A review of instruments of experimental psychological diagnostics of gender dysphoria and gender incongruence in the context of transition to ICD-11

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Abstract

In 2024, Russia will change over to the 11th version of the International Classification of Diseases (ICD-11) where the diagnosis “transsexualism” will be replaced by “gender incongruence”. At present, clinical practice guidelines rooted in evidence-based medicine are being developed. This means that validated instruments of experimental psychological diagnostics should be used. In the present review, we identify ten instruments used in international practice. After discussing their strengths and weaknesses we can recommend four instruments for diagnosing gender dysphoria and gender incongruence: Transgender Congruence Scale, Trans Collaborations Clinical Check-In (TC3), Gender Congruence and Life Satisfaction Scale, and Utrecht Gender Dysphoria Scale — Gender Spectrum (UDGS-GS). Six instruments are recommended for prescribing psychotherapy aimed to help the patients accept their gender identity and build resilience: Transgender Congruence Scale, Gender Identity Reflection and Rumination Scale, Gender Preoccupation and Stability Questionnaire, Trans Collaborations Clinical Check-In (TC3), Gender Congruence and Life Satisfaction Scale, and Transgender Identity Survey. At the same time, we do not recommend two widely used instruments — Utrecht Gender Dysphoria Scale (classical version) and Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults — due to their inapplicability to gender non-binary individuals and those in the process of gender transition. In the article we also discuss issues related to differential diagnostics in the context of ICD-11, as well as peculiarities of using diagnostic scales with gender non-binary individuals, intersex people and detransitioners.

About the authors

Yana Kirey-Sitnikova

Eurasian Coalition on Health, Rights, Gender and Sexual Diversity

Author for correspondence.
Email: yana.kirey.sitnikova@gmail.com
ORCID iD: 0000-0002-9603-5114

Master of Public Health

Estonia, Tallinn

Egor A. Burtsev

Herzen State Pedagogical University of Russia

Email: egor.halk@gmail.com
ORCID iD: 0000-0003-4614-5814

clinical psychologist, postgraduate student

Russian Federation, St. Petersburg

References

  1. Karpov AS, Vvedenskij GE, Dmitrieva TB. Problemy organizacii okazanija medicinskoj pomoshhi licam s transseksua-lizmom. Rossijskij psihiatricheskij zhurnal. 2001;(4):13–18. (In Russ.)
  2. Kirey-Sitnikova Y. Access to trans healthcare in Russia. In: Appenroth M, Varela M, editors. Trans & Gender Diverse Care: International Perspectives. Berlin: Transcript Independent Academic Publishing; 2022. In Print.
  3. Kirey-Sitnikova Ya. Some challenges of developing clinical practice guidelines on gender dysphoria and gender incongruence. Health Care Standardization Problems. 2021;9–10: 47–53. (In Russ.)
  4. Schwend SA. Trans health care from a depathologization and human rights perspective. Public Health Rev. 2020;41(1):3.
  5. Benestad EEP. From gender dysphoria to gender euphoria: An assisted journey. Sexologies. 2010;19(4):225–231.
  6. Ashley F, Ells C. In favor of covering ethically important cosmetic surgeries: Facial feminization surgery for transgender people. Am J Bioeth. 2018;18(12):23–25.
  7. Bowman SJ, Casey LJ, McAloon J, Wootton BM. Assessing gender dysphoria: A systematic review of patient-reported outcome measures. Psychol Sex Orientat Gend Divers. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/26835611/ (access date: 04.03.2022).
  8. Ho F, Mussap AJ. Development of the Trans and Gender Diverse Social Anxiety Scale. Anxiety Stress Coping. 2020;33(6):675–697.
  9. Chakrapani V, Vijin PP, Logie CH et al. Assessment of a “Transgender Identity Stigma” scale among trans women in India: Findings from exploratory and confirmatory factor analyses. Int J Transgenderism. 2017;18(3):271–281.
  10. Riggle EDB, Mohr JJ. A proposed multi factor measure of positive identity for transgender identified individuals. Psychol