際際滷

際際滷Share a Scribd company logo

Gender dysphoria

Download as PPTX, PDF
Aratrika Sen
Aratrika Sen

This document discusses gender dysphoria and transgender identities. It defines key terms like gender dysphoria, transgender, transsexual, genderqueer, and cross-dresser. Prevalence of gender dysphoria is unknown due to stigma and methodological challenges but studies estimate rates between 0.005-0.014% for those assigned male and 0.002-0.003% for those assigned female. Biological and psycho-social factors may influence gender identity development. Treatment involves developing social skills for children, slowing puberty and implementing cross-sex hormones for adolescents, and hormone therapy and possible sexual reassignment surgery for adults.

1 of 19
Download to read offline
GENDER DYSPHORIA DR. RANJAN BHATTACHARYA DR. TAMOGHNA BANDYOPADHYAY DR. ARATRIKA SEN
Introduction: 1ST COINED BY ROBERT STOLLER PREVIOUSLY CALLED GENDER IDENTITY DISORDER {DSM-IV} REFERS TO PERSONS WITH A MARKED INCONGRUENCE BETWEEN THEIR EXPERIENCED OR EXPRESSED GENDER AND THE ONE THEY WERE ASSIGNED AT BIRTH.
TRANSGENDE R Used to refer to those who identify with a gender different from the one they were born with. Can be of many types: Transsexuals Genderqueer Cross-dressers
TRANSSEXUA L INCONSISTENT WITH ASSIGNED SEX DESIRE FOR PERMANENT CHANGE SEEKING MEDICAL ASSISTANCE
GENDERQUEE R NO EXCLUSIVE GENDER IDENTITY BIGENDER TRIGENDER AGENDER DEMIGENDER GENDERFLUID
CROSS DRESSER WEARING DRESS OF OPPOSITE SEX NOT ALWAYS TRANSGENDER PREVIOUSLY CALLED TRANSVESTISM
Prevalence: Unknown for a variety of reasons: Concealment of these identities due to stigma Methodological problems in defining the populations of interest and designing adequate sampling strategies. Most such prevalence studies show prevalence rate ranging from 0.005 to 0.014 in male-assigned and 0.002 to0. 003 in female-assigned
Contd. In children, sex ratio of children referred for gender dysphoria is 4-5 boys for each girl, hypothesized as social stigma towards feminine boys.
ETIOLOGY BIOLOGICAL Resting state of tissue in mammals is initially female, as the fetus develops, a male is produced only if androgen is introduced. Maleness depends on fetal and perinatal androgens PSYCHO-SOCIAL Formation of gender identity is influenced by the interaction of childrens temperament and parents qualities and attitudes. Sex role stereotypes are the beliefs, characteristics and behaviors of individual culture that are deemed normal and appropriate for boys and girls to possess.
Gender dysphoria
Symptoms in Children: Strong desire to be desired sex Believes self to be the desired sex. Cross dressing as the desired sex. Engaging in stereotypical game/role play as desired sex. Preference to have friends or play with others of the desired sex. Refusal to wear stereotypical clothing of biological sex. Disgust with own genitalia
Symptoms in Adolescents and Adults: Strong desire to be the desired sex. Believes self to be the desired sex. Passing as the desired sex. Desire to live and be accepted as desired sex. Belief of being born with wrong sex. Intense desire to change primary and secondary sex characteristics.
Treatment: TREATMENT IN CHILDREN: At present, no convincing evidence indicates that psychiatric or psychological intervention children for children with GID affects the direction of subsequent sexual orientation. The treatment of GDin children is directed largely at developing social skills and comfort in the sexrole expected by birth anatomy. To the extent that treatment is successful, transsexual development may be interrupted. No hormonal or psychopharmacological treatments for GDin childhood have been identified.
Contd: TREATMENT IN ADOLESCENTS: Adolescents whose GIDhas persisted beyond puberty present unique treatment problem. Treatment management is to slowing down or stopping pubertal changes expected by anatomical birth sexand then implementing cross-sex body changes with cross-sex hormones. Parents must also be informed. The goal of family intervention is to keep the family stable and to provide a supportive environment for the teenager.
Contd: TREATMENT IN ADULTS: Adult patients coming to a gender identity clinic usually present with straight forward requests for hormonal and surgicalsexreassignment. No drug treatmenthasbeen shownto be effectiveinreducingcross-gender. When patient GID is severe and intractable, sex reassignment may be the best solution.
Hormonal Therapy: Personsborn male are typically treated with daily doses of oral estrogen- conjugated equine estrogens or ethinyl- estradiol which leads to - breastenlargement, testicular atrophy, decreased libido, facial hair removal is required by lasertreatment or electrolysis. Biological women are treated with monthly or three weekly injections of testosterone. The pitch of the voice drops permanently into the male range asthe vocal cords thicken The clitoris enlarges to two or threetimes. Increased libido. Hair growth changes to the male pattern, and afull complement of facial hairmay grow. Cross-sex steroid hormones affect general body fat and muscle distribution aswell aspromote breast development in patients born male.
Sexual Reassignment Surgery: [SRS] - For apersonborn anatomicallymale consistsprincipallyof removalof themale genitaliaand constructionof labia,and vaginoplasty. - Postoperativecomplicationsincludeurethral strictures,recto-vaginalfistulas,vaginal stenosis, and inadequatewidthor depth. - Female-to-malepatientstypicallymay undergo bilateralmastectomyand construct neophallus.Becauseof increasedtechnicalskills inphalloplasty,morefemale-to-male patients arenow electingtheseprocedures.
Pre-Requisites for SRS: A true transsexual with gender dysphoria Surgery recommended by 2 mental health specialists trained in gender identity issues. Hormone treatment for at least one year. Living true life test for a minimum of one year. Emotionally stable. Knowing about the irreversibility. Not be equal as biological entity: biological breast or biological vagina. Infertility. Side effects of surgery Medically healthy with any medical conditions being treated and under control. Support of spouse, family, significant other, friends Economically stable
THANK YOU

