Salud Mental y Atención Sanitaria de Adolescentes Transgénero y no Conformes con el GéneroUna Revisión Sistemática
- Lorena Sánchez-Reyes 1
- Rocío Anguita-Martínez 1
- María José Castro-Alija 1
-
1
Universidad de Valladolid
info
ISSN: 0214-7823, 1886-1415
Ano de publicación: 2024
Título do exemplar: LA PSICOLOGÍA FORENSE EN ESPAÑA
Volume: 45
Número: 3
Páxinas: 136-145
Tipo: Artigo
Outras publicacións en: Papeles del psicólogo
Resumo
With increased frequency there are more transgender youths who request and require health care for issues regarding gender identity. The aim of this paper is to conduct a systematic review on the mental health of transgender adolescents and health care to which they have access regarding their discovery of transgender issues. This systematic review was undertaken by analysing international literature following PRISMA guidelines for systematic scientific reviews. The searches were conducted in the following databases: MEDLINE, SciELO, Psicodoc, PsycINFO and PubMed. A total of 24 articles complied with the inclusion criteria. The results indicate that transgender and non-conforming gender adolescents are an especially vulnerable group because they display high rates of mental health problems when compared to their cisgender peers. Hormone therapy for gender affirmation points to possible psychological benefits for this population group. In conclusion, transgender and non-conforming gender adolescents may exhibit mental health problems associated with the discrimination, rejection/repudiation, or bullying/harassment experienced in their corresponding social, health, and educational environments. This demands the need for a social change that promotes the acceptance and normalization of non-normative identities and genders
Referencias bibliográficas
- American Pychiatric Association [APA]. (2014). Guía de consulta de los Criterios Diagnósticos del DSM-5™. https://www.eafit.edu.co/ninos/ reddelaspreguntas/Documents/dsm-v-guia-consulta-manualdiagnostico-estadistico-trastornos-mentales.pdf
- Asenjo Araque, N., García Gibert, C., Rodríguez Molina, J. M., Becerra Fernández, A. y Lucio Pérez, M. J. y Grupo GIDSEEN. (2015). Disforia de género en la infancia y adolescencia: una revisión de su abordaje, diagnóstico y persistencia. Revista de Psicología Clínica con Niños y Adolescentes, 2(1), 33-36. https://www.revistapcna.com/sites/default/files/14-19.pdf
- Bauer, G. R., Pacaud, D., Couch, R., Metzger, D. L., Gale, L., Gotovac, S., Mokashi, A., Feder, S., Raiche, J., Nixon Speechley, K., Temple Newhook, J., Ghosh, S., Pullen Sansfaçon, A., Susset, F. y Lawson, M. L. et for the Trans Youth CAN! Research Team. (2021). Transgender youth referred to clinics for gender-affirming medical care in Canada. Pediatrics, 148(5), 1-13. https://doi.org/10.1542/peds.2020-047266
- Bauer, G. R., Lawson, M. L. y Metzger, D. L. (2022). Do clinical data from transgender adolescents support the phenomenon of “rapid onset gender dysphoria”? The Journal of Pediatrics, 243, 224-227. https://doi. org/10.1016/j.jpeds.2021.11.020
- Becerra-Culqui, T. A., Liu, Y., Nash, R., Cromwell, L., Flanders, D., Getahun, D., Giammattei, S., Hunkeler, E., Lash, T. L., Millman, A., Quinn, V., Robinson, B., Roblin, D., Sandberg, D., Silverberg, M., Tangpricha, V. y Goodman, M. (2018). Mental health of transgender and gender nonconforming youth compared with their peers. Pediatrics, 141(5). https://doi.org/10.1542/peds.2017-3845
- Bloom, T. M., Nguyen, T. P., Lami, F., Pace, C. C., Poulakis, Z., Telfer, M., Taylor, A., Pang, K. C. y Tollit, M. A. (2021). Measurement tools for gender identity, gender expression, and gender dysphoria in transgender and gender-diverse children and adolescents: a systematic review. The Lancet Child & Adolescent Health, 5(8), 582-588. https://doi.org/10.1016/ S2352-4642(21)00098-5
