Article

Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder

Department of Psychiatry, JJ Peters VA Medical Center, Bronx, NY, USA.
Archives of Sexual Behavior (Impact Factor: 3.53). 06/2012; 41(4):759-96. DOI: 10.1007/s10508-012-9975-x
Source: PubMed

ABSTRACT Both the diagnosis and treatment of Gender Identity Disorder (GID) are controversial. Although linked, they are separate issues and the DSM does not evaluate treatments. The Board of Trustees (BOT) of the American Psychiatric Association (APA), therefore, formed a Task Force charged to perform a critical review of the literature on the treatment of GID at different ages, to assess the quality of evidence pertaining to treatment, and to prepare a report that included an opinion as to whether or not sufficient credible literature exists for development of treatment recommendations by the APA. The literature on treatment of gender dysphoria in individuals with disorders of sex development was also assessed. The completed report was accepted by the BOT on September 11, 2011. The quality of evidence pertaining to most aspects of treatment in all subgroups was determined to be low; however, areas of broad clinical consensus were identified and were deemed sufficient to support recommendations for treatment in all subgroups. With subjective improvement as the primary outcome measure, current evidence was judged sufficient to support recommendations for adults in the form of an evidence-based APA Practice Guideline with gaps in the empirical data supplemented by clinical consensus. The report recommends that the APA take steps beyond drafting treatment recommendations. These include issuing position statements to clarify the APA's position regarding the medical necessity of treatments for GID, the ethical bounds of treatments of gender variant minors, and the rights of persons of any age who are gender variant, transgender or transsexual.

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    • "The fi rst was in support of access to care (APA, 2012a) while the second puts APA on the record as opposing any form of discrimination against transgender individuals (APA, 2012b). APA also appointed a task force to review and recommend treatment guidelines for transgender individuals (Byne et al., 2012).) For example, in May 2014, the US Department of Health and Human Services (HHS) reversed a long-outdated 1981 ruling that classifi ed medical treatment for gender reassignment as ' experimental ' (USDHHS, 2014). "
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    ABSTRACT: The American Psychiatric Association (APA) recently completed a several year process of revising the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). During that time, there were objections raised to retaining DSM's gender identity disorder diagnoses and calls to remove them, just as homosexuality had been removed from DSM-II in 1973. At the conclusion of the DSM-5 revision process, the gender diagnoses were retained, albeit in altered form and bearing the new name of 'gender dysphoria'. The author of this paper was a member of the DSM-5 Workgroup on Sexual and Gender Identity Disorders and presently serves on the WHO Working Group on Sexual Disorders and Sexual Health. Both groups faced similar tasks: reconciling patients' needs for access to care with the stigma of being given a psychiatric diagnosis. The differing nature of the two diagnostic manuals led to two different outcomes. As background, this paper updates the history of homosexuality and the gender diagnoses in the DSM and in the International Statistical Classification of Diseases and Related Health Problems (ICD) as well as what is expected to happen to the homosexuality and gender diagnoses following the current ICD-11 revision process.
    International Review of Psychiatry 08/2015; · 1.80 Impact Factor
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    • "The American Psychiatric Association (APA) and American Medical Association (AMA) recognize the benefits and necessity of gender transition treatments to help the transgender individual achieve lifelong comfort with his or her body and gender role (AMA, 2014; Byne et al., 2012). Most surgeons require transitioning individuals to live full time in the affirmed gender for at least 1 to 2 years prior to performing irreversible gender-affirming surgeries. "
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    ABSTRACT: Several surveys have characterized the experiences of transgender individuals with the police and show a general lack of trust of law enforcement by the transgender community. To the best of the author’s knowledge, however, no published study has addressed the perspectives of United States law enforcement personnel. This nationwide survey assessed awareness, attitudes, and experiences of law enforcement personnel with respect to transgender individuals. The survey showed a high degree of awareness (95%) of the term transgender but also revealed a noticeable polarization of attitudes, ranging from generally accepting and empathetic to less tolerant and less accommodating. A majority of respondents (71%) reported that they had never attended sensitivity training to help them better understand and assist transgender people in the law enforcement setting. Of those who reported receiving training, 16 of 18 said it was somewhat helpful or very helpful. Notably, only 27% of respondents believed their department had written policies or procedures with respect to interacting with and processing transgender individuals. The survey clearly reveals a need for more police departments to consider sensitivity training of their law enforcement professionals to increase understanding and openness to gender fluidity and non-traditional gender presentation and to review best practices in interacting with the transgender community.
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    • "B. die des Scottish Intercollegiate Guideline Network – SIGN), ist die große Mehrheit der vorhandenen Evidenz zur Behandlung der Geschlechtsdysphorie ohnehin von methodisch geringer Qualität und damit dem niedrigsten Evidenzlevel zuzuordnen (vgl. Byne et al. 2012). "
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    ABSTRACT: Health care for individuals whose gender experience differs from the sex assigned to them at birth has so far taken place in the conflicted space between one's right to self-determination and the (mental) health professionals' fear of coming to wrong decisions. The "Standards of Care recommended by the German Society for Sex Research. The Academy for Sexual Medicine and the Society for Sexology" (Becker et al. 1997) were an attempt to regulate this field of controversy on the basis of scientific and clinical evidence within the German health care system. In the meantime, these standards are considered to be in need of revision, against the background of both the 7th version of the international Standards of Care of the World Professional Association of Transgender Health (WPATH 2011) and the most recent judgement of the German Federal Constitutional Court (Bundesver- fassungsgericht BVerfG). In the summer of 2011, the German Society of Sex Research (Deutsche Gesellschaft fiir Sexualforschung, DGfS) took the initiative to develop evidence-based guidelines in collaboration with related professional societies following methodologies proposed by the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) in order to improve the quality of health care. The present article describes the background and procedures involved in the development of these clinical guidelines, and provides a view of future aspects of the process. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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