Department of Sexology and Gender Problems, Ghent University Hospital, Ghent, Belgium.
J Sex Med. 2014 Jan;11(1):119-26. doi: 10.1111/jsm.12363. Epub 2013 Oct 28.
At the start of gender reassignment therapy, persons with a gender identity disorder (GID) may deal with various forms of psychopathology. Until now, a limited number of publications focus on the effect of the different phases of treatment on this comorbidity and other psychosocial factors.
The aim of this study was to investigate how gender reassignment therapy affects psychopathology and other psychosocial factors.
This is a prospective study that assessed 57 individuals with GID by using the Symptom Checklist-90 (SCL-90) at three different points of time: at presentation, after the start of hormonal treatment, and after sex reassignment surgery (SRS). Questionnaires on psychosocial variables were used to evaluate the evolution between the presentation and the postoperative period. The data were statistically analyzed by using SPSS 19.0, with significance levels set at P < 0.05.
The psychopathological parameters include overall psychoneurotic distress, anxiety, agoraphobia, depression, somatization, paranoid ideation/psychoticism, interpersonal sensitivity, hostility, and sleeping problems. The psychosocial parameters consist of relationship, living situation, employment, sexual contacts, social contacts, substance abuse, and suicide attempt.
A difference in SCL-90 overall psychoneurotic distress was observed at the different points of assessments (P = 0.003), with the most prominent decrease occurring after the initiation of hormone therapy (P < 0.001). Significant decreases were found in the subscales such as anxiety, depression, interpersonal sensitivity, and hostility. Furthermore, the SCL-90 scores resembled those of a general population after hormone therapy was initiated. Analysis of the psychosocial variables showed no significant differences between pre- and postoperative assessments.
A marked reduction in psychopathology occurs during the process of sex reassignment therapy, especially after the initiation of hormone therapy.
在性别重置治疗开始时，患有性别认同障碍（GID）的人可能会遇到各种形式的精神病理学。到目前为止，只有少数出版物关注治疗的不同阶段对这种共病和其他社会心理因素的影响。
本研究旨在探讨性别重置治疗如何影响精神病理学和其他社会心理因素。
这是一项前瞻性研究，通过在三个不同时间点使用症状清单 90（SCL-90）评估 57 名 GID 患者：就诊时、开始激素治疗后和性别重置手术后（SRS）。使用社会心理变量问卷评估就诊和术后期间的演变。使用 SPSS 19.0 对数据进行统计分析，显著性水平设为 P<0.05。
精神病理学参数包括整体神经症困扰、焦虑、广场恐怖症、抑郁、躯体化、偏执观念/精神病、人际敏感、敌意和睡眠问题。社会心理参数包括人际关系、生活状况、就业、性接触、社会接触、物质滥用和自杀企图。
在不同评估点观察到 SCL-90 整体神经症困扰存在差异（P=0.003），激素治疗开始后下降最明显（P<0.001）。在焦虑、抑郁、人际敏感和敌意等子量表中发现显著下降。此外，激素治疗开始后，SCL-90 评分与一般人群相似。对社会心理变量的分析表明，术前和术后评估之间没有显著差异。
在性别重置治疗过程中，精神病理学明显减少，尤其是在激素治疗开始后。
