Disforia de Género: Conceitos, Diagnóstico e Abordagem Clínica
DOI:
https://doi.org/10.20344/amp.21057Palavras-chave:
Disforia de género/diagnóstico, Disforia de género/tratamentoResumo
A disforia de género é definida como uma condição em que existe sofrimento mental associado à incongruência entre o género experienciado pela pessoa e o sexo que lhe foi atribuído à nascença. O género como conceito e a disforia de género como condição com necessidade de intervenção multidisciplinar têm evoluído tão rapidamente quanto a sua visibilidade na sociedade, tornando premente a necessidade de promover a literacia e a formação de todos os profissionais de saúde nesta área. Este artigo de revisão pretende contribuir para o esclarecimento informado e baseado em evidência científica acerca das pessoas com disforia de género e sua abordagem clínica, contribuindo para uma prática segura, inclusiva e livre de discriminação no que concerne aos seus cuidados de saúde.
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Appendix I: Indo-European roots. The American Heritage Dictionary of the English Language. 4th ed. Boston: Houghton Mifflin Company; 2000.
Crocq MA. How gender dysphoria and incongruence became medical diagnoses – a historical review. Dialogues Clin Neurosci. 2021;1:44-51. DOI: https://doi.org/10.1080/19585969.2022.2042166
Beek TF, Cohen-Kettenis PT, Kreukels BP. Gender incongruence/gender dysphoria and its classification history. Int Rev Psychiatry. 2015;1369-627.
Money J. Hermaphroditism, gender and precocity in hyperadrenocorticism: psychologic findings. Bull John Hopkins Hosp. 1955;96:253-64.
Drescher J. Gender dysphoria and disorders of sex development. Progress in care and knowledge. Chapter 7. Gender identity diagnoses: history and controversies. New York: Springer Science; 2013. DOI: https://doi.org/10.1007/978-1-4614-7441-8_7
World Health Organization. International statistical classification of diseases and related health problems. 9th ed. Genebra: WHO; 1977.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd ed. Washington: APA; 1980.
American Psychiatric Association. Diagnostic and statistical classification of diseases and related health problems. 4th ed. Washington: APA; 1994.
American Psychiatric Association. Diagnostic and statistical classification of diseases and related health problems. 5th ed. Washington: APA; 2013.
Schaefer LC, Wheeler CW. Harry Benjamin’s first ten cases (1938-1953): a clinical historical note. Arch Sex Behav. 1995;24:73-93. DOI: https://doi.org/10.1007/BF01541990
Cohen-Kettenis PT, Gooren LJ. Transsexualismo: a review of etiology, diagnosis and treatment. J Psychosom Res. 1999;46:315-33. DOI: https://doi.org/10.1016/S0022-3999(98)00085-3
Coleman E, Radix AE, Bouman WP, Brown GR, de Vries AL, Deutsch MB, et al. Standards of care for the health of transgender and gender diverse people, Version 8. Int. J Transgend Health. 2022;23:S1-259.
Drescher J. Controversies in gender diagnoses. LGBT Health. 2014;1:10-4. DOI: https://doi.org/10.1089/lgbt.2013.1500
Drescher J. Queer diagnoses: parallels and contrasts in the history of homosexuality, gender variance, and the diagnostic and statistical manual (DSM). Arch Sex Behav. 2010;39:427-60. DOI: https://doi.org/10.1007/s10508-009-9531-5
World Health Organization. International statistical classification of diseases and related health problems. 11th ed. Genebra: WHO; 2019.
Bem SL. Gender schema theory: a cognitive account of sex typing. Psychol Rev. 1981;88:354-64. DOI: https://doi.org/10.1037//0033-295X.88.4.354
Guss C, Shumer D, Katz-Wise SL. Transgender and gender nonconforming adolescent care: psychosocial and medical considerations. Curr Opin Pediatr. 2015;26:421-6. DOI: https://doi.org/10.1097/MOP.0000000000000240
Moretti P, Bachetti MC, Sciarma T, Tortorella A. Dysphoria as a psychiatric syndrome: a preliminary study for a new transnosographic dimensional approach. Psychiatr Danub. 2018;30:582-7.
