.4%) having two or more psychiatric comorbidities in addition to gender dysphoria. The mental health professionals comprising affirmation care teams face the challenge of adapting the care protocols to the uniqueness of each demand by developing individualized forms to promote healthy development. This can be done by focusing not only on medical and physical interventions for gender affirmation but also on the promotion of mental health and general emotional well-being. Thus, the gender affirmation model, which advocates for global assessment and personalized guidance, proved to be adequate. Nevertheless, access to multidisciplinary health services specializing in gender is essential for promoting the general well-being of the population of transgender youth.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil

et al. 2021

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“…Another study done in the Brazilian transgender persons seeking health services gender specifically also had a similar indicator. Most people with gender incongruence who reported taking a leave of absence from their work stated that it was due to social stigma and prejudice (Soll et al, 2018). This is important because it indicates that the impact on the impairment of social functions may be more related to social context than to dysphoria.…”

Section: Discussionmentioning

confidence: 99%

“…The structured interview used in the study was the same one used in the Mexican study (Robles et al, 2016) but translated, cultural adapted, and applied to the Brazilian population (Soll et al, 2018; Lobato et al, 2019). For this study, three categories were considered: diagnostic criteria, psychological distress, and loss in social functioning.…”

Section: Methodsmentioning

confidence: 99%

Use of the House-Tree-Person Projective Drawings and Parental Styles Inventory in the Global Psychological Evaluation of Transgender Youth Who Seek Healthcare at the Gender Identity Program

et al. 2019

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The present study explores data collected in the psychological evaluation of transgender youth and their families who seek healthcare at the Gender Identity Program. Great psychosocial changes mark the transition from infancy to adulthood. Transgender youth may have these aspects of their developmental stage potentialized. A study was conducted with 23 transgender youth (mean age = 14 ± 2.38 years) and their caregivers. Eleven of the youngsters were assigned male at birth, while 12 were assigned female. The research protocol consisted of a survey and systematization of the data collected in the initial global psychological evaluation performed at the healthcare facility, including house-tree-person (HTP) projective drawings and the parental styles inventory. The present study aimed to explore the data collected during the psychological evaluation of youngsters diagnosed with gender incongruence, relating the HTP projective drawing technique to parental styles and gender trajectories. The results indicate two key points. One evidenced that parental styles could be either preventive or risk components in maintaining adequate socialization in these young people but not in affecting the level of gender dysphoria. The other was that coherence is introduced in the person’s perception of his or her projected self-image and his or her expressed gender as he/she becomes more comfortable in expressing his/her gender identity. Treating youngsters inherently brings ethical issues to clinical practice. Thus, global psychological evaluation tailored to this population is a fundamental resource that the psychology professional can use in consultations with youngsters because this tool brings a global understanding about the natural development cycle, facilitating the formulation of therapeutic conducts and exchanges within interdisciplinary transgender health care teams.

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“…An 11-year-old individual, designated a boy at birth, was referred to the Gender Identity Program (PROTIG). The patient fit the criteria for male-to-female (MtF) GD (DSM-5) and gender incongruence (ICD-11 inventory) (Robles et al, 2016 ), which was translated and adapted for the Brazilian population (Soll et al, 2017 ). At admission, current psychosis, mood disorders, anxiety and global development disorders were excluded.…”

Section: Introductionmentioning

confidence: 99%

Brain Maturation, Cognition and Voice Pattern in a Gender Dysphoria Case under Pubertal Suppression

Schneider

Spritzer

Soll

et al. 2017

Front. Hum. Neurosci.

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Introduction: Gender dysphoria (GD) (DMS-5) is a condition marked by increasing psychological suffering that accompanies the incongruence between one's experienced or expressed gender and one's assigned gender. Manifestation of GD can be seen early on during childhood and adolescence. During this period, the development of undesirable sexual characteristics marks an acute suffering of being opposite to the sex of birth. Pubertal suppression with gonadotropin releasing hormone analogs (GnRHa) has been proposed for these individuals as a reversible treatment for postponing the pubertal development and attenuating psychological suffering. Recently, increased interest has been observed on the impact of this treatment on brain maturation, cognition and psychological performance.Objectives: The aim of this clinical report is to review the effects of puberty suppression on the brain white matter (WM) during adolescence. WM Fractional anisotropy, voice and cognitive functions were assessed before and during the treatment. MRI scans were acquired before, and after 22 and 28 months of hormonal suppression.Methods: We performed a longitudinal evaluation of a pubertal transgender girl undergoing hormonal treatment with GnRH analog. Three longitudinal magnetic resonance imaging (MRI) scans were performed for diffusion tensor imaging (DTI), regarding Fractional Anisotropy (FA) for regions of interest analysis. In parallel, voice samples for acoustic analysis as well as executive functioning with the Wechsler Intelligence Scale (WISC-IV) were performed.Results: During the follow-up, white matter fractional anisotropy did not increase, compared to normal male puberty effects on the brain. After 22 months of pubertal suppression, operational memory dropped 9 points and remained stable after 28 months of follow-up. The fundamental frequency of voice varied during the first year; however, it remained in the female range.Conclusion: Brain white matter fractional anisotropy remained unchanged in the GD girl during pubertal suppression with GnRHa for 28 months, which may be related to the reduced serum testosterone levels and/or to the patient's baseline low average cognitive performance.Global performance on the Weschler scale was slightly lower during pubertal suppression compared to baseline, predominantly due to a reduction in operational memory. Either a baseline of low average cognition or the hormonal status could play a role in cognitive performance during pubertal suppression. The voice pattern during the follow-up seemed to reflect testosterone levels under suppression by GnRHa treatment.

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Gender incongruence: a comparative study using ICD-10 and DSM-5 diagnostic criteria

Cited by 13 publications

References 20 publications

Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil

Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil

Use of the House-Tree-Person Projective Drawings and Parental Styles Inventory in the Global Psychological Evaluation of Transgender Youth Who Seek Healthcare at the Gender Identity Program

Brain Maturation, Cognition and Voice Pattern in a Gender Dysphoria Case under Pubertal Suppression

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