Questions and Answers
Counselling and psychotherapy should prioritize goals for an individual's gender identity to align with the sex assigned at birth.
False
All individuals with gender dysphoria are required to live in their new gender role for a period of 2 years before surgery.
False
Hormone therapy is deemed ineffective in improving the quality of life for adults with gender dysphoria.
False
Follow-up studies suggest that outcomes after sex reassignment surgery are generally unfavorable.
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Individuals with gender dysphoria who are non-homosexual relative to their natal sex tend to function more satisfactorily after surgery.
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A meta-analysis indicated that 86% of females-to-males reported improvement in quality of life post-treatment.
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The early-onset form of gender dysphoria is typically associated with later heterosexual orientation.
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In both biological males and females, late-onset gender dysphoria is usually linked to homosexual orientation.
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Boys are diagnosed with gender dysphoria more frequently than girls.
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Adults undergoing hormone therapy typically do not show any improvement in quality of life when additionally undergoing sex reassignment surgery.
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The prevalence of transsexualism in adult males is reported to be 1:10,000.
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Sexual masochism disorder specifically involves the experience of suffering or humiliation for achieving sexual excitement.
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Comorbid psychopathology is significantly less prevalent in adults with gender dysphoria than in the general population.
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39% of monozygotic twins with gender dysphoria were concordant for the condition.
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The prevalence of sexual masochism disorder is relatively low in women compared to men.
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Gender dysphoria is associated with a positive congruence between one's experienced gender and assigned gender.
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Mood and anxiety disorders are the most common associated psychopathologies in gender dysphoria.
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The term 'gender identity disorder' has been replaced by 'gender dysphoria' in the DSM-5 to better reflect emotional distress.
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Individuals with gender dysphoria are more likely to die from suicide than the general population.
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All dizygotic twins with gender dysphoria are concordant for the condition.
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Gender dysphoria management typically requires a multidisciplinary approach including endocrine and psychological input.
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Psychosocial processes can cause gender identity to become more fluid in children and adults.
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Non-binary individuals identify strictly with male or female gender roles.
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The treatment efficacy for sexual masochism disorder has been well-documented and is widely agreed upon in the medical community.
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The Standards of Care for the Health of Transsexual, Transgender and Gender-Nonconforming People is Version 6.
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Transgender individuals can have various sexual orientations, including heterosexual, homosexual, and asexual.
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Individuals who have undergone sex reassignment surgery have a lower risk of hospitalization for psychiatric problems compared to controls.
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The classification of individuals with gender dysphoria within a psychopathological model is universally accepted.
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Prenatal sex hormones have no influence on feelings of gender incongruence.
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Subtypes of gender dysphoria are determined solely by sexual orientation.
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Study Notes
Prevalence
- Approximately 0.5% of the population identifies as transgender.
- In Sweden, the ratio for legal name change applications is 1:7,750 for adult males and 1:13,000 for females.
- In Ireland, 1:10,000 adult males and 1:28,000 females are referred for hormonal treatment.
- A meta-analysis indicates a transsexualism prevalence of 1:15,000 in males and 1:38,000 in females.
Associated Psychopathology
- Adults with gender dysphoria have higher comorbidity rates of mood and anxiety disorders compared to the general population.
- A study of 300 individuals post-sex reassignment surgery revealed 19% of males-to-females and 17% of females-to-males were hospitalized for psychiatric reasons other than gender dysphoria before the surgery.
- Post-surgery, the risk of psychiatric hospitalization remained over double compared to controls.
- Individuals with gender dysphoria are 4.9 times more likely to attempt suicide and 19 times more likely to die by suicide.
- In a European study, 38% of individuals had a current Axis I disorder and 69% had a lifetime Axis I disorder, primarily mood and anxiety disorders.
Aetiology
- Gender dysphoria’s causes include a combination of genetic, hormonal, brain structure, and psychosocial factors.
- Genetic Factors: Family and twin studies suggest a genetic component; 39% of monozygotic twins showed concordance for gender dysphoria, while none of the dizygotic twins did.
- Prenatal Hormones: Atypical sexual differentiation of the brain due to prenatal hormone exposure may lead to gender incongruence.
- Brain Structure: Studies indicate homosexual male-to-females demonstrate dissimilarities in brain grey matter volume, cortical thickness, and white matter microstructure compared to their natal sex. Non-homosexual male-to-females show less clear results.
- Psychosocial Factors: Gender identity can exhibit fluidity; clinical populations may show reduced cross-gender behavior over time, especially without social transition prior to puberty.
Treatment
- Treatment protocols for adults with gender dysphoria have been standardized in high-income countries, influenced by clinical guidelines such as the Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People.
- Multidisciplinary management includes endocrine, surgical, and psychological support, with an emphasis on alleviating emotional distress rather than enforcing alignment with assigned gender.
- Individuals with gender dysphoria generally undertake a "real life experience" for a year in their new gender role before surgery, though this requirement faces criticism regarding its psychosocial risks.
Hormonal Therapy
- Hormone therapy is an effective treatment option, with significant quality of life improvements linked to concomitant sex reassignment surgery.
- Males-to-females undergo testosterone suppression while females-to-males receive androgen therapy, leading to various physical changes, including deeper voice and increased facial hair in males-to-females.
Gender-Confirming Surgery
- Surgical options include mammoplasty and orchidectomy for male-to-female procedures, and mastectomy and phalloplasty for female-to-male procedures.
- Follow-up studies post-surgery generally report favorable outcomes, but a meta-analysis reveals 86% of females-to-males and 71% of males-to-females report quality of life improvement, albeit with notable minority dissatisfaction.
Gender Identity Disorders in Children
- Children with gender dysphoria often demonstrate behaviors aligning with the opposite sex, with both early-onset (typically from ages 2-4) and later-onset forms.
- Early-onset forms are associated with later homosexual orientations, whereas late-onset forms tend to be non-homosexual.
- Referral rates for gender dysphoria are higher in boys compared to girls.
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Description
This quiz explores the prevalence of gender dysphoria and its associated psychopathology. It examines statistics related to transgender identity and the rates of those seeking medical intervention. Test your knowledge on the significance of these findings in understanding gender dysphoria.
