Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists

Abstract

Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however, medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinically competent, and culturally attuned care to gender-variant patients, including those who identify as transgender or transsexual or meet criteria for the diagnosis of Gender Dysphoria (GD) as defined by The Diagnostic and Statistical Manual of Mental Disorders (5th edition). The article will also be helpful for other mental health professionals. The following areas are addressed: evolution of diagnostic nosology, epidemiology, gender development, and mental health assessment, differential diagnosis, treatment, and referral for gender-affirming somatic treatments of adults with GD.

Understanding the Lived Experiences of Transitioning Adults with Gender Dysphoria in the United Kingdom: An Interpretative Phenomenological Analysis

“…The transgender community often experience stigmatization, prejudice and discrimination in both social and medical environments, such as in school and the workplace as a result of their gender non-conformity (Byne et al, 2018). For example, Jaffee, Shires and Stroumsa (2016) found that 30.8% of transgender clients had faced discrimination in healthcare services, which resulted in delaying or refusing to seek needed medical care.…”

Readiness assessments for gender-affirming surgical treatments: A systematic scoping review of historical practices and changing ethical considerations

“…Many authors describe the process of informed consent for GAC (1,58,60,(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76). In China, a signature indicating informed consent from the patient's family is required in addition to that of the patient (60).…”

“…Many authors emphasize evaluating for and addressing social determinants of health including housing status, income, transportation, trauma history, etc. ( 1 , 58 , 60 , 67 , 69 – 71 , 75 – 77 ). Deutsch advocated for the psychosocial evaluation being the most important aspect of the evaluation and suggests that one of the letters required for bottom surgery be replaced by a functional assessment (i.e., ADLs/iADLs), which could be repeated as needed or removed entirely for high functioning patients ( 69 ).…”