Gender Dysphoria and Social Anxiety: An Exploratory Study in Spain.
Social anxiety in gender dysphoria is still under investigation.



To determine the prevalence and associated factors of social anxiety in a sample of individuals with gender dysphoria.



A cross-sectional design was used in a clinical sample attending a public gender identity unit in Spain. The sample consisted of 210 individuals (48% trans female and 52% trans male).



Mini-International Neuropsychiatric Interview (MINI) for diagnosis of social anxiety disorder, Structured Clinical Interview, Exposure to Violence Questionnaire (EVQ), Beck Depression Inventory (BDI-II), and Functional Social Support Questionnaire (Duke-UNC-11).



Of the total sample, 31.4% had social anxiety disorder. Social anxiety disorder was highly correlated with age (r = -0.181; CI = 0.061-0.264; P = .009) and depression (r = 0.345; CI = 0.213-0.468; P < .001); it is strongly associated to current cannabis use (relative risk [RR] = 1.251; CI = 1.070-1.463; P = .001) and lifetime suicidal ideation (RR = 1.902; CI 1.286-2.814; P < .001). Moreover, it is significantly associated to lifetime nonsuicidal self-injury (RR = 1.188; CI 1.018-1.386; P = .011), nationality (RR = 7.792; CI 1.059-57.392; P = .013), perceived violence at school during childhood and adolescence (r = 0.169; CI = 0.036-0.303; P = .014), unemployment (RR = 1.333; CI 1.02-1.742; P = .021), and hospitalization of parents in childhood (RR = 1.146; CI = 1.003-4.419; P = .046). Using multivariable analysis, the highly significant variables within the model were depression score (odds ratio [OR] = 1.083; CI = 1.045-1.123; P < .001) and current cannabis use (OR = 3.873; CI = 1.534-9.779, P = .004), also age (OR = 0.948; CI = 0.909-0.989; P = .012), hospitalization of parents during childhood (OR = 2.618; CI = 1.107-6.189; P = .028), and nationality (OR = 9.427; CI = 1.065-83.457; P = .044) were associated with social anxiety disorder.



This study highlights the necessity of implementing actions to prevent and treat social anxiety in this high-risk population.
Mental Health Clinical Unit, University Regional Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain; Transsexual and Gender Identity Unit, University Regional Hospital of Málaga, Málaga, Spain.
Trinidad
T
Bergero-Miguel
Mental Health Clinical Unit, University Regional Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain; Faculty of Psychology, University of Málaga, Málaga, Spain.
María A
MA
García-Encinas
Mental Health Clinical Unit, University Regional Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain; Faculty of Psychology, University of Málaga, Málaga, Spain.
Amelia
A
Villena-Jimena
Mental Health Clinical Unit, University Regional Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain; Grupo de Investigación en Salud Mental (INTRAM) (PAIDI CTS456), Málaga, Spain; Department of Public, Health and Psychiatry, Faculty of Medicine, University of Malaga, Spain.
Lucía
L
Pérez-Costillas
Mental Health Clinical Unit, University Regional Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain; Faculty of Psychology, University of Málaga, Málaga, Spain.
Nicolás
N
Sánchez-Álvarez
Mental Health Clinical Unit, University Regional Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain; Grupo de Investigación en Salud Mental (INTRAM) (PAIDI CTS456), Málaga, Spain. Electronic address: yolanda.dediego@ibima.eu.
Yolanda
Y
de Diego-Otero
Mental Health Clinical Unit, University Regional Hospital of Málaga, Biomedical Research Institute of Malaga (IBIMA), Málaga, Spain; Faculty of Psychology, University of Málaga, Málaga, Spain; Grupo Andaluz de Investigación Psicosocial (GAP) (CTS945), Málaga, Spain.
Jose
J
Guzman-Parra
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology; D019548:Crime Victims / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D003866:Depressive Disorder / Q000523:psychology; D000069581:Exposure to Violence / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D000068116:Gender Dysphoria / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D000072861:Phobia, Social / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016728:Self-Injurious Behavior / Q000523:psychology; D013030:Spain; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D014189:Transsexualism / Q000523:psychology*
Social Anxiety; Social Phobia; Transgender; Transsexuals; Victimization