Heino F. L. Meyer-Bahlburg

Heino F. L. Meyer-Bahlburg
Columbia University | CU · Department of Psychiatry

Dr. rer. nat.

About

278
Publications
215,816
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15,728
Citations
Citations since 2016
41 Research Items
6757 Citations
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201620172018201920202021202202004006008001,000

Publications

Publications (278)
Article
Full-text available
A senior pediatric endocrinologist at a leading medical school in Canada has for years provided the introductory lecture on Disorders of Sex Development/Intersexuality (DSD/I) in the standard second-year course. In 2020/2021, two students complained to medical school administrators about six specific issues of intersex theory and care that were add...
Article
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Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this are...
Article
Introduction To describe experiences of clitoromegaly in women with congenial adrenal hyperplasia (CAH). Methods CAH females (46XX, >=16 years old) from the United States and Canada were eligible for a cross-sectional online survey (2019-2020) if reporting clitoromegaly (life-long: “growing up with a larger than average clitoris,” secondary: “clit...
Article
In the United States, ~1.4 million individuals identify as transgender. Many transgender adolescents experience gender dysphoria related to incongruence between their gender identity and sex assigned at birth. This dysphoria may worsen as puberty progresses. Puberty suppression by gonadotropin-releasing hormone agonists (GnRHa), such as leuprolide,...
Article
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Gender Dysphoria in Adults: An Overview and Primer for Psychiatrists William Byne 1 2, Dan H Karasic 3, Eli Coleman 4, A Evan Eyler 5, Jeremy D Kidd 6, Heino F L Meyer-Bahlburg 7, Richard R Pleak 8, Jack Pula 9 PMID: 29756044 PMCID: PMC5944396 DOI: 10.1089/trgh.2017.0053 Free PMC article Abstract Regardless of their area of specialization, adult...
Article
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The rate of adolescents with gender-nonconforming behavior and/or gender dysphoria seeking mental health care has dramatically increased in the past decade. Many of these youths also present with co-occurring psychiatric problems, including depression, anxiety, suicidality, substance use, and others. This combination may generate a complex clinical...
Article
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In recent decades, two interrelated major controversies have been unfolding in the area of sex/gender research. (1) Are gender-identity variants to be understood as psychopathology or natural variation? (2) Is gender (and perhaps even sex) better conceptualized as binary or non-binary? The answer depends on the conceptual context and related consid...
Article
Transgender development in adolescents often occurs in the context of diverse psychiatric symptoms or diagnoses preceding, co-occurring with, or following the onset of the atypical gender identity variations. In addition, it tends to upset the prevailing binary gender ideology and, thereby, strain intra-family relationships as well as elicit stigma...
Article
Nonclassical congenital adrenal hyperplasia (NC-CAH) is by far a subtler and milder enzymatic defect to the classical form of the disease. A nuanced understanding of NC-CAH will lead to increased detection of the disorder in those initially misdiagnosed as having polycystic ovary syndrome, will assist in the detection of pregnancies at risk for sev...
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Objective To update the congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency clinical practice guideline published by the Endocrine Society in 2010. Conclusions The writing committee presents updated best practice guidelines for the clinical management of congenital adrenal hyperplasia based on published evidence and expert opin...
Data
Gender Dysphoria and patient-initiated gender transition occur with increased frequency in individuals with somatic intersex conditions, a subset of disorders/differences of sex development (DSD). Providers need to be aware of assessment and treatment-relevant characteristics of these individuals that differ from gender-dysphoric individuals withou...
Article
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The risk of intersex-related stigma often serves as social indication for "corrective" genital surgery, but has not been comprehensively documented. In preparation for the development of an intersex-specific stigma assessment tool, this qualitative project aimed to explore stigma in girls and women with classical congenital adrenal hyperplasia (CAH...
Article
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Regardless of their area of specialization, adult psychiatrists are likely to encounter gender-variant patients; however , medical school curricula and psychiatric residency training programs devote little attention to their care. This article aims to assist adult psychiatrists who are not gender specialists in the delivery of respectful, clinicall...
