Transgender: case of severe gender dysphoria with mutism and social withdrawal
DOI:
https://doi.org/10.25118/2763-9037.2023.v13.411Keywords:
gender dysphoria, transgender persons, psychic symptoms, mental health assistance, health services for transgender personsAbstract
Introduction: The transgenderism is a phenomenon that can cause psychic suffering for those who experience it, configuring what is called “gender dysphoria”. Despite the advances, is it known that this group is more vulnerable to mental illness - especially if there is no adequate gender affirmation therapy. Objective: We aim to expose a case of severe gender dysphoria aggravated by the lack of an adequate multidisciplinary intervention. Case description: A transgender girl, 13 years old, presenting with depressed mood, self-mutilation, suicidal ideation, poor hygiene, mutism and social isolation triggered by incompatibility with your sexual characters. The mutism was given by worsening dysphoria when hearing your own thick voice. She didn’t realize verbal communication at home or in medical consultations that, even though presential, were made through letters. A family’s demand was the prescription of hormones blockers to postpone her puberty, but the experts in her city didn’t feel safe to drive the case. Today, after moving to a major center, she underwent a multidisciplinary therapy with Psychiatrist, Endocrinologist and Speech-language Pathologist - demonstrating improvement in mental health. Conclusion: This report reaffirms the need for a multidisciplinary team to approaching and managing gender dysphoria and other pathologies that affect transgender individuals. There is a lack of access to the service in several areas, therefore, it is necessary to provide accessible care to guarantee the health of this population.
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Sociedade Brasileira de Pediatria. Departamento Científico de Adolescência. Incongruência/disforia de gênero atualizado e revisado. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2020. https://www.sbp.com.br/fileadmin/user_upload/Adolescencia_-_16_-_22373c-GPA_-_Incongruencia-DisforiaGenero.pdf
Fausto-Sterling A. The dynamic development of gender variability. J Homosex. 2012;59(3):398-421. https://doi.org/10.1080/00918369.2012.653310 - PMID:22455327
Leite PM, Rocha GCS, Assis FM, Ferro LD, Almeida JP, Amaral WN. Impactos do tratamento hormonal em adolescentes transgêneros. Braz J Health Rev. 2021;4(2):4777-84. https://doi.org/10.34119/bjhrv4n2-062
Kyriakou A, Nicolaides NC, Skordis N. Current approach to the clinical care of adolescents with gender dysphoria. Acta Biomed. 2020;91(1):165-75. https://doi.org/10.23750/abm.v91i1.9244
Sociedade Brasileira de Pediatria. Departamento Científico de Adolescência. Guia prático de atualização. Disforia de gênero. Rio de Janeiro: Sociedade Brasileira de Pediatria; 2017. https://www.sbp.com.br/fileadmin/user_upload/19706c-GP_-_Disforia_de_Genero.pdf
Beidel DC, Turner SM, Sallee FR, Ammerman RT, Crosby LA, Pathak S. SET-C versus fluoxetine in the treatment of childhood social phobia. J Am Acad Child Adolesc Psychiatry. 2007;46:1622. https://doi.org/10.1097/chi.0b013e318154bb57
Biswas PN, Wilton LV, Shakir SA. The pharmacovigilance of mirtazapine: results of a prescription event monitoring study on 13554 patients in England. J Psychopharmacol. 2003;17(1):121-126. https://doi.org/10.1177/0269881103017001716 - PubMed 12680749
Alvares E, Puliafico A, Leonte, KG, Albano AM. Psychotherapy for anxiety disorders in children and adolescents. UpToDate, 2023. https://www.medilib.ir/uptodate/show/15927
Sarris J, McIntyre E, Camfield DA. Plant-based medicines for anxiety disorders, Part 1: a review of preclinical studies. CNS Drugs 2013;27:207-219. https://doi.org/10.1007/s40263-013-0044-3 PMID:23436255
O'Connell MA, Nguyen TP, Ahler A, Skinner SR, Pang KC. Approach to the patient: pharmacological management of trans and gender diverse adolescents. J Clin Endocrinol Metab. 2022;107(1):241-57. https://doi.org/10.1210/clinem/dgab634 PMID:34476487 - PMCID:PMC8684462
Cano-Prais HA, Costa-Val A, Souza ER. Incongruências classificatórias: uma análise dos discursos sobre as propostas da CID11 em relação às experiências trans. Cad Pagu. 2021;(62):e216219. https://doi.org/10.1590/18094449202100620019
Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K. Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Netw Open. 2022;5(2):1-13. https://doi.org/10.1001/jamanetworkopen.2022.0978 - PMID:35212746 - PMCID:PMC8881768
Travers A, Armour C, Hansen M, Cunningham T, Lagdon S, Hyland P, Vallières F, McCarthy A, Walshe C. Lesbian, gay or bisexual identity as a risk factor for trauma and mental health problems in Northern Irish students and the protective role of social support. Eur J Psychotraumatol. 2020;11(1):1-10. https://doi.org/10.1080/20008198.2019.1708144 - PMID:32128041 - PMCID:PMC7034482
Wilson C, Cariola LA. LGBTQI+ youth and mental health: a systematic review of qualitative research. Adolesc Res Rev. 2020;5(2):187-211. https://doi.org/10.1007/s40894-019-00118-w
Alves ML, Costa RA, Lopes GPG, Setton LRA, Mattos RMPR, Pimentel DMM. Reflections on the impact of sexuality in mental health of medical students: a quantitative study in a brazilian university. Rev Port Psiquiatr Saúde Ment. 2022;8(3):89-95. https://doi.org/10.51338/rppsm.329
Clark BA, Veale JF, Greyson D, Saewyc E. Primary care access and foregone care: a survey of transgender adolescents and young adults. Fam Pract. 2018;35(3):302-6. https://doi.org/10.1093/fampra/cmx112 - PMID:29177485 - PMCID:PMC5965101
Winter S, Diamond M, Green J, Karasic D, Reed T, Whittle S, Wylie K. Transgender people: health at the margins of society. Lancet. 2016;388(10042):390-400. https://doi.org/10.1016/S0140-6736(16)00683-8 - PMID:27323925
Malhotra S, Khurshid A, Hendricks KA, Mann JR. Medical school sexual health curriculum and training in the United States. J Natl Med Assoc. 2008;100(9):1097-106. https://doi.org/10.1016/S0027-9684(15)31452-8 - PMID:18807442
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Copyright (c) 2023 Ricardo Alves Costa, Catharina Pessoa Lebre Tavares, Rebecca Schuster Dorea Leite, Ana Cecília Menezes Nóbrega, Tássia Mayara Cardoso Rodrigues Rollemberg
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