This study provided information on the long term psychosexual and psychiatric outcomes of 139 boys with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 7.49 years; range, 3–12 years) and at follow-up (mean age, 20.58 years; range, 13–39 years) were used to evaluate gender identity and sexual orientation outcome. At follow-up, 17 participants (12.2%) were judged to have persistent gender dysphoria. Regarding sexual orientation, 82 (63.6%) participants were classified as bisexual/ homosexual in fantasy and 51 (47.2%) participants were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. With gender identity and sexual orientation combined, the most common long-term outcome was desistence of GID with a bisexual/homosexual sexual orientation followed by desistence of GID with a heterosexual sexual orientation. The rates of persistent gender dysphoria and bisexual/homosexual sexual orientation were substantially higher than the base rates in the general male population. Childhood assessment data were used to identify within-group predictors of variation in gender identity and sexual orientation outcome. Social class and severity of cross-gender behavior in childhood were significant predictors of gender identity outcome. Severity of childhood cross-gender behavior was a significant predictor of sexual orientation at follow-up. Regarding psychiatric functioning, the heterosexual desisters reported significantly less behavioral and psychiatric difficulties compared to the bisexual/homosexual persisters and, to a lesser extent, the bisexual/ homosexual desisters. Clinical and theoretical implications of these follow-up data are discussed.

This study provided information on the long term psychosexual and psychiatric outcomes of 139 boys with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 7.49 years; range, 3–12 years) and at follow-up (mean age, 20.58 years; range, 13–39 years) were used to evaluate gender identity and sexual orientation outcome. At follow-up, 17 participants (12.2%) were judged to have persistent gender dysphoria. Regarding sexual orientation, 82 (63.6%) participants were classified as bisexual/ homosexual in fantasy and 51 (47.2%) participants were classified as bisexual/homosexual in behavior. The remaining participants were classified as either heterosexual or asexual. With gender identity and sexual orientation combined, the most common long-term outcome was desistence of GID with a bisexual/homosexual sexual orientation followed by desistence of GID with a heterosexual sexual orientation. The rates of persistent gender dysphoria and bisexual/homosexual sexual orientation were substantially higher than the base rates in the general male population. Childhood assessment data were used to identify within-group predictors of variation in gender identity and sexual orientation outcome. Social class and severity of cross-gender behavior in childhood were significant predictors of gender identity outcome. Severity of childhood cross-gender behavior was a significant predictor of sexual orientation at follow-up. Regarding psychiatric functioning, the heterosexual desisters reported significantly less behavioral and psychiatric difficulties compared to the bisexual/homosexual persisters and, to a lesser extent, the bisexual/ homosexual desisters. Clinical and theoretical implications of these follow-up data are discussed.

Thesis (M.A.)--Marshall University, 2004. / Title from document title page. Document formatted into pages; contains 154 p. Includes abstract. Includes bibliographical references (p. 111-112).

No description available.

The introduction of comments regarding the care of persons with gender identity disorder (GID) residing in prison settings began in 1998 with Version 5 of the Standards of Care (SOC), the first major revision of the SOC since 1985. Minor revisions to this brief section were made for Version 6 in 2001. Since 2001, there have been many legal and regulatory actions in countries where the SOC are widely used as the minimum standards to evaluate and treat persons with GID that have referenced this section in the SOC. The original paragraph addressing care for incarcerated persons has proven to be helpful by its existence, but limiting in its brevity and lack of scope. Version 7, likely to be a significant revision compared with the minor changes in Version 6, can be informed by the information that has come to light in the last 6 years, most notably through court actions that have used, or misused, the SOC. This invited article reviews the background of this section, rationale for revisions, suggested conceptual changes, and specific content for consideration for inclusion in Version 7 of the SOC.

