Gender identity disorder and eating disorders: similarities and differences in terms of body uneasiness.
BACKGROUND
Subjects with gender identity disorder (GID) have been reported to be highly dissatisfied with their body, and it has been suggested that the body is their primary source of suffering. AIMS.: To evaluate quality and intensity of body uneasiness in GID subjects, comparing them with a sample of eating disorder patients and a control group. To detect similarities and differences between subgroups of GID subjects, on the basis of genotypic sex and transitional stage.


METHODS
Fifty male-to-female (MtF) GID (25 without and 25 with genital reassignment surgery performed), 50 female-to-male (FtM) GID (28 without and 22 with genital reassignment surgery performed), 88 eating disorder subjects (26 anorexia nervosa, 26 bulimia nervosa, and 36 binge eating disorder), and 107 healthy subjects were evaluated.


METHODS
Subjects were studied by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the Symptom Checklist (SCL-90), and the Body Uneasiness Test (BUT).


RESULTS
GID and controls reported lower psychiatric comorbidity and lower SCL-90 General Severity Index (GSI) scores than eating disorder subjects. GID MtF without genital reassignment surgery showed the highest BUT values, whereas GID FtM without genital reassignment surgery and eating disorder subjects showed higher values compared with both GID MtF and FtM who underwent genital reassignment surgery and controls. Considering BUT subscales, a different pattern of body uneasiness was observed in GID and eating disorder subjects. GID MtF and FtM without genital reassignment surgery showed the highest BUT GSI/SCL-90 GSI ratio compared with all the eating disorder groups.


CONCLUSIONS
GID and eating disorders are characterized by a severe body uneasiness, which represents the core of distress in both conditions. Different dimensions of body uneasiness seem to be involved in GID subsamples, depending on reassignment stage and genotypic sex. In eating disorder subjects body uneasiness is primarily linked to general psychopathology, whereas in GID such a relationship is lacking.
Andrology Unit, Department of Clinical Physiopathology, Florence University School of Medicine, Largo Brambilla 3, Florence, Italy.
Elisa
E
Bandini
Alessandra Daphne
AD
Fisher
Giovanni
G
Castellini
Carolina
C
Lo Sauro
Lorenzo
L
Lelli
Maria Cristina
MC
Meriggiola
Helen
H
Casale
Laura
L
Benni
Naika
N
Ferruccio
Carlo
C
Faravelli
Davide
D
Dettore
Mario
M
Maggi
Valdo
V
Ricca
D000328:Adult; D000704:Analysis of Variance; D001828:Body Image / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D001068:Feeding and Eating Disorders / Q000150:complications / Q000523:psychology*; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications; D057829:Gender-Affirming Procedures; D014189:Transsexualism / Q000523:psychology*