Audit as discovery: context and complexity in secondary-to-primary care mental health service users

Firth, Miriam; Powling, Laura; Witter, Martina

doi:10.1080/02650533.2010.514134

Cited by 1 publication

(1 citation statement)

References 18 publications

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“…However, the usual processes of anonymisation were felt to be inadequate to prevent identification, therefore the examples themselves are amalgams of different actual cases, altered and blended to provide verisimilitude without over‐embellishment. (See also Firth, 2012; Firth, Powling, & Witter, 2012). Clients are referred to by their preferred names and pronouns.…”

Section: Case Examplesmentioning

confidence: 99%

Childhood abuse and depressive vulnerability in clients with gender dysphoria

Firth

2013

Couns and Psychother Res

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Background: The recent reclassification of gender identity disorder as gender dysphoria (GD) in DSM-5 identifies those seeking to pursue gender transition via specialist services as necessarily 'distressed' and therefore mentally disordered. Distress in gender variant clients may arise from a variety of stressors, external and intra-psychic, many of which may have their roots in childhood experience [E. Bandini et al. (2011)]. Aims: (1) to review current thinking on gender variance and recognition and classification of GD (2) to detail the contribution of childhood adversity to distress in gender variant clients from an audit of 50 such clients (33 assigned/natal males and 17 assigned/natal females) of a mainstream NHS psychosexual service. Methods: Current issues in classification and diagnosis of GD, and debate on the aetiology of gender variance, are reviewed briefly. Audit findings on health, treatment issues and support, and thematic analysis of childhood experiences, provide the basis for a case example of a post-transition client experiencing some common difficulties associated with GD and childhood adversity. Conclusions: Pragmatism of diagnosis and treatment of GD contrasts with the variety of theories of causation of gender variance itself. 'Distress' as a precondition of treatment may reflect childhood experience as much as GD-specific symptoms, and may contribute more to persistent psychological vulnerability. While educational programmes in schools and a better knowledge base in counselling and related training curricula are indicated, gender dysphoric clients, pre-and post-transition, experience common life problems for which generic forms of counselling and therapy are appropriate.

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Section: Case Examplesmentioning

confidence: 99%

Childhood abuse and depressive vulnerability in clients with gender dysphoria

Firth

2013

Couns and Psychother Res

View full text Add to dashboard Cite

show abstract

Audit as discovery: context and complexity in secondary-to-primary care mental health service users

Cited by 1 publication

References 18 publications

Childhood abuse and depressive vulnerability in clients with gender dysphoria

Childhood abuse and depressive vulnerability in clients with gender dysphoria

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