Article
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Stigma defined as ?undesired differentness? (Goffman, 1963) and subtyped as ?experienced? or ?enacted,? ?anticipated,? and ?internalized? has been documented for patients with diverse chronic diseases. However, no systematic data exist on the association of stigma with somatic intersexuality. The current report concerns women with classical congeni...
Chapter
This chapter addresses the development of persons with gender identity variants and their hormonal treatment. Research to date has focused mostly on transsexuals, i.e., persons who meet criteria for clinically defined gender dysphoria and transition to the ‘other’ gender (in terms of the traditional binary gender system). The development of gender...
Article
As a side effect of globalization, the ideological and religious heterogeneity of many local populations is increasing. This trend is particularly noticeable at tertiary-care medical centers serving patients with rare conditions such as somatic intersexuality or gender dysphoria and transgenderism (both with and without somatic intersexuality). Thi...
Article
Objectives To perform a qualitative study of stigma experienced in medical settings by children and adolescents with congenital genital ambiguity (CGA). Methods 62 women with classical congenital adrenal hyperplasia (CAH) of variable severity took part in a qualitative retrospective interview that focused on the impact of CAH and its medical treatm...
Article
Purpose of review: The review summarizes relevant research focused on prevalence and natural history of gender nonconforming/transgender youth, and outcomes of currently recommended clinical practice guidelines. This review identifies gaps in knowledge, and provides recommendations foci for future research. Recent findings: Increasing numbers of...
Article
Ten years after the consensus meeting on disorders of sex development (DSD), genital surgery continues to raise questions and criticisms concerning its indications, its technical aspects, timing and evaluation. This standpoint details each distinct situation and its possible management in 5 main groups of DSD patients with atypical genitalia: the 4...
Article
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Purpose of review: Transgender individuals experience unique health disparities but are the subject of little focused health research. This manuscript reviews current literature on transgender medical and mental health outcomes and proposes research priorities to address knowledge gaps. Recent findings: Published research in transgender healthca...
Article
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The goal of this update regarding the diagnosis and care of persons with disorders of sex development (DSDs) is to address changes in the clinical approach since the 2005 Consensus Conference, since knowledge and viewpoints change. An effort was made to include representatives from a broad perspective including support and advocacy groups. The goal...
Article
Background: Societal changes are increasingly moving the conceptualization of gender from a set of binary categories towards a bimodal continuum, which along with the cautious conclusions resulting from the 2005 Consensus Conference influences gender-related clinical work with patients with disorders of sex development. Objective: This article p...
Article
‘‘Corrective,’’‘‘normalizing,’’or‘‘gender-confirming’’genital surgery in individuals with inborn genital ambiguity continues to be highly controversial in regard to its appropriateness, timing, and techniques. In this context, Baratz and Feder (2015) raised three points of critique concerning a brief paragraph of mine in a wide-ranging overview cha...
Article
Understanding psychological development in individuals with disorders of sex development (DSD) is important for optimizing their clinical care and for identifying paths to competence and health in all individuals. In this paper, we focus on psychological outcomes likely to be influenced by processes of physical sexual differentiation that may be at...
Article
Patient perceptions of genital esthetics are motivating requests for plastic surgeries that could change sexual sensitivity. There is little information about the sensitivities of labial and introital sites. The aim of this study is to assess the relationship between sexual sensitivity and self-reported sizes of labial and introital sites. Sixty-tw...
Article
Individuals born with ambiguous or intersexed genitalia due to a somatic disorder of sex development present particular psychosocial challenges concerning gender assignment, corrective genital surgery, and information management. Related clinical policies have undergone major changes over recent decades and are currently still in a state of flux an...
Article
This article summarizes for the practicing endocrinologist the current literature on the psychobiology of the development of gender identity and its variants in individuals with disorders of sex development (DSD) or with non-DSD transgenderism. Gender reassignment remains the treatment of choice for strong and persistent gender dysphoria in both ca...
