Consensus on gender dysphoria or gender incongruence
PDF

Keywords

Gender Dysphoria
Disorder Gender Identity
Transgender Persons
Transsexualism
Hormone Replacement Therapy
Sex Reassignment Surgery
Sex Reassignment Procedures

How to Cite

Sierra Osorio, A. M. ., Tovar, H., Imitola Madero , A. M., Chahin, S., Angulo Mosquera, M. ., Cantini, J., Riatiga Ibañez, D. A., Palacios Bayona, K. L., Bautista Alarcón , K. A. ., & Atuesta Fajardo, J. Y. . (2022). Consensus on gender dysphoria or gender incongruence. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 9(1). https://doi.org/10.53853/encr.9.1.734

Abstract

Introduction: Gender incongruence is an individual's dissatisfaction with their assigned gender and their identification with a gender other than that associated with their birth sex, based on physical sex characteristics, and given by their genitalia at birth; "dysphoria" refers to the psychological distress and discomfort experienced; only some people with gender incongruence experience gender dysphoria at some point in their lives. Gender incongruence is a condition, which should not be evaluated as inherently pathological or negative.

Objective: Generate recommendations from expert consensus on terminology, diagnostic criteria for gender incongruence/gender dysphoria, comprehensive management of comorbidities in gender incongruence/gender dysphoria, Defining the management and therapeutic goals of affirmative hormone therapy in those over 18 years old, defining the criteria for performing gender affirmation surgery, defining the medical monitoring in patients over 18 years of age with gender incongruence/dysphoria, defining the criteria for the use of puberty blockers, defining the criteria and recommendations for the initiation of cross-sex hormone therapy, and defining the management algorithm for approaching the newborn with atypical genitalia-certain sex assignment.

Materials and methods: A modified Delphi type consensus was carried out with the participation of 10 clinical specialists (endocrinologists, pediatric endocrinologists, aesthetic and reconstructive plastic surgeons, urologists, and psychiatrists), as well as a development group. Based on the analysis of the results, recommendations were presented.

Results: Recommendations were defined for: terminology, diagnostic criteria on gender incongruence/gender dysphoria, comprehensive management of comorbidities in gender incongruence/gender dysphoria, management and therapeutic goals of hormone affirmative therapy in over 18s, criteria for performing gender affirming surgery, medical monitoring in patients over 18 years old with gender incongruence/dysphoria, criteria for the use of puberty blockers, criteria and recommendations for initiation of cross-sex hormone therapy, and a management algorithm for approaching the newborn with atypical genitalia-certain sex assignment.

Conclusions: Gender incongruence and gender dysphoria are words with similarity, but not synonymous. However, their diagnostic criteria, affirmative hormonal treatments, gender affirming surgeries and medical monitoring are the same.

https://doi.org/10.53853/encr.9.1.734
PDF

References

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 May;120(5):386–91.

Butler G. Gender incongruence. Paediatr Child Health. 2020 Dec 1;30(12):407–10.

Osorio AMS, Rivera MA, Tovar H. Disforia de género/Incongruencia de género. Terapia hormonal en adultos. Rev Colomb Endocrinol Diabetes Metab. 2018 Nov 20;5(4):32–6.

Arcelus J, Bouman WP, Noortgate WVD, Claes L, Witcomb G, Fernandez-Aranda F. Systematic Review and Meta-Analysis of Prevalence Studies in Transsexualism. Eur Psychiatry. 2015 Sep;30(6):807–15.

Gómez Gil E, Trilla García A, Godás Sieso T, Halperin Rabinovich I, Puig Domingo M, Vidal Hagemeijer A et al. Estimación de la prevalencia, incidencia y razón de sexos del transexualismo en Cataluña según la demanda asistencial. Actas Esp Psiquiatr. 2006;34(5):295–302.

Becerra Fernández A, Rodriguez Molina JM, Asenjo-Araque, N, et al. Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand. Archives of Sexual Behavior 2017: 46(5). DOI: 10.1007/s10508-017-0955-z

Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review. PLOS ONE. 2011 Jun 9;6(6):e20476.

Manterola D C, Zavando M D. Cómo interpretar los “Niveles de Evidencia” en los diferentes escenarios clínicos. Rev Chil Cir. 2009 Dec;61(6):582–95.

Matas A, Matas A. Diseño del formato de escalas tipo Likert: un estado de la cuestión. Rev Electrónica Investig Educ. 2018 Mar;20(1):38–47.

Moreno-Pérez Ó, Esteva De Antonio I. Guías de práctica clínica para la valoración y tratamiento de la transexualidad. Grupo de Identidad y Diferenciación Sexual de la SEEN (GIDSEEN)*(anexo 1). Endocrinol Nutr. 2012 Jun 1;59(6):367–82.

Zucker KJ, Lawrence AA, Kreukels BPC. Gender Dysphoria in Adults. Annu Rev Clin Psychol. 2016 Mar 28;12(1):217–47.

Ettner R. Mental Health Evaluation for Gender Confirmation Surgery. Clin Plast Surg. 2018 Jul 1;45(3):307–11.

Rew L, Young CC, Monge M, Bogucka R. Review: Puberty blockers for transgender and gender diverse youth—a critical review of the literature. Child Adolesc Ment Health. 2021;26(1):3–14.

Edwards-Leeper L, Leibowitz S, Sangganjanavanich VF. Affirmative practice with transgender and gender nonconforming youth: Expanding the model. Psychol Sex Orientat Gend Divers. 2016 Jun;3(2):165–72.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Copyright (c) 2022 Revista Colombiana de Endocrinología, Diabetes & Metabolismo

Downloads

Download data is not yet available.