title: Body Satisfaction and Physical Appearance in Gender Dysphoria.
abstract: Gender dysphoria (GD) is often accompanied by dissatisfaction with physical appearance and body image problems. The aim of this study was to compare body satisfaction with perceived appearance by others in various GD subgroups. Data collection was part of the European Network for the Investigation of Gender Incongruence. Between 2007 and 2012, 660 adults who fulfilled the criteria of the DSM-IV gender identity disorder diagnosis (1.31:1 male-to-female [MtF]:female-to-male [FtM] ratio) were included into the study. Data were collected before the start of clinical gender-confirming interventions. Sexual orientation was measured via a semi-structured interview whereas onset age was based on clinician report. Body satisfaction was assessed using the Body Image Scale. Congruence of appearance with the experienced gender was measured by means of a clinician rating. Overall, FtMs had a more positive body image than MtFs. Besides genital dissatisfaction, problem areas for MtFs included posture, face, and hair, whereas FtMs were mainly dissatisfied with hip and chest regions. Clinicians evaluated the physical appearance to be more congruent with the experienced gender in FtMs than in MtFs. Within the MtF group, those with early onset GD and an androphilic sexual orientation had appearances more in line with their gender identity. In conclusion, body image problems in GD go beyond sex characteristics only. An incongruent physical appearance may result in more difficult psychological adaptation and in more exposure to discrimination and stigmatization.
authors.affiliation: Department of Medical Psychology, Center of Expertise on Gender Dysphoria, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. t.vandegrift@vumc.nl.|Department of Plastic, Reconstructive & Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands. t.vandegrift@vumc.nl.
authors.forename: Tim C
authors.initials: TC
authors.lastname: van de Grift
authors.affiliation: Department of Medical Psychology, Center of Expertise on Gender Dysphoria, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Peggy T
authors.initials: PT
authors.lastname: Cohen-Kettenis
authors.affiliation: Department of Medical Psychology, Center of Expertise on Gender Dysphoria, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Steensma
authors.affiliation: Center of Sexology and Gender Problems, Ghent University Hospital, Ghent, Belgium.
authors.forename: Griet
authors.initials: G
authors.lastname: De Cuypere
authors.affiliation: Department of Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hertha
authors.initials: H
authors.lastname: Richter-Appelt
authors.affiliation: Department of Neuropsychiatry and Psychosomatic Medicine, Division of Clinical Neuroscience, Rikshospitalet, Oslo, Norway.
authors.forename: Ira R H
authors.initials: IR
authors.lastname: Haraldsen
authors.affiliation: Department of Plastic, Reconstructive & Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Rieky E G
authors.initials: RE
authors.lastname: Dikmans
authors.affiliation: Department of Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Susanne C
authors.initials: SC
authors.lastname: Cerwenka
authors.affiliation: Department of Medical Psychology, Center of Expertise on Gender Dysphoria, EMGO Institute for Health and Care Research, VU University Medical Center, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
authors.forename: Baudewijntje P C
authors.initials: BP
authors.lastname: Kreukels
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D000068116:Gender Dysphoria / Q000523:psychology*; D005783:Gender Identity; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D000067029:Physical Appearance, Body; D012727:Sex Characteristics; D012725:Sexual Behavior / Q000523:psychology; D014189:Transsexualism / Q000523:psychology
keywords: Appearance; Body image; Gender dysphoria; Sexual orientation