Oda Hiroyuki, Kinoshita Toshihiko
Department of Neuropsychiatry, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi City, Osaka, 570-8506, Japan.
BMC Psychiatry. 2017 Jul 17;17(1):256. doi: 10.1186/s12888-017-1423-y.
Cross-sex hormone treatment (CSHT) is an important option for gender dysphoria (GD) individuals to improve the quality of life. However, in Japan, sex reassignment surgery (SRS) and CSHT for GD had been discontinued until 1998 (over 30 years). After resumption, the number of GD individuals wishing treatment rapidly increased. On the other hand, the number of medical institutions available for evaluation was limited. For this reason, hormonal treatment has been administered to GD individuals requiring the prompt start of CSHT in the absence of mental health assessment by specialists. In this study, we examined the efficacy of CSHT and psychotherapy.
The participants were 155 female-to-male (FtM) individuals who consulted our gender identity clinic, and were definitively diagnosed. A cross-sectional study was conducted by dividing them into two groups: groups with and without CSHT on the initial consultation (Group CSHT: n = 53, Group no-CSHT: n = 102). In all participants, Minnesota Multiphasic Personality Inventory (MMPI) and blood hormone tests were performed on the initial consultation. In addition, CSHT was combined with psychotherapy for a specific period in Group no-CSHT, and FtM individuals in whom an additional MMPI test could be conducted (Group combined treatment (CT), n = 14) were enrolled in a longitudinal study.
In the cross-sectional study, there was no significant difference on the MMPI test. In the longitudinal study, there were improvements in the clinical scales other than the Mf scale on the MMPI test. In Group CT, the D, Sc, and Si scale scores on the initial consultation were significantly higher than in Group CSHT. However, there was no clinical scale with a significantly higher value after the start of treatment. The Pd scale score was significantly lower.
CSHT improved mental health. Psychotherapy-combined CSHT may further improve it.
The study was reviewed and approved by the Ethics Committee of Kansai Medical University (A comprehensive treatment for gender dysphoria: No. 0314 registered date 10th December 2003), and was approved at UMIN000028102 on 6th July 2017 as retrospectively registered.
跨性别激素治疗（CSHT）是改善性别焦虑症（GD）患者生活质量的重要选择。然而，在日本，用于GD的性别重置手术（SRS）和CSHT直到1998年（超过30年）才恢复。恢复后，希望接受治疗的GD患者数量迅速增加。另一方面，可供评估的医疗机构数量有限。因此，在没有专家进行心理健康评估的情况下，激素治疗已被用于那些需要迅速开始CSHT的GD患者。在本研究中，我们研究了CSHT和心理治疗的疗效。
参与者为155名前来我们性别认同诊所咨询并被明确诊断的女性变男性（FtM）患者。通过将他们分为两组进行横断面研究：初次咨询时接受CSHT的组（CSHT组：n = 53，未接受CSHT组：n = 102）。在所有参与者初次咨询时进行明尼苏达多相人格调查表（MMPI）和血液激素测试。此外，未接受CSHT组在特定时期将CSHT与心理治疗相结合，并且对可以进行额外MMPI测试的FtM患者（联合治疗组（CT），n = 14）进行纵向研究。
在横断面研究中，MMPI测试没有显著差异。在纵向研究中，MMPI测试中除Mf量表外的临床量表有所改善。在CT组中，初次咨询时的D、Sc和Si量表得分显著高于CSHT组。然而，治疗开始后没有临床量表的值显著更高。Pd量表得分显著更低。
CSHT改善了心理健康。联合心理治疗的CSHT可能会进一步改善心理健康。
该研究经过关西医科大学伦理委员会审查并批准（性别焦虑症的综合治疗：2003年12月10日注册编号0314），并于2017年7月6日在UMIN000028102获得批准，作为回顾性注册。
