Articolo speciale
Disforia di genere e dintorni
About gender dysphoria
Gianluca Tornese1, Massimo Di Grazia1,2, Anna Roia3, Giovanna Morini3, Doria Cosentini3, Marco Carrozzi3, Alessandro Ventura1,2
1UCO di Clinica Pediatrica, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
2Dipartimento Clinico di Scienze Mediche, Chirurgiche e della Salute, Università di Trieste
3SC di Neuropsichiatria Infantile, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
Settembre 2016 - pagg. 437 -444
Abstract
Gender identity is a dimension of sexual identity and refers to persistent personal conception
of oneself as male or female. Gender identity development is not always in accordance
with the biological sex, therefore - even from an early age - some children do not identify
themselves with the gender assigned at birth (gender variance). In some cases this condition
may be accompanied by discomfort (gender dysphoria). Paediatricians are often the first
contact these children/adolescents have with the health care system, therefore they should
be able to answer the questions of their families and when they identify a possible gender
dysphoria should address this issue easily, finding any associated psychosocial problems.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Contenuto riservato
Per leggere l'articolo completo è necessario effettuare il login.
Non sei ancora registrato? Registrati
Bibliografia
1. Stein MT, Zucker KJ, Dixon SD. Sammy:
gender identity concerns in a six-year-old boy.
Pediatrics 2001;107(Suppl. 1):850-4.
2. Ferrari F, Ragaglia EM, Rigliano P (a cura di).
Gender: che cos’è e cosa non è. 2015. http: //
www.sipsis.it/wp-content/uploads/2015/12/
Gender-cos%C3%A8-e-cosa-non-%C3%A8.pdf.
3. Dèttore D, Ristori J, Casale S. GID and gender-
variant children in Italy: A study in preschool
children. J Gay Lesbian Ment Health
2010;15(1):12-29.
4. Dèttore D, Antonelli P, Ristori J. L’identità
sessuale e di genere: definizione e sviluppo.
In: Dèttore D, Ristori J, Antonelli P (a cura di).
La disforia di genere in età evolutiva. Roma:
ALPES Italia Ed, 2015.
5. Institute of Medicine (US) Committee on
Lesbian GB and THI and RG and O. The
Health of Lesbian, Gay, Bisexual, and Transgender
People. Washington, DC: National
Academies Press, 2011.
6. Fisk NM. Editorial: Gender dysphoria syndrome-
the conceptualization that liberalizes
indications for total gender reorientation and
implies a broadly based multi-dimensional
rehabilitative regimen. West J Med 1974;120
(5):386-91.
7. Coleman E, Bockting W, Botzer M, et al.
Standards of care for the health of transsexual,
transgender, and gender-nonconforming
people, version 7. Int J Transgenderism
2011;13:165-232.
8. American Psychiatric Association. Manuale
diagnostico e statistico dei disturbi mentali
(DSM-5). 5a ed. Milano: Raffaello Cortina Editore,
2014.
9. Steensma TD. From Gender variance to
gender dysphoria: psychosexual development
of gender atypical children and adolescents.
May 2013.
10. Giordano S, Vettori N. Aspetti etici e giuridici
del trattamento medico degli adolescenti
con disforia di genere. In: Dèttore D, Ristori J,
Antonelli P (a cura di). La disforia di genere in
età evolutiva. Roma: ALPES Italia Ed, 2015.
11. Bandini E. Disforia di genere: diagnosi, fenomenologia,
andamento nel tempo e frequenza.
In: Dèttore D, Ristori J, Antonelli P (a
cura di). La disforia di genere in età evolutiva.
Roma: ALPES Italia Ed, 2015.
12. Achenbach TM, Edelbrock CS. Manual for
the child behavior checklist and revised child
behavior profile. Department of Psychiatry of
the University of Vermont. Burlington, 1983.
13. Verhulst F, van der Ende J, Koot H. Handleiding
Voor de CBCL/4-18 [Manual for the
CBCL/4-18]. Rotterdam, Netherlands, 1996.