- Bonifacio, J. H., Maser, C., Stadelman, K. y Palmert, M. (2019). Management of gender dysphoria in adolescents in primary care. Canadian Medical Association Journal (CMAJ), 191(3), E69-E75. https://doi.org/10.1503/ cmaj.180672
- Castilla Peón, M. F. (2018). Manejo médico de personas transgénero en la niñez y la adolescencia. Boletín Médico del Hospital Infantil de México, 75, 7-14. http://dx.doi.org/10.24875/BMHIM.M18000003
- Chen, D., Abrams, M., Clark, L., Ehrensaft, D., Tishelman, A. C., Chan, Y. M., Garofalo, R., Olson-Kennedy, J., Rosenthal, S. M. y Hidalgo, M. A. (2021). Psychosocial characteristics of transgender youth seeking gender-affirming medical treatment: baseline findings from the trans youth care study. Journal of Adolescent Health, 68(6), 1104-1111. https://doi.org/10.1016/j. jadohealth.2020.07.033
- Chodzen, G., Hidalgo, M. A., Chen, D. y Garofalo, R. (2018). Minority stress factors associated with depression and anxiety among transgender and gender-nonconforming youth. Journal of Adolescent Health, 64(4), 467-471. https://doi.org/10.1016/j.jadohealth.2018.07.006
- Clark, T. C., Lucassen, M. F. y Bullen, P. et al. (2014). The health and wellbeing of transgender high school students: results from the New Zealand Adolescent Health Survey (Youth’12). Journal of Adolescent Health, 55, 93-9. https://doi.org/10.1016/j.jadohealth.2013.11.008
- Edwards-Leeper, L., Leibowitz, S. y Sangganjanavanich, V. F. (2016). Affirmative practice with transgender and gender nonconforming youth: expanding the model. Psychology of Sexual Orientation and Gender Diversity, 3(2), 165-172. https://doi.org/10.1037/sgd0000167
- Eisenberg, M. E., Gower, A. L., McMorris, B. J., Rider, G. N., Shea, G. y Coleman, E. (2017). Risk and protective factors in the lives of transgender/ gender nonconforming adolescents. Journal of Adolescent Health, 61, 521- 6. https://doi.org/10.1016/j.jadohealth.2017.04.014
- Fernández, O., Ballester, R., Iglesias, P., Morell, V. y Gil, M. D. (2018). Transexualidad y Adolescencia: Una revisión sistemática. Revista INFAD De Psicología. International Journal of Developmental and Educational Psychology, 2(1), 91-104. https://doi.org/10.17060/ijodaep.2018.n1.v2.1175
- Gordo, R., García, X. R., Álvarez, Y., Díaz, D. y Gándara, J. J. (2018). Disforia de género: realidad asistencial en psiquiatría del niño y el adolescente. Psicosomática y Psiquiatría, 7, 9-19. https://raco.cat/index. php/PsicosomPsiquiatr/article/view/392531/485885
- Gridley, S. J., Crouch, J. M., Evans, Y., Eng, W., Antoon, E., Lyapustina, M., Schimmel-Bristow, A., Woodward, J., Dundon, K., Schaff, R., McCarty, C., Ahrens, K. y Breland, D. J. (2016). Youth and caregiver perspectives on barriers to gender-affirming health care for transgender youth. Journal of Adolescent Health, 59(3), 254-261. https://doi. org/10.1016/j.jadohealth.2016.03.017
- Grinten, H. C. van der, Verhaak, C., Steensma, T., Middelberb, T., Roeffen, J. y Klink, D. (2021). Gender incongruence and gender dysphoria in childhood and adolescence-current insights in diagnostics, management, and followup. European Journal of Pediatrics, 180, 1349-1357. https://doi.org/10.1007/ s00431-020-03906-y
- Guss, C., Shumer, D. y Katz-Wise, S. L. (2015). Transgender and gender nonconforming adolescent care: psychosocial and medical considerations. Current Opinion in Pediatrics, 27(4), 421-426. https://doi.org/10.1097/ mop.0000000000000240
- Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., Rosenthal, S. M., Safer, J. D., Tangpricha, V. y T'Sjoen, G. G. (2017). Endocrine treatment of gender-dysphoric/genderincongruent persons: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869- 3903. https://doi.org/10.1210/jc.2017-01658 Erratum in: (2018). The Journal of Clinical Endocrinology & Metabolism, 103(7), 2758-2759. https://doi.org/10.1210/jc.2018-01268
- Holt, V., Skagerberg, E. y Dunsford, M. (2016). Young people with features of gender dysphoria: demographics and associated difficulties. Clinical Child Psychology and Psychiatry, 21, 108-18. https://journals. sagepub.com/doi/10.1177/1359104514558431