The Institute of Medicine report of 2011 defined Transgender Specific Health Needs as one of four priority research areas. While there is research asserting that health care providers (HCPs) do not have adequate training in providing competent care to transgender patients, there are no studies to date assessing HCPs' gender identity attitudes and their willingness to learn the Standards of Care (SOC) developed for this patient population. According to the Agency for Health Care Research and Quality, as of 2010, 52% of Nurse Practitioners (NPs) were practicing in primary care settings. As more than half of NPs practice in primary care and transgender patients often initially present their gender concerns to their primary care provider, this study focuses on the NP population. This study describes a sample of NPs' attitudes towards gender variance, as well as their perceived need and interest in learning the SOC as published by the World Professional Association for Transgender Health. Multi-state purposive sampling of NP professional organizations was conducted. Two conservative and two progressive states' professional organizations were included in the sample. The states were randomly assigned within both geopolitical groups to intervention or control with the use of a random numbers table. Comparisons between geopolitical groups and between control and intervention groups cannot be made due to low response rates of all states. The majority of this small sample of NPs agreed that they needed and wanted additional training in transgender health care. Future research with representative sample sizes is needed to better understand provider-sided barriers to caring for this marginalized patient population.

Few bodies consistently portray natural or unaltered forms. Instead, humans inhabit bodies imbued with sociocultural meanings about what is attractive, appropriate, functional, and presentable. As such, embodiment is always gendered. The social, extra-corporeal body is a central locus for expressing gender. Surgical body modifications represent inherently gendered technologies of the body. But psychomedical institutions subject people who seek gender-crossing surgeries to increased surveillance, managing and regulating cross-gender embodiment as disorderly. Using mixed research methods, this research systematically compared transgender and cisgender (non-transgender) people’s experiences before, during, and after surgical body modification. I conducted a content analysis of 445 threads on a message board for an online cisgender surgery community, an analysis of 15 international protocols for transgender-specific surgeries, and 40 in-depth interviews with cisgender and transgender people who had surgery. The content analysis of the online community revealed similar themes among cisgender and transgender surgery users. However, detailed protocols existed only for transgender consumers of surgery. Interview findings showed that transgender and cisgender people reported similar presurgical feelings toward their bodies, similar cosmetic and psychological motivations for surgery, and similar benefits of surgery. For both cisgender and transgender people, surgery enhanced the inner self through improving the outer gendered body. Despite these similar embodied experiences, having a cisgender gender status determined respondents’ abilities to pursue surgery autonomously and with institutional support. Ultimately, this research highlights inequalities that result from gender status and manifest in psychomedical institutions by identifying the psychosocial impacts of provider/consumer or doctor/patient interactions, relating gendered embodiment to regulatory systems of authority, and illuminating policy implications for clinical practice and legal classifications of sex and gender.

The author reports on a case series of four inmates who engaged in attempted or completed surgical self-treatment of their gender dysphoria via autocastration, autopenectomy, or a combination in the absence of concomitant psychosis, intoxication, or other comorbidities that could reasonably account for this rare behavior. These behaviors occurred in the context of persistent denials of access to transgender health care in prison settings. The literature on genital self-harm is also reviewed. Incarcerated persons with severe GID may resort to life-threatening surgical self-treatments when persistently denied access to psychiatric evaluation and cross-sex hormonal treatment. In all cases of surgical self-treatment (SST; i.e., autocastration with the primary intent to reduce circulating testosterone levels) the intensity of gender dysphoria decreased compared to reported baseline levels, although symptoms of GID were still present. Of the four inmates, two were able to obtain access to cross-sex hormones after successful litigation at the time of this writing; another was not. One case remains active. This case series expands the limited literature on surgical self-treatment in the form of autocastration and autopenectomy with a focus on the potential influence of incarceration with denial of access to transgender health care.

No description available.

The DSM-IV-TR diagnosis Gender Identity Disorder Not Otherwise Specified (GID NOS) is used to describe individuals who have gender issues but do not meet the current criteria for GID. As part of a consensus process conducted by the World Professional Association for Transgender Health, the authors make the following recommendations for DSM 5: removal from the chapter on sexual disorders, more specific diagnostic criteria, retention of clinical significance criteria, and removal of exclusionary criteria of Intersex/Disorders of Sex Development. Changes to the existing clinical examples were also recommended, suggesting additional clinical examples that encompass a broader range of gender-variance and more commonly found transgender presentations. The diagnosis must reflect the severity of the clinical issues that represent legitimate identity experiences and possible need for gender-confirming treatments.