Using the Defensive Style Questionnaire to evaluate the impact of sex reassignment surgery on defensive mechanisms in transsexual patients

Lobato, Maria Inês Rodrigues; Koff, Walter José; Crestana, Tiago; Chaves, Camila Martins; Salvador, Jaqueline; Petry, Analídia Rodolpho; Silveira, Esalba; Henriques, Alexandre Annes; Cervo, Fábio; Böhme, Eduardo Siaim; Massuda, Raffael

doi:10.1590/s1516-44462009005000007

Cited by 9 publications

(6 citation statements)

References 19 publications

(15 reference statements)

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“…In transgender people, the OR of being HIV positive was 25 in those who sold sex and used drugs, which highlighted the disproportionate risk of HIV infection in transgender people practicing these risky behaviours [22].…”

Section: Discussionmentioning

confidence: 99%

Community-Based Rapid HIV Testing in Brazil for Vulnerable Populations: Whom are We Reaching?

Barros¹,

Sabidó²,

Mir³

et al. 2017

J AIDS Clin Res

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Objective: Rapid HIV testing and counselling in community settings delivered by trained peers can allow easier access to and uptake of HIV testing and care. The programme 'Live Better Knowing' offers rapid HIV testing to key populations across Brazil. This cross-sectional study aims at describing the HIV prevalence in population subgroups and at assessing the association of sex work (SW) and/or drug use with a positive HIV result. Methods:Between January 2013 and April 2016, key populations were invited for HIV rapid oral fluid tests (DPP HIV-1/2 Bio-Manguinhos/Fiocruz, Rio de Janeiro, Brazil) by peers. HIV testing was offered in identified venues and areas where these populations socialize. Participants were interviewed using a brief questionnaire about their socio-demographic and risk behaviour. Multivariable logistic regression was used to assess the effect of SW and/or drug use on the risk of HIV.Results: Among the 43,358 participants, 42.9% were ciswomen, 2.9% were transvestites, 2.7% were transgender, 19.8% were men who have sex with men (MSM) and 31.9% were heterosexual men. Overall, 52.1% were first-time HIV testers. The HIV prevalence among the ciswomen, transvestites, transgender people, MSM and heterosexual men was 0.9%, 7.2%, 4%, 3.4% and 1%, respectively. Individuals who performed SW and used drugs had the highest HIV prevalence within each population group (ciswomen 1.7%, transvestites 8.1%, transgender 7.4%, MSM 5.9% and heterosexual men 2.6%). The adjusted odds ratios with 95% confidence intervals for selling sex combined with drug use were 2.90 (1.21-6.96) in ciswomen, 25.01 (2.67-234.57) in transgender people and 2.42 (1.31-4.48) in MSM. Conclusion:This outreach programme attracted persons with high risk practices who had never been tested. Our findings suggest that transvestites and transgender people (particularly those who sell sex) constitute a high risk population for HIV in urgent need of enhanced prevention, treatment and care services.

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Section: Discussionmentioning

confidence: 99%

Community-Based Rapid HIV Testing in Brazil for Vulnerable Populations: Whom are We Reaching?

Barros¹,

Sabidó²,

Mir³

et al. 2017

J AIDS Clin Res

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“…Despite research advances, literature on the defensive functioning of transgender people remains scarce. Lobato et al (2009), using the self-report Defense Style Questionnaire (DSQ, Bond et al, 1983), investigated defenses in a sample of 32 trans women before and after gender reassignment, finding no significant differences 1 year post-surgery. However, the study lacked a control group, and thus the maturity of the defensive array could not be measured.…”

Section: Introductionmentioning

confidence: 99%

Defensive Functioning of Individuals Diagnosed With Gender Dysphoria at the Beginning of Their Hormonal Treatment

et al. 2021

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Defense mechanisms are relevant indicators of psychological functioning and vulnerability to psychopathology. Their evaluation can unveil individuals' unconscious strategies for mediating reactions to emotional conflict and external stressors. At the beginning of their journey toward gender reassignment, individuals diagnosed with gender dysphoria (GD) may experience conflict and stressful experiences that trigger a wide range of defense mechanisms. Mature defenses may strengthen these individuals as they travel along this important path, while neurotic and immature defenses may exacerbate their body dissatisfaction (BD) and hinder their processing of change. Only a few studies have investigated self-reported defensive functioning in transgender people, finding a higher frequency of maladaptive defense mechanisms relative to controls. The present study was the first to apply an in-depth clinician-rated tool to assess the entire hierarchy of defense mechanisms within a sample of transgender people. Defensive functioning and personality organization were assessed in 36 individuals diagnosed with GD (14 trans women, 22 trans men, mean age 23.47 years), using the Defense Mechanisms Rating Scales (Perry, 1990) and the Shedler-Westen Assessment Procedure-200 (Shedler et al., 2014). Body uneasiness was assessed using the Body Uneasiness Test (BUT; Cuzzolaro et al., 2006). The findings showed that defensive functioning correlated positively with healthy personality functioning and negatively with BD. Compared to cisgender controls, participants with GD who presented greater defensive functioning were found to be more immature and to demonstrate significant differences in many levels of functioning. The clinical implications of the results suggest that psychological interventions aimed at improving defensive functioning in individuals with GD will be important in helping them manage the challenges posed by their gender transition.

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“…4,5 However, there are discrepancies in the estimates from different countries due to inconsistent diagnostic criteria, cultural differences, and limited availability of specialized services for diagnosis and treatment. 6 The etiology of GD is unknown, although some previous studies suggested a biological basis, and other studies suggested a psychological basis. 6 Gender dysphoria often manifests in childhood, and the typical feelings of incongruence seem to increase with age, mainly during adolescence, when these feelings tend to be more prominent, 7 and when subjects with GD may begin to look for medications or surgery for sex reassignment.…”

Section: Introductionmentioning

confidence: 99%

“…6 The etiology of GD is unknown, although some previous studies suggested a biological basis, and other studies suggested a psychological basis. 6 Gender dysphoria often manifests in childhood, and the typical feelings of incongruence seem to increase with age, mainly during adolescence, when these feelings tend to be more prominent, 7 and when subjects with GD may begin to look for medications or surgery for sex reassignment. 8 The lack of acceptance of one's appearance can generate intense suffering, and this suffering often declines when surgical and hormonal treatments lead to changes in appearance.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics in a Sample of Transsexual People

Lerri

Romão

Santos

et al. 2017

Rev Bras Ginecol Obstet

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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 ¼ 0.03), and it was also lower among the subjects who were married compared to those who were dating or single (p ¼ 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. ResumoObjetivo 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

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Using the Defensive Style Questionnaire to evaluate the impact of sex reassignment surgery on defensive mechanisms in transsexual patients

Cited by 9 publications

References 19 publications

Community-Based Rapid HIV Testing in Brazil for Vulnerable Populations: Whom are We Reaching?

Community-Based Rapid HIV Testing in Brazil for Vulnerable Populations: Whom are We Reaching?

Defensive Functioning of Individuals Diagnosed With Gender Dysphoria at the Beginning of Their Hormonal Treatment

Clinical Characteristics in a Sample of Transsexual People

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