Psychiatric History Common in Gender Identity Disorder
(HealthDay News) – Young patients presenting with gender identity disorder often have significant psychiatric history; and youth in the top decile of gender nonconformity have elevated exposure to abuse, according to two studies published online Feb. 20 in Pediatrics.
Norman P. Spack, MD, from the Children's Hospital Boston, and colleagues assessed 97 consecutive patients younger than 21 years of age, with gender identity disorder, referred to a pediatric medical center between 1998 and 2010. The researchers found the genotypic male to female ratio to be 43:54 (0.8:1). Patients presented at a mean age of 14.8 years, without sex difference. The Tanner stage at presentation was 4.1 and 3.6 for genotypic female and male patients, respectively (P=0.02). Forty-three patients (44.3%) presented with significant psychiatric history, including self-mutilation (20.6%) and suicide attempts (9.3%).
Andrea L. Roberts, PhD, from the Harvard School of Public Health in Boston, and colleagues investigated whether gender nonconformity before age 11 is associated with childhood sexual, physical, and psychological abuse, and the lifetime risk of probable posttraumatic stress disorder (PTSD). Data were collected from 9,864 participants in the 2007 wave of the Growing Up Today Study. Compared with youth below median nonconformity, the researchers found that those in the top decile of childhood gender nonconformity had elevated exposure to childhood physical, psychological, and sexual abuse, and probable PTSD. After adjusting for sexual orientation, gender nonconformity predicted an elevated risk of lifetime probable PTSD in youth.
"We identify gender nonconformity as an important indicator of children at increased risk of sexual, physical, and psychological abuse," Roberts and colleagues write.