More Related Content

Gender dysphoria

  • 1. GENDER DYSPHORIA DR. RANJAN BHATTACHARYA DR. TAMOGHNA BANDYOPADHYAY DR. ARATRIKA SEN
  • 2. Introduction: 1ST COINED BY ROBERT STOLLER PREVIOUSLY CALLED GENDER IDENTITY DISORDER {DSM-IV} REFERS TO PERSONS WITH A MARKED INCONGRUENCE BETWEEN THEIR EXPERIENCED OR EXPRESSED GENDER AND THE ONE THEY WERE ASSIGNED AT BIRTH.
  • 3. TRANSGENDE R Used to refer to those who identify with a gender different from the one they were born with. Can be of many types: Transsexuals Genderqueer Cross-dressers
  • 4. TRANSSEXUA L INCONSISTENT WITH ASSIGNED SEX DESIRE FOR PERMANENT CHANGE SEEKING MEDICAL ASSISTANCE
  • 5. GENDERQUEE R NO EXCLUSIVE GENDER IDENTITY BIGENDER TRIGENDER AGENDER DEMIGENDER GENDERFLUID
  • 6. CROSS DRESSER WEARING DRESS OF OPPOSITE SEX NOT ALWAYS TRANSGENDER PREVIOUSLY CALLED TRANSVESTISM
  • 7. Prevalence: Unknown for a variety of reasons: Concealment of these identities due to stigma Methodological problems in defining the populations of interest and designing adequate sampling strategies. Most such prevalence studies show prevalence rate ranging from 0.005 to 0.014 in male-assigned and 0.002 to0. 003 in female-assigned
  • 8. Contd. In children, sex ratio of children referred for gender dysphoria is 4-5 boys for each girl, hypothesized as social stigma towards feminine boys.
  • 9. ETIOLOGY BIOLOGICAL Resting state of tissue in mammals is initially female, as the fetus develops, a male is produced only if androgen is introduced. Maleness depends on fetal and perinatal androgens PSYCHO-SOCIAL Formation of gender identity is influenced by the interaction of childrens temperament and parents qualities and attitudes. Sex role stereotypes are the beliefs, characteristics and behaviors of individual culture that are deemed normal and appropriate for boys and girls to possess.
  • 11. Symptoms in Children: Strong desire to be desired sex Believes self to be the desired sex. Cross dressing as the desired sex. Engaging in stereotypical game/role play as desired sex. Preference to have friends or play with others of the desired sex. Refusal to wear stereotypical clothing of biological sex. Disgust with own genitalia
  • 12. Symptoms in Adolescents and Adults: Strong desire to be the desired sex. Believes self to be the desired sex. Passing as the desired sex. Desire to live and be accepted as desired sex. Belief of being born with wrong sex. Intense desire to change primary and secondary sex characteristics.
  • 13. Treatment: TREATMENT IN CHILDREN: At present, no convincing evidence indicates that psychiatric or psychological intervention children for children with GID affects the direction of subsequent sexual orientation. The treatment of GDin children is directed largely at developing social skills and comfort in the sexrole expected by birth anatomy. To the extent that treatment is successful, transsexual development may be interrupted. No hormonal or psychopharmacological treatments for GDin childhood have been identified.
  • 14. Contd: TREATMENT IN ADOLESCENTS: Adolescents whose GIDhas persisted beyond puberty present unique treatment problem. Treatment management is to slowing down or stopping pubertal changes expected by anatomical birth sexand then implementing cross-sex body changes with cross-sex hormones. Parents must also be informed. The goal of family intervention is to keep the family stable and to provide a supportive environment for the teenager.
  • 15. Contd: TREATMENT IN ADULTS: Adult patients coming to a gender identity clinic usually present with straight forward requests for hormonal and surgicalsexreassignment. No drug treatmenthasbeen shownto be effectiveinreducingcross-gender. When patient GID is severe and intractable, sex reassignment may be the best solution.
  • 16. Hormonal Therapy: Personsborn male are typically treated with daily doses of oral estrogen- conjugated equine estrogens or ethinyl- estradiol which leads to - breastenlargement, testicular atrophy, decreased libido, facial hair removal is required by lasertreatment or electrolysis. Biological women are treated with monthly or three weekly injections of testosterone. The pitch of the voice drops permanently into the male range asthe vocal cords thicken The clitoris enlarges to two or threetimes. Increased libido. Hair growth changes to the male pattern, and afull complement of facial hairmay grow. Cross-sex steroid hormones affect general body fat and muscle distribution aswell aspromote breast development in patients born male.
  • 17. Sexual Reassignment Surgery: [SRS] - For apersonborn anatomicallymale consistsprincipallyof removalof themale genitaliaand constructionof labia,and vaginoplasty. - Postoperativecomplicationsincludeurethral strictures,recto-vaginalfistulas,vaginal stenosis, and inadequatewidthor depth. - Female-to-malepatientstypicallymay undergo bilateralmastectomyand construct neophallus.Becauseof increasedtechnicalskills inphalloplasty,morefemale-to-male patients arenow electingtheseprocedures.
  • 18. Pre-Requisites for SRS: A true transsexual with gender dysphoria Surgery recommended by 2 mental health specialists trained in gender identity issues. Hormone treatment for at least one year. Living true life test for a minimum of one year. Emotionally stable. Knowing about the irreversibility. Not be equal as biological entity: biological breast or biological vagina. Infertility. Side effects of surgery Medically healthy with any medical conditions being treated and under control. Support of spouse, family, significant other, friends Economically stable