Gender Dysphoria and Social Anxiety: An Exploratory Study in Spain

Abstract

Introduction Social anxiety in gender dysphoria is still under investigation. Aim To determine the prevalence and associated factors of social anxiety in a sample of individuals with gender dysphoria. Methods A cross-sectional design was used in a clinical sample attending a public gender identity unit in Spain. The sample consisted of 210 individuals (48% trans female and 52% trans male). Main outcome measures Mini-International Neuropsychiatric Interview (MINI) for diagnosis of social anxiety disorder, Structured Clinical Interview, Exposure to Violence Questionnaire (EVQ), Beck Depression Inventory (BDI-II), and Functional Social Support Questionnaire (Duke-UNC-11). Results Of the total sample, 31.4% had social anxiety disorder. Social anxiety disorder was highly correlated with age (r = −0.181; CI = 0.061–0.264; P = .009) and depression (r = 0.345; CI = 0.213–0.468; P < .001); it is strongly associated to current cannabis use (relative risk [RR] = 1.251; CI = 1.070–1.463; P = .001) and lifetime suicidal ideation (RR = 1.902; CI 1.286–2.814; P < .001). Moreover, it is significantly associated to lifetime nonsuicidal self-injury (RR = 1.188; CI 1.018–1.386; P = .011), nationality (RR = 7.792; CI 1.059–57.392; P = .013), perceived violence at school during childhood and adolescence (r = 0.169; CI = 0.036–0.303; P = .014), unemployment (RR = 1.333; CI 1.02–1.742; P = .021), and hospitalization of parents in childhood (RR = 1.146; CI = 1.003–4.419; P = .046). Using multivariable analysis, the highly significant variables within the model were depression score (odds ratio [OR] = 1.083; CI = 1.045–1.123; P < .001) and current cannabis use (OR = 3.873; CI = 1.534–9.779, P = .004), also age (OR = 0.948; CI = 0.909–0.989; P = .012), hospitalization of parents during childhood (OR = 2.618; CI = 1.107–6.189; P = .028), and nationality (OR = 9.427; CI = 1.065–83.457; P = .044) were associated with social anxiety disorder. Conclusion This study highlights the necessity of implementing actions to prevent and treat social anxiety in this high-risk population.

A Review of Evidence Based Treatments for Transgender Youth Diagnosed with Social Anxiety Disorder

“…More specifically, TGNC youth have rates of social anxiety disorder that reportedly range from 9.5% to 31.4%. 2 , 5 , 23 Social anxiety disorder consists of anxiety specific to social situations where the possibility of being scrutinized by others exists and occurs in a variety of settings, including school, home, and social interactions. 3 Social anxiety disorder has a lifetime prevalence of 12.1% in the United States and can result in impaired social, academic, and work performance.…”

“…Bergero-Miguel et al found that while gender dysphoria was significantly related to social anxiety disorder, only one variable related to minority stress, perceived violence at school, was significantly related to the disorder. 2 …”

“… 1 Youth who identify as transgender and/or gender nonconforming (TGNC) might also meet criteria for gender dysphoria. 2 Gender dysphoria is a term included within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to describe the distress present in the context of incongruence between sex assigned at birth and gender identity. 2 , 3 While these terms are related, they are not interchangeable.…”

“… 2 Gender dysphoria is a term included within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to describe the distress present in the context of incongruence between sex assigned at birth and gender identity. 2 , 3 While these terms are related, they are not interchangeable. Many, but not all, TGNC people experience gender dysphoria, and not all people who experience gender dysphoria identify as TGNC.…”

The Emotional and Mental Health of a Trans Man

“…In David´s history there are many factors that may impair mental health: his parents abandoned him, he has traits of low self-esteem and negative feelings about his genitals, which he considered abnormal and ugly, and he is always worried about hiding his genital. In fact, early study showed that one third of trans people suffer from anxiety, depression and social anxiety disorder [7], as well as significantly greater general psychopathology, lower self-esteem, and experienced greater transphobia and interpersonal problems [8].…”