Jiménez-López José Luis
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Departamento de Psiquiatría y Psicología. Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2023 Sep 4;61(5):617-622. doi: 10.5281/zenodo.8316452.
Gender dysphoria is the diagnosis included in the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, which refers to the marked incongruence that exists between the gender that is felt or expressed and the one assigned at birth. The discomfort generated by the incongruity can cause gender affirmation to be requested through hormonal treatment or surgical sex reassignment, which is expected to disappear such discomfort. However, not all people with gender incongruence manifest discomfort and when the discomfort exists it is not always of psychopathological characteristics (dysphoria), which for some authors represents gender affirmation for aesthetic purposes (correct the incongruity). There are reports of increased medical care for transgender people who request somatic transition, but in Mexico there are no standardized protocols for their care; it is only recommended to promote access to hormonal treatment and mental health services to transgender people who request it. The eventual inclusion of surgical management in the Mexican guidelines will require clarity of concepts and unification of criteria to select the cases that should enter the health system for treatment, which is why health personnel must be prepared to identify those who can benefit from the somatic transition. The presence of dysphoria and psychiatric comorbidity may be key elements when the evaluation is carried out.
性别焦虑症是美国精神病学协会出版的《精神疾病诊断与统计手册》中包含的一种诊断，它指的是个体所感受到或表达的性别与出生时被指定的性别之间存在明显的不一致。这种不一致所产生的不适感可能会导致个体通过激素治疗或手术性别重置来寻求性别确认，期望这种不适感能够消失。然而，并非所有性别不一致的人都会表现出不适感，而且当不适感存在时，它并不总是具有精神病理学特征（焦虑症），对于一些作者来说，这代表了出于审美目的的性别确认（纠正不一致）。有报告称，要求进行身体转变的跨性别者的医疗护理有所增加，但在墨西哥，针对他们的护理没有标准化的方案；仅建议为有需求的跨性别者提供获得激素治疗和心理健康服务的途径。最终将手术管理纳入墨西哥的指导方针将需要概念清晰和标准统一，以便选择那些应进入卫生系统接受治疗的病例，这就是为什么卫生人员必须做好准备，识别出那些能够从身体转变中受益的人。在进行评估时，焦虑症的存在和精神疾病合并症可能是关键因素。
