Romani Alessia, Mazzoli Francesca, Ristori Jiska, Cocchetti Carlotta, Cassioli Emanuele, Castellini Giovanni, Mosconi Maddalena, Meriggiola Maria Cristina, Gualdi Sara, Giovanardi Guido, Lingiardi Vittorio, Vignozzi Linda, Maggi Mario, Fisher Alessandra D
Andrology, Women's Endocrinology and Gender Incongruence Unit, Florence University Hospital, 50139 Florence, Italy.
Psychiatry Unit, Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy.
J Sex Med. 2021 Nov;18(11):1933-1944. doi: 10.1016/j.jsxm.2021.08.012.
Over the last few years, the gender binary has been questioned, highlighting the existence of gender diverse people, who identify as neither (exclusively) male nor female.
The present study evaluated the possible differences in terms of psychological wellbeing between binary and gender diverse individuals, as well as the role of perceived social acceptance and religious fundamentalism as possible mediators of psychopathology in gender diverse people. Furthermore, the diversity of gender-affirming hormonal treatment requests according to gender identification was investigated.
A sample of 563 transgender people aged 18-70 was enrolled (n = 264 assigned female at birth, AFAB and n = 299 assigned male at birth, AMAB), all individuals referring to several Italian gender clinics. A subdivision of the study population based on the gender identity visual analog scale (GI-VAS) median was performed, in order to distinguish between gender diverse and binary transgender individuals. Moreover, a linear regression analysis was performed entering logarithmically transformed GI-VAS (Log GI-VAS) into the models with psychometric scales.
Psychometric and sociodemographic data, as well as information regarding requests for gender-affirming treatments, were extrapolated from the clinical interviews conducted during the first referral.
Gender diverse individuals showed significantly less intense gender dysphoria and higher levels of depression and anxiety compared to binary ones; accordingly, a less binary gender identity correlated with higher levels of depression and anxiety and lower levels of gender dysphoria. The depressive symptomatology in gender diverse people was partially mediated by perceived discrimination and humiliation. Moreover, gender diverse AMAB people sought a non-standard hormonal treatment more often than their binary counterpart.
The present study highlights the importance for transgender health professionals, when planning gender-affirming hormonal treatments, to offer flexible interventions, tailored on the patient's needs and goals.
STRENGTHS & LIMITATIONS: Strengths included exploring whether and how perceived discrimination may affect mental health in gender diverse people. Limitations included the enrolled sample of people referring to different gender clinics, which is not fully representative of the transgender population.
This study highlights the importance of evaluating each individual's unique health care needs, exploring each single request and its underlying reasons. Romani A., Mazzoli F., Ristori J., et al. Psychological Wellbeing and Perceived Social Acceptance in Gender Diverse Individuals. J Sex Med 2021;18:1933-1944.
在过去几年中，二元性别观念受到质疑，这凸显了性别多样化人群的存在，他们既不（完全）认同男性也不认同女性。
本研究评估了二元性别者与性别多样化个体在心理健康方面可能存在的差异，以及感知到的社会接纳和宗教原教旨主义作为性别多样化人群精神病理学可能中介因素的作用。此外，还调查了根据性别认同划分的性别肯定激素治疗请求的多样性。
招募了563名年龄在18至70岁之间的跨性别者（出生时被指定为女性者264名，出生时被指定为男性者299名），所有个体均来自意大利的几家性别诊所。根据性别认同视觉模拟量表（GI-VAS）中位数对研究人群进行细分，以区分性别多样化和二元性别跨性别个体。此外，进行了线性回归分析，将对数转换后的GI-VAS（Log GI-VAS）纳入心理测量量表模型。
与二元性别者相比，性别多样化个体表现出明显较轻的性别焦虑，以及较高水平的抑郁和焦虑；相应地，性别认同越不二元，抑郁和焦虑水平越高，性别焦虑水平越低。性别多样化人群的抑郁症状部分由感知到的歧视和羞辱介导。此外，出生时被指定为男性的性别多样化者比二元性别者更常寻求非标准的激素治疗。
本研究强调了跨性别健康专业人员在规划性别肯定激素治疗时，根据患者的需求和目标提供灵活干预措施的重要性。
优点包括探讨了感知到的歧视是否以及如何影响性别多样化人群的心理健康。局限性包括所招募的来自不同性别诊所的样本，不能完全代表跨性别群体。
本研究强调了评估每个个体独特的医疗保健需求、探究每个请求及其潜在原因的重要性。罗曼尼A、马佐利F、里斯托里J等。性别多样化个体的心理健康与感知到的社会接纳。《性医学杂志》2021年；18:1933 - 1944。
