Psychosocial and Psychological Vulnerability in Adolescents with Gender Dysphoria: A "Proof of Principle" Study.
For adolescents with gender dysphoria, it has become common to be offered hormonal treatment to either delay or suppress pubertal development and/or to masculinize or feminize the body. At the same time, it has been our clinical impression that the psychological vulnerability of at least some of these youth has been overlooked. Fifty consecutive referrals of adolescents with a DSM-IV-TR diagnosis of gender identity disorder (GID) constituted the sample. Information obtained at intake was coded for the presence or absence of 15 psychosocial and psychological vulnerability factors. The mean number of psychosocial/psychological vulnerability factors coded as present was 5.56 (range, 0-13). Over half of the sample had six or more of the vulnerability factors. The number of factors coded as present was significantly correlated with behavioral and emotional problems on the Youth Self-Report Form and the Child Behavior Checklist, but not with demographic variables or IQ. The findings supported the clinical impression that a large percentage of adolescents referred for gender dysphoria have a substantial co-occurring history of psychosocial and psychological vulnerability, thus supporting a "proof of principle" for the importance of a comprehensive psychologic/psychiatric assessment that goes beyond an evaluation of gender dysphoria per se.
a Department of Medicine , University of Toronto , Toronto , Ontario , Canada.
Melanie
M
Bechard
b Department of Psychology , University of Toronto Mississauga , Mississauga , Ontario , Canada.|c Child, Youth, and Family Program, Underserved Populations Research Program , Centre for Addiction and Mental Health , Toronto , Ontario , Canada.
Doug P
DP
VanderLaan
d Gender Identity Service, Child, Youth, and Family Program , Centre for Addiction and Mental Health , Toronto , Ontario , Canada.
Hayley
H
Wood
d Gender Identity Service, Child, Youth, and Family Program , Centre for Addiction and Mental Health , Toronto , Ontario , Canada.|e Reproductive Life Stages Program , Women's College Hospital , Toronto , Ontario , Canada.
Lori
L
Wasserman
d Gender Identity Service, Child, Youth, and Family Program , Centre for Addiction and Mental Health , Toronto , Ontario , Canada.|f Department of Psychiatry , University of Toronto , Toronto , Ontario , Canada.
Kenneth J
KJ
Zucker
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D005260:Female; D000068116:Gender Dysphoria / Q000188:drug therapy / Q000523:psychology*; D005783:Gender Identity; D007987:Gonadotropin-Releasing Hormone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010379:Peer Group; D012741:Sexual Maturation / Q000502:physiology*
D007987:Gonadotropin-Releasing Hormone