Article
The syndromes of congenital adrenal hyperplasia, particularly their classical variants, present diverse medical and psychosocial challenges to the affected individual that may affect all stages of life from the prenatal phase through old age. This chapter reviews the psychological outcomes in terms of gender, general cognitive development, psychopa...
Article
Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The sensitivity of the foreskin and its importance in erogenous sensitivity is widely debated and controversial. This is part of the actual public debate on circumcision for non-medical reason. Today some studies on the effect of circumcision on sexual function are available. H...
Article
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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...
Article
Full-text available
The Standards of Care (SOC) for the Health of Transsexual, Transgender, and Gender Nonconforming People is a publication of the World Professional Association for Transgender Health (WPATH). The overall goal of the SOC is to provide clinical guidance for health professionals to assist transsexual, transgender, and gender nonconforming people with s...
Article
Full-text available
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...
Article
To test whether dexamethasone (DEX) treatment in pregnancies at risk for congenital adrenal hyperplasia (CAH) impairs cognitive functioning in the offspring. Observational follow-up of prenatally DEX-exposed offspring and controls. Study 1 included 140 children aged 512 years: 67 DEX-exposed (long-term: eight CAH girls) and 73 unexposed (with 15 CA...
Article
Individuals born with a somatic disorder of sex development (DSD) have high rates of gender-atypical behavior, gender uncertainty, gender dysphoria, and patient-initiated gender change in childhood, adolescence,and adulthood. This article addresses the issues a mental health services provider has to consider in evaluating and assisting such patient...
Article
The disturbance of the hypothalamic-pituitary- adrenal axis characteristic of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) is likely to affect brain development, yet neuroanatomic work is only beginning. Fetal hyperandrogenemia in 46, XX 21-OHD leads to masculinized brain organization and, consequently, at later st...
Article
In terms of their gender-related behavior, persons with (non-intersex) gender identity disorder (GID; aka transsexualism) of early onset resemble patients with somatic intersexuality who request a change of gender. However, there is currently no known intersex analog for GID of late onset. Neuroanatomy studies of somatic intersex are too few for pr...
Article
Full-text available
We developed clinical practice guidelines for congenital adrenal hyperplasia (CAH). The Task Force included a chair, selected by The Endocrine Society Clinical Guidelines Subcommittee (CGS), ten additional clinicians experienced in treating CAH, a methodologist, and a medical writer. Additional experts were also consulted. The authors received no c...
Article
Full-text available
Steroid 21-hydroxylase deficiency accounts for about 95% of cases of congenital adrenal hyperplasia (CAH). Newborns are currently being screened for the classical forms of this disease throughout the United States and in 12 other countries. As such, it seems important to develop the best practice guidelines for treating not only infants and childre...
Article
Full-text available
A survey on various issues related to the DSM-IV-TR gender identity disorder diagnosis was conducted among 201 organizations concerned with the welfare of transgender people from North America, Europe, Africa, Asia, Oceania, and Latin America. Forty-three organizations from all continents completed the survey. A majority of 55.8% believed the diagn...
Article
Full-text available
Steroid 21-hydroxylase deficiency accounts for about 95% of cases of congenital adrenal hyperplasia (CAH). Newborns are currently being screened for the classical forms of this disease throughout the United States and in 12 other countries. As such, it seems important to develop the best practice guidelines for treating not only infants and childre...
Article
Many individuals born with genital ambiguity and related conditions (recently recategorized as disorders of sex development [DSD]) experience gender uncertainty or gender dysphoria, and some may undergo self-initiated gender change. Whether these phenomena are sufficiently similar to the presentations of gender identity variants (GIVs) in non-DSD p...
Article
The categorization of gender identity variants (GIVs) as "mental disorders" in the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association is highly controversial among professionals as well as among persons with GIV. After providing a brief history of GIV categorizations in the DSM, this paper presents s...