- Kaltiala, R., Heino, E., Työläjärvi, M. y Suomalainen, L. (2020). Adolescent development and psychosocial functioning after starting cross-sex hormones for gender dysphoria. Nordic Journal of Psychiatry, 74(3), 213-219. https://doi.org/10.1080/08039488.2019.1691260
- Kingsbury, M., Hammond, N. G., Johnstone, F. y Colman, I. (2022). Suicidality among sexual minority and transgender adolescents: a nationally representative population-based study of youth in Canada. Canadian Medical Association Journal, 194(22), E767-E774. https:// doi.org/10.1503/cmaj.212054
- Kuper, L. E., Stewart, S., Preston, S., Lau, M. y Lopez, X. (2020). Body dissatisfaction and mental health outcomes of youth on gender-affirming hormone therapy. Pediatrics, 145(4), 1-9. https://doi.org/10.1542/ peds.2019-3006
- Kyriakou, A., Nicolaides, N. y Skordis, N. (2020). Current approach to the clinical care of adolescents with gender dysphoria. Acta Biomed, 91(1), 165-175. https://doi.org/10.23750/abm.v91i1.9244
- Littman, L. (2018). Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria. PLoS ONE, 13(8), 1-44. https://doi.org/10.1371/journal.pone.0202330
- López, J. y González, C. (2018). Valoración de la supresión de la pubertad en menores con problemas de identidad de género. Cuadernos de Bioética, 29(97), 247-256. http://aebioetica.org/revistas/2018/29/97/247.pdf
- López, D., Pérez, O., Cuellar, I., Pedreira, J. L., Campos, L., Cuesta, M. y Ramos, J. T. (2020). Evaluación psicosocial en adolescentes transgénero. Anales de Pediatría, 93(1), 41-48. https://www. analesdepediatria.org/es-evaluacion-psicosocial-adolescentestransgenero-articulo-S1695403320300424
- Mahfouda, S., Moore, J. K., Siafarikas, A., Zepf, F. D. y Lin, A. (2017). Puberty suppression in transgender children and adolescents. The Lancet Diabetes & Endocrinology, 5(10), 816-826. https://doi.org/10.1016/ S2213-8587(17)30099-2
- Miranda-Novoa, M. (2022). El Tratamiento de afirmación de género en menores con disforia de género y la validez del consentimiento informado. Cuadernos de Bioética, 33(107), 99-109. http://aebioetica. org/revistas/2022/33/107/99.pdf
- Modrego Pardo, I., Gómez Balaguer, M., Hurtado Murillo, F., Cuñat Navarro, E., Solá Izquierdo, E. y Morillas Ariño, C. (2021). Selfinjurious and suicidal behaviour in a transsexual adolescent and young adult population, treated at a specialised gender identity unit in Spain. Endocrinología, Diabetes y Nutrición, 68(5), 338-345. https://doi. org/10.1016/j.endinu.2020.04.006
- Nos, A. L., Klein, D. A., Adirim, T. A., Schvey, N. A., Hisle-Gorman, E., Susi, A. y Roberts, C. M. (2022). Association of gonadotropin-releasing hormone analogue use with subsequent use of gender-affirming hormones among transgender adolescents. JAMA Netword Open, 5(11). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2798002
- Olson, J., Schrager, S. M., Belzer, M., Simons, L. K. y Clark, L. F. (2015). Baseline physiologic and psychosocial characteristics of transgender youth seeking care for gender dysphoria. Journal of Adolescent Health, 57(4), 374-380. https://doi.org/10.1016/j.jadohealth.2015.04.027
- Organización Mundial de la Salud [OMS]. (2018). Mortality and Morbidity Statistics (CIE-11). Genève: OMS. Recovered from https://icd.who.int/ icd11refguide/en/index.html
- Organización Mundial de la Salud (OMS). (25 de abril de 2022). Salud mental del adolescente. Recuperado de: https://www.who.int/es/newsroom/fact-sheets/detail/adolescent-mental-health
- Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. British Medical Journal, 372, n71. https://doi. org/10.1136/bmj.n71
- Peng, K., Zhu, X., Gillespie, A., Wang, Y., Gao, Y., Xin, Y., Qi, J., Ou, J., Zhong, S., Zhao, L., Liu, J., Wang, C. y Chen, R. (2019). Selfreported rates of abuse, neglect, and bullying experienced by transgender and gender-nonbinary adolescents in China. JAMA Network Open, 2(9). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/ 2749453