14. Achenbach TM, Edelbrock CS. Behavioral
problems and competencies reported by
parents of normal and disturbed children
aged four through sixteen. Monogr Soc Res
Child Dev 1981;46(1):1-82.
15. Zucker KJ, Bradley SJ, Sanikhani M. Sex
differences in referral rates of children with
gender identity disorder: some hypotheses. J
Abnorm Child Psychol 1997;25(3):217-27.
16. Coolidge FL, Thede LL, Young SE. The heritability
of gender identity disorder in a child
and adolescent twin sample. Behav Genet
2002;32(4):251-7.
17. Zucker KJ, Lawrence AA. Epidemiology of
gender identity disorder: recommendations
for the standards of care of the world professional
association for transgender health. Int J
Transgenderism 2009;11(1):8-18.
18. Cohen-Kettenis PT, Pfäfflin F. The DSM
diagnostic criteria for gender identity disorder
in adolescents and adults. Arch Sex Behav
2010;39(2):499-513.
19. American Psychiatric Association. Manuale
diagnostico e statistico dei disturbi mentali
(DSM-III). Milano: Masson, 1983.
20. Diamond M. Sex and gender are different:
sexual identity and gender identity are different.
Clin Child Psychol Psychiatry 2002;7(3):
320-34.
21. Imperato-McGinley J, Guerrero L, Gautier
T, Peterson RE. Steroid 5alpha-reductase deficiency
in man: an inherited form of male pseudohermaphroditism.
Science 1974;186(4170):
1213-5.
22. Cohen-Kettenis PT. Gender change in
46,XY persons with 5-alpha-reductase-2 deficiency
and 17-beta-hydroxysteroid dehydrogenase-
3 deficiency. Arch Sex Behav 2005;34
(4):399-410.
23. Chowdhury TK, Chowdhury MZ, Mili F,
Hutson JM, Banu T. Gender identity shows a
high correlation with Prader score in patients
with Disorders of Sex Development (DSD)
presenting in mid childhood. Pediatr Surg Int
2014;30(5):527-32.
24. Meyer-Bahlburg HFL, Dolezal C, Baker
SW, New MI. Sexual orientation in women
with classical or non-classical congenital adrenal
hyperplasia as a function of degree of prenatal
androgen excess. Arch Sex Behav 2008;
37(1):85-99.
25. Dessens AB, Slijper FME, Drop SLS. Gender
dysphoria and gender change in chromosomal
females with congenital adrenal hyperplasia.
Arch Sex Behav 2005;34(4):389-97.
26. Roberts AL, Rosario M, Corliss HL, Koenen
KC, Austin SB. Childhood gender nonconformity:
a risk indicator for childhood abuse
and posttraumatic stress in youth. Pediatrics
2012;129(3):410-7.
27. Cohen-Kettenis PT. Gender identity disorder
in DSM? J Am Acad Child Adolesc Psychiatry
2001;40(4):391.
28. Zucker KJ, Bradley SJ. Gender identity disorder
and psychosexual problems in children
and adolescents. New York: Guilford
Press, 1995.
29. Drummond KD, Bradley SJ, Peterson-Badali
M, Zucker KJ. A follow-up study of girls
with gender identity disorder. Dev Psychol
2008;44(1):34-45.
30. Wallien MSC, Cohen-Kettenis PT. Psychosexual
outcome of gender-dysphoric children.
J Am Acad Child Adolesc Psychiatry 2008;
47(12):1413-23.
31. de Vries AL, Steensma TD, Doreleijers TA,
Cohen-Kettenis PT. Puberty suppression in
adolescents with gender identity disorder: A
prospective follow-up study. J Sex Med 2011;8
(8):2276-83.
32. Steensma TD, Kreukels BP, de Vries AL,
Cohen-Kettenis PT. Gender identity development
in adolescence. Horm Behav 2013;64(2):
288-97.
33. Landén M, Wålinder J, Lundström B. Clinical
characteristics of a total cohort of female
and male applicants for sex reassignment: a
descriptive study. Acta Psychiatr Scand 1998;
97(3):189-94.
