School refusal by patients with gender identity disorder.
OBJECTIVE
The accumulating evidence suggests that school refusal behavior is associated with severe negative outcomes. However, previous research has not addressed school refusal by patients with gender identity disorder (GID). In this study, we tried to clarify the prevalence of school refusal among GID patients and the relationship of school refusal to demographic characteristics.


METHODS
A total of 579 consecutive Japanese GID patients at the outpatient GID Clinic of Okayama University Hospital between April 1997 and October 2005 were evaluated.


RESULTS
The prevalence of school refusal was 29.2% of the total sample. School refusal was more frequent among GID patients with divorced parents than those with intact families. Multiple logistic regression analysis showed that younger age at consultation and divorce of parents were significantly associated with school refusal among the male-to-female GID patients.


CONCLUSIONS
The rate of school refusal among GID patients is high, and school refusal is closely related with a low level of education and current unemployment. We should pay more attention to GID patients of school age to prevent their school refusal, which results in low educational achievement.
Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. terada@cc.okayama-u.ac.jp
Seishi
S
Terada
Yosuke
Y
Matsumoto
Toshiki
T
Sato
Nobuyuki
N
Okabe
Yuki
Y
Kishimoto
Yosuke
Y
Uchitomi
D000041:Absenteeism; D000328:Adult; D003625:Data Collection; D005260:Female; D005783:Gender Identity; D006801:Humans; D007407:Interviews as Topic; D007564:Japan; D016015:Logistic Models; D008297:Male; D012574:Schools; D013334:Students / Q000523:psychology*; D014189:Transsexualism; D055815:Young Adult