title: Mental health and gender dysphoria: A review of the literature.
abstract: Studies investigating the prevalence of psychiatric disorders among trans individuals have identified elevated rates of psychopathology. Research has also provided conflicting psychiatric outcomes following gender-confirming medical interventions. This review identifies 38 cross-sectional and longitudinal studies describing prevalence rates of psychiatric disorders and psychiatric outcomes, pre- and post-gender-confirming medical interventions, for people with gender dysphoria. It indicates that, although the levels of psychopathology and psychiatric disorders in trans people attending services at the time of assessment are higher than in the cis population, they do improve following gender-confirming medical intervention, in many cases reaching normative values. The main Axis I psychiatric disorders were found to be depression and anxiety disorder. Other major psychiatric disorders, such as schizophrenia and bipolar disorder, were rare and were no more prevalent than in the general population. There was conflicting evidence regarding gender differences: some studies found higher psychopathology in trans women, while others found no differences between gender groups. Although many studies were methodologically weak, and included people at different stages of transition within the same cohort of patients, overall this review indicates that trans people attending transgender health-care services appear to have a higher risk of psychiatric morbidity (that improves following treatment), and thus confirms the vulnerability of this population.
authors.affiliation: a Gender Team, Centre for Andrology and Sexual Medicine and Centre for Psychiatry Research, Department of Clinical Neuroscience , Karolinska Institute and University Hospital , Stockholm , Sweden ;
authors.forename: Cecilia
authors.initials: C
authors.lastname: Dhejne
authors.affiliation: b Centre of Expertise on Gender Dysphoria, VU University Medical Centre , Amsterdam , Netherlands ;
authors.forename: Roy
authors.initials: R
authors.lastname: Van Vlerken
authors.affiliation: c Centre for Sexology and Gender, University Hospital , Ghent , Belgium ;
authors.forename: Gunter
authors.initials: G
authors.lastname: Heylens
authors.affiliation: d Nottingham Centre for Gender Dysphoria , Nottingham , UK ;|e Division of Psychiatry and Applied Psychology , Faculty of Medicine & Health Sciences, University of Nottingham , Nottingham , UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Arcelus
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D000068116:Gender Dysphoria / Q000150:complications / Q000523:psychology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D011599:Psychopathology; D063106:Transgender Persons / Q000523:psychology
keywords: Gender dysphoria; anxiety; depression; mental health; psychiatric disorders; transsexualism