Article
The purpose of this study was the construction, scaling, and scale validation of a self-report questionnaire assessing biographical information and motivation for pregnancy and infant care in men and women with disorders of sex development or other gender variations of potential clinical relevance. The overall design of the questionnaire and the in...
Article
This report concerns the possible long-term effects of prenatal exposure to diethylstilbestrol (DES) on menstrual cycle functioning in DES-exposed females. Sixty DES-exposed women, 30 women with a history of abnormal Papanicolaou (Pap) smear findings, 30 women with no history of DES exposure or abnormal Pap smears, and 20 non-exposed female sibling...
Article
The psychological impact of knowledge of DES exposure on young women was evaluated and compared for 3 time points: (1) following the disclosure of their DES exposure, (2) following their first DES-related examination (both retrospectively), and (3) at the time of the interview. Sixty DES-exposed daughters described their reactions and worries at ea...
Article
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This study aimed to provide further validity evidence for the dimensional measurement of gender identity and gender dysphoria in both adolescents and adults. Adolescents and adults with gender identity disorder (GID) were compared to clinical control (CC) adolescents and adults on the Gender Identity/Gender Dysphoria Questionnaire for Adolescents a...
Article
To assess the perceptions of healthy men of their genital anatomy and sexual sensitivity, along with the re-test reliability of these ratings, in a new self-reported questionnaire, the Self-Assessment of Genital Anatomy and Sexual Function, Male (SAGASF-M). Eighty-one healthy, sexually active, men aged 22-57 years (median 33), with no history of ge...
Article
In spite of significant changes in the management policies of intersexuality clinical evidence show that not all pubertal or adult individuals live according to the assigned sex during infancy. The purpose of this study was to analyze the clinical management of an individual diagnosed as a female pseudohermaphrodite with congenital adrenal hyperpla...
Article
Gender-variant individuals with somatic disorders of sex development (DSD) differ from gender-variant individuals without DSD in phenomenon, context of presentation, etiology, and treatment options. Over the last 15 years, medical and psychosocial management policies have been widely debated, and recent international consensus conferences have reco...
Article
Gender-variant individuals with somatic disorders of sex development (DSD) differ from gender-variant individuals without DSD in phenomenon, context of presentation, etiology, and treatment options. Over the last 15 years, medical and psychosocial management policies have been widely debated, and recent international consensus conferences have reco...
Article
Sex-Dimorphic BehaviourGender IdentityHomosexualityConclusion AcknowledgementsReferencesDiscussionReferences
Article
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To examine the effect of maternal HIV infection, as well as other individual, family, and contextual factors on the mental health of inner-city, ethnic minority early adolescents. Participants included 220 HIV-negative early adolescents (10-14 years) and their mothers, half of whom were HIV-infected. Individual interviews were conducted regarding y...
Article
46,XX individuals with classical congenital adrenal hyperplasia (CAH) due to deficiency of the enzyme, 21-hydroxylase, show variable degrees of masculinization of body and behavior due to excess adrenal androgen production. Increased bisexuality and homosexuality have also been reported. This article provides a review of existing reports of the lat...
Article
Full-text available
The present study reports on the construction of a dimensional measure of gender identity (gender dysphoria) for adolescents and adults. The 27-item gender identity/gender dysphoria questionnaire for adolescents and adults (GIDYQ-AA) was administered to 389 university students (heterosexual and nonheterosexual) and 73 clinic-referred patients with...
Article
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HBIGDA members' treatment of persons with disorders of sex development (DSD), was assessed by questionnaire. The response rate was 71%. Ninety-three members (40% of respondents) provided a variety of clinical services to all ages and to parents of children with a DSD condition. The majority of these 93 had seen just a few such individuals but ten H...
Article
Full-text available
The present study reports on the construction of a dimensional measure of gender identity (gender dysphoria) for adolescents and adults. The 27-item gender identity/gender dysphoria questionnaire for adolescents and adults (GID YQ-AA) was administered to 389 university); students (heterosexual and nonheterosexual) and 73 clinic-referred patients wi...