- Reisner, S. L., Vetters, R., Leclerc, M., Zaslow, S., Wolfrum, S., Shumer, D. y Mimiaga, M. J. (2015). Mental health of transgender youth in care at an adolescent urban community health center: A matched retrospective cohort study. Journal of Adolescent Health, 56(3), 274-279. https://doi. org/10.1016/j.jadohealth.2014.10.264
- Riaño Galán, I., Río Pastoriza, I. del, Chueca Guindulain, M., Gabaldón Fraile, S. y Montalvo Jääskeläinem, F. de (2018). Statement by the Spanish Paediatric Association in relation to gender diversity in childhood and adolescence: Ethical and legal view from a multidisciplinary perspective. Anales de Pediatría (Barcelona), 89(2), 123.e1-123.e6. https://www.analesdepediatria.org/en-statement-byspanish-paediatric-association-articulo-S2341287918301224
- Rider, G. N., McMorris, B. J., Gower, A. L., Coleman, E. y Eisenberg, M. E. (2018). Health and care utilization of transgender and gender nonconforming youth: a population-based study. Pediatrics, 141(3), 1-8. https://doi.org/10.1542/peds.2017-1683
- Rusow, J. A., Hidalgo, M. A., Calvetti, S., Quint, M., Wu, S., Bray, B. C. y Kipke, M. D. (2022). Health and service utilization among a sample of gender-diverse youth of color: the TRUTH study. BMC Public Health, 22(1):2312. https://doi.org/10.1186/s12889-022-14585-9
- Sevilla Rodríguez, A. J., Aparicio García, M. E. y Limiñana Gras, R. M. (2019). La salud de adolescentes y adultos transgénero: revisión sistemática desde la perspectiva de género. Revista Iberoamericana de Diagnóstico y Evaluación Psicológica. (RIDEP), 50(1), 5-20. https:// doi.org/10.21865/RIDEP50.1.01
- Shields, J. P., Cohen, R., Glassman, J. R., Whitaker, K., Franks, H. y Bertolini, I. (2013). Estimating population size and demographic characteristics of lesbian, gay, bisexual, and transgender youth in middle school. Journal of Adolescent Health, 52, 248-50. https://doi. org/10.1016/j.jadohealth.2012.06.016
- Shumer, D. E., Nokoff, N. y Spack, N. (2016). Advances in the care of transgender children and adolescents. Advances in Pediatrics, 63(1), 79- 102. https://doi.org/10.1016/j.yapd.2016.04.018
- Sumia, M., Lindberg, N., Työläjärvi, M. y Riittakerttu, K. H. (2017). Current and recalled childhood gender identity in community youth in comparison to referred adolescents seeking sex reassignment. Journal of Adolescence, 56, 34-9. https://doi.org/10.1016/j.adolescence.2017.01.006
- Thoma, B. C., Salk, R. H., Choukas-Bradley, S., Goldstein, T. R., Levine, M. D. y Mariscal, M. P. (2019). Suicidality disparities between transgender and cisgender adolescents. Pediatrics, 144(5), 1-9. https:// doi.org/10.1542/peds.2019-1183
- Toomey, R. B, Syvertsen, A. K. y Shramko, M. (2018). Transgender adolescent suicide behavior. Pediatrics, 142(4), 1-8. https://doi. org/10.1542/peds.2017-4218
- Tordoff, D. M., Wanta, J. W., Collin, A., Stepney, C., Inwards-Breland, D. J. y Ahrens, K. (2022). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open, 5(2). https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423
- Vries, A. L. de, Steensma, T. D., Doreleijers, T. A. y Cohen-Kettenis, P. T. (2011). Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. The Journal of Sexual Medicine, 8, 2276- 83. https://doi.org/10.1111/j.1743-6109.2010.01943.x
- Vrouenraets, L. J. J. J., Fredriks, A. M., Hannema, S. E., CohenKettenis, P. T. y Vries, M. C. de (2016). Perceptions of sex, gender, and puberty suppression: a qualitative analysis of transgender youth. Archives of Sexual Behavior, 45, 1697-1703. https://dx.doi. org/10.1007%2Fs10508-016-0764-9
- World Professional Association for Transgender Health (WPATH). (2012). Standards of Care for the Health of Transsexual, Transgender, and Gender Non conforming People All rights reserved. (7ª versión), pp. 1-124. https://www.wpath.org/media/cms/Documents/SOC%20v7/ SOC%20V7_Spanish.pdf