34. Fisher AD, Ristori J, Bandini E, et al. Medical
treatment in gender dysphoric adolescents
endorsed by SIAMS-SIE-SIEDP-ONIG.
J Endocrinol Invest 2014;37(7):675-87.
35. Stieglitz KA. Development, risk, and resilience
of transgender youth. J Assoc Nurses
AIDS Care 2010;21(3):192-206.
36. Skagerberg E, Parkinson R, Carmichael P.
Self-harming thoughts and behaviors in a
group of children and adolescents with gender
dysphoria. Int J Transgenderism 2013;14
(2):86-92.
37. Zucker KJ. Gender identity development
and issues. Child Adolesc Psychiatr Clin N
Am 2004;13(3):551-68, vii.
38. Cohen-Kettenis PT, Pfäfflin F. Transgenderism
and intersexuality in childhood and
adolescence: making choices. SAGE Publications,
2003.
39. Alanko K, Santtila P, Witting K, et al. Psychiatric
symptoms and same-sex sexual attraction
and behavior in light of childhood
gender atypical behavior and parental relationships.
J Sex Res 2009; 46(5):494-504.
40. Plöderl M, Fartacek R. Childhood gender
nonconformity and harassment as predictors
of suicidality among gay, lesbian, bisexual,
and heterosexual Austrians. Arch Sex Behav
2009;38(3):400-10.
41. D’Augelli AR, Grossman AH, Starks MT.
Childhood gender atypicality, victimization, and
PTSD among lesbian, gay, and bisexual youth. J
Interpers Violence 2006;21(11):1462-82.
42. Spack NP, Edwards-Leeper L, Feldman
HA, et al. Children and adolescents with gender
identity disorder referred to a pediatric
medical center. Pediatrics 2012;129(3):418-25.
43. Vance SR, Ehrensaft D, Rosenthal SM.
Psychological and medical care of gender
nonconforming youth. Pediatrics 2014;134(6):
1184-92.
44. Hembree WC, Cohen-Kettenis PT, Delemarre-
van de Waal HA, et al. Endocrine treatment
of transsexual persons: An endocrine society
clinical practice guideline. J Clin Endocrinol
Metab 2009;94(9):3132-54.
45. Delemarre-van de Waal HA, Cohen-Kettenis
PT. Clinical management of gender identity
disorder in adolescents: a protocol on psychological
and paediatric endocrinology
aspects. Eur J Endocrinol 2006;155(Suppl. 1):
S131-S137.
46. de Vries AL, Steensma TD, Doreleijers TA,
Cohen-Kettenis PT. Puberty suppression in
adolescents with gender identity disorder: a
prospective follow-up study. J Sex Med 2011;8
(8):2276-83.
47. Cohen-Kettenis PT, de Vries AL. Interventi
precoci con adolescenti con disforia di genere.
In: Dèttore D, Ristori J, Antonelli P (a
cura di). La disforia di genere in età evolutiva.
Roma: ALPES Italia Ed, 2015.
48. de Vries AL, McGuire JK, Steensma TD,
Wagenaar EC, Doreleijers TA, Cohen-Kettenis
PT. Young adult psychological outcome after
puberty suppression and gender reassignment.
Pediatrics 2014;134(4):696-704.
49. Grossman AH, D’Augelli AR. Transgender
youth and life-threatening behaviors. Suicide
Life Threat Behav 2007;37(5):527-37.
50. Grossman AH, D’Augelli AR. Transgender
youth: invisible and vulnerable. J Homosex
2006;51(1):111-28.
51. Reardon S. Largest ever study of transgender
teenagers set to kick off. Nature
2016;531(7596):560.
52. Olson KR, Durwood L, DeMeules M,
McLaughlin KA. Mental health of transgender
children who are supported in their identities.
Pediatrics 2016;137(3):1-8.
53. [No authors listed] Does changing gender
make children happier? Arch Dis Child 2016;
101(5):460.
54. Meyer WJ. Gender identity disorder: an
emerging problem for pediatricians. Pediatrics
2012;129(3):571-3.
Corrispondenza: gianluca.tornese@burlo.trieste.it