Psychiatric Comorbidity Among Children With Gender Identity Disorder

Wallien, Madeleine S. C.; Swaab, Hanna; Cohen‐Kettenis, Peggy T.

doi:10.1097/chi.0b013e3181373848

Cited by 136 publications

(64 citation statements)

References 12 publications

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“…Similar to previous reports on children with GID (Cohen-Kettenis et al, 2003;Wallien et al, 2007;Zucker & Bradley, 1995), university students with GD were more likely than those without to have various anxious and depressive symptoms. Furthermore, our findings lend evidence to support that young adults with GD are more likely to have symptoms of somatoform disorders (Hepp et al, 2005); specifically, symptoms of hypochondriasis were most significantly associated in both sexes and body dysmorphic disorder in females, suggesting the possibility that the presence of high bodily concerns or pathological bodily worries may be related to the dissatisfaction toward their physical/sexual appearances in young adulthood.…”

Section: Co-occurring Psychopathologysupporting

confidence: 87%

“…The role of concurrent psychopathology to GD thus warrants further investigation. Children with GID are reported to be more likely to exhibit emotional/behavioral problems, particularly internalizing symptoms (Cohen-Kettenis, Owen, Kaijser, Bradley, & Zucker, 2003;Wallien, Swaab, & Cohen-Kettenis, 2007;Zucker, 2007;Zucker & Bradley, 1995), in which separation anxiety (Sreenivasan, 1985;Zucker, Bradley, & Lowry Sullivan, 1996) figures into the ontogenesis of GID according to some investigators (Coates, 1990;Coates & Person, 1985;Zucker & Bradley, 1995). Others, however, also report externalizing behavior problems (Coolidge et al, 2002;Wallien et al, 2007).…”

Section: Introductionmentioning

confidence: 94%

“…Children with GID are reported to be more likely to exhibit emotional/behavioral problems, particularly internalizing symptoms (Cohen-Kettenis, Owen, Kaijser, Bradley, & Zucker, 2003;Wallien, Swaab, & Cohen-Kettenis, 2007;Zucker, 2007;Zucker & Bradley, 1995), in which separation anxiety (Sreenivasan, 1985;Zucker, Bradley, & Lowry Sullivan, 1996) figures into the ontogenesis of GID according to some investigators (Coates, 1990;Coates & Person, 1985;Zucker & Bradley, 1995). Others, however, also report externalizing behavior problems (Coolidge et al, 2002;Wallien et al, 2007). On the other hand, adults with GID may exhibit high rates of DSM-IV co-morbidity, including mood disorders, substance-related disorders, anxiety disorders, and somatoform disorders (Hepp, Kraemer, Schnyder, Miller, & Delsignore, 2005), and 70% of Taiwanese adults with transsexualism reported at least one other DSM-III psychiatric diagnosis, particularly anxiety disorders (Chang et al, 2006).…”

Section: Introductionmentioning

confidence: 94%

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Correlates of Gender Dysphoria in Taiwanese University Students

et al. 2009

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There have been no published reports regarding the epidemiological and psychiatric features of gender dysphoria in non-clinical young adults. The current study aimed to investigate the demographics, co-occurring psychiatric symptoms, and perceived parenting style and family support in Taiwanese young adults with gender dysphoria. The sample consisted of 5010 university freshmen (male, 51.6%) with a mean age of 19.6 years (SD = 2.7) from a national university in Taiwan. The questionnaires used for this university-based survey included the Adult Self Report Inventory-4 for psychopathology (including gender dysphoria), the Parental Bonding Instrument for parenting style, and the Family APGAR for perceived family support. Results showed that gender dysphoria was more prevalent in females (7.3%) than males (1.9%). Young adults with gender dysphoria were more likely to meet a wide but specific range of co-occurring psychiatric symptoms. The most significantly associated symptoms for males were agoraphobia, hypochondriasis, manic episode, and pathological gambling, and for females dissociative disorder, hypochondriasis, and body dysmorphic disorder. Both males and females with gender dysphoria perceived significantly less support from their families and less affection/care from both parents. Findings suggest that gender dysphoria, associated with a specific range of psychopathology and family/parenting dissatisfaction (with both similar and dissimilar patterns between sexes), is not uncommon in Taiwanese university students, particularly in females. This implies the importance of attention and specific measures to offset psychiatric conditions and to promote mental well-being of this population.

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Section: Co-occurring Psychopathologysupporting

confidence: 87%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 94%

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Correlates of Gender Dysphoria in Taiwanese University Students

et al. 2009

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“…Although clinical guidelines that restrict access to hormonal or surgical treatments may reflect a variety of implicit assumptions regarding the experience of persons who transition gender, one important basis for their development has been the finding that, although GV is not in itself evidence of medical or psychiatric pathology, neither is it protective from concurrent psychiatric illness (Cole, O'Boyle, Emory, & Meyer, 1997;Hepp, Kraemer, Schnyder,Miller,&Delsignore,2005;Kerstingetal.,2003;Wallien, Swaab, & Cohen-Kettenis, 2007). Further, notes that although some clinicians have observed that proceeding with transition planning can sometimes alleviate other Axis I related symptoms (Coleetal.,1997;Kuiper&Cohen-Kettenis,1998;Landen etal., 1998;Olsson &Moller, 2003;Pfäfflin &Junge,1998), others have reported lower likelihood of good long-term outcome (e.g., poor adjustment or regret) when concurrent disorders are present.…”

Section: Mental Health Evaluation Options Prior To Hormonal Therapymentioning

confidence: 93%

Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder

et al. 2012

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Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA. The literature on treatment of gender dysphoria in individuals with disorders of sex development was also assessed. The completed report was accepted by the BOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as the primary outcome measure, current evidence was judged sufficient to support recommendations for adults in the form of an evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variant minors, and the rights of persons of any age who are gender variant, transgender or transsexual.

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“…Reducing psychiatric morbidity will definitely help reducing peer and social ostracism. 9,10,13 There are strong indicators of increased suicidality among people with GID and presence of depressive symptoms should be alarming and efforts should be made to address the suicide risk and behaviour at utmost priority. 14 The issue of homosexuality in the transgender individuals of course complicate the situation.…”

Section: Disscusionmentioning

confidence: 99%