Zucker KJ. Epidemiology of gender dysphoria and transgender identity. Sexual Health. 2017;14:404-11. DOI: https://doi.org/10.1071/SH17067
Cooper K, Russell A, Mandy W, Butler C. The phenomenology of gender dysphoria in adults: A systematic review and meta-synthesis. Clin Psychol Rev. 2020;80:101875. DOI: https://doi.org/10.1016/j.cpr.2020.101875
Goodrich KM. Lived experiences of college-age transsexual individuals. J Coll Couns. 2012;15:215-32. DOI: https://doi.org/10.1002/j.2161-1882.2012.00017.x
Mullen G, Moane G. A qualitative exploration of transgender identity affirmation at the personal, interpersonal, and sociocultural level. Int J Transgend. 2013;14:140-54. DOI: https://doi.org/10.1080/15532739.2013.824847
Giovanardi G, Morales P, Mirabella M, Fortunato A, Chianura L, Speranza AM, et al. Transition memories: experiences of trans adult women with hormone therapy and their beliefs on the usage of hormone blockers to suppress puberty. J Endocrinol Invest. 2019;1-10. DOI: https://doi.org/10.1007/s40618-019-01045-2
Applegarth G, Nuttal J. The lived experience of transgender people of talking therapies. Int J Transgend. 2016;17:66-72. DOI: https://doi.org/10.1080/15532739.2016.1149540
Baams L, Beek T, Hille H, Zevenbergen FC, Bos HM. Gender nonconformity, perceived stigmatization, and psychological well-being in Dutch sexual minority youth and young adults. A mediation analysis. Arch Sex Behav. 2013;42:765-73. DOI: https://doi.org/10.1007/s10508-012-0055-z
Bockting W, Miner MH, Romine R, Hamilton A, Coleman E. Stigma, mental health, and resilience in an online sample of the US transgender population. Am J Public Health. 2013;103:943-51. DOI: https://doi.org/10.2105/AJPH.2013.301241
Connolly MD, Zervos MJ, Barone CJ, Johnson CC, Joseph CL. The mental health of transgender youth: advances in understanding. J Adolesc Health. 2016;59:489-95. DOI: https://doi.org/10.1016/j.jadohealth.2016.06.012
Puckett JA, Maroney MR, Wadsworth LP, Mustanki B, Newcomb ME. Coping and discrimination: The insidious effects of gender minority stigma on depression and anxiety in transgender individuals. J Clin Psychol. 2019;76:176-94. DOI: https://doi.org/10.1002/jclp.22865
Rood BA, Maroney MR, Puckett JA, Berman AK, Reisner SL, Pantalone DW. Identity concealment in transgender adults: a qualitative assessment of minority stress and gender affirmation. Am J Orthopsychiat. 2017;18:704-13. DOI: https://doi.org/10.1037/ort0000303
Smith AJ, Hallum-Montes R, Nevin K, Zenker R, Sutherland B, Reagor S, et al. Determinants of transgender individuals’ well-being, mental health and suicidality in a rural state. Rural Ment Health. 2018;42:116-32. DOI: https://doi.org/10.1037/rmh0000089
Rood BA, Reisner SL, Surace FI, Puckett JA, Maroney MR, Pantalone DW. Expecting rejection: understanding the minority stress experiences of transgender and gender-nonconforming individuals. Transgend Health. 2016;1:151-64. DOI: https://doi.org/10.1089/trgh.2016.0012
Scandurra C, Vitelli R, Maldonato NM, Valerio P, Bochicchio V. A qualitative study on minority stress subjectively experienced by transgender and gender nonconforming people in Italy. Sexologies. 2019;28:61-71. DOI: https://doi.org/10.1016/j.sexol.2019.05.002
Byne W, Karasic DH, Coleman E, Eyler AE, Kidd JD, Meyer-Bahlburg HF, et al. Gender dysphoria in adults: an overview and primer for psychiatrists. Transgend Health. 2018;3:57-A3. DOI: https://doi.org/10.1089/trgh.2017.0053
Walter PB, Amets SS, Joz M, Adam S, Joshua DS, Madeline BD, et al. Language and trans health. Int J Transgend. 2017;18:1-6. DOI: https://doi.org/10.1080/15532739.2016.1262127
Rodrigues J, Lemos C, Figueiredo Z. Discriminação e barreiras ao acesso ao serviço nacional de saúde percecionados por pessoas trans. Rev Port Psiquiatria Saúde Mental. 2020;6:98-108. DOI: https://doi.org/10.51338/rppsm.2020.v6.i3.152
Rothblum ED. The Oxford handbook of sexual and gender minority mental health. Oxford: Oxford University Press; 2020. DOI: https://doi.org/10.1093/oxfordhb/9780190067991.001.0001
Portugal. Decreto-Lei n.º38/2018. Diário da República, I Série, n.º 151 (2018/08/07). p.3922-4.
Lew-Starowicz, M, Giraldi A, Krüger TH. Psychiatry and sexual medicine: a comprehensive guide for clinical practitioners. Hannover: Springer International Publishing; 2021. DOI: https://doi.org/10.1007/978-3-030-52298-8
Murad MH, Elamin MB, Garcia MZ, Mullan RJ, Murad A, Erwin PJ, et al. Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes. Clin Endocrinol. 2010;72:214-31. DOI: https://doi.org/10.1111/j.1365-2265.2009.03625.x
Dhejne C, Van VR, Heylens G, Arcelus J. Mental health and gender dysphoria: a review of the literature. Int Rev Psychiatry. 2016;28:44-57. DOI: https://doi.org/10.3109/09540261.2015.1115753
Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema SE, Meyer WJ, Murad MH, et al. Endocrine treatment of gender- dysphoric/gender-incongruent persons: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2017;102:3869-903. DOI: https://doi.org/10.1210/jc.2017-01658
Heylens G, Verroken C, De Cock S, T’Sjoen G, Cuypere G. Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with agender identity disorder. J Sex Med. 2014;11:19-26. DOI: https://doi.org/10.1111/jsm.12363
Direção-Geral da Saúde, Administração Central do Sistema de Saúde. Circular Normativa Conjunta. URGUS – Unidade do SNS para o acompanhamento de utentes no processo de reatribuição sexual. Lisboa: DGS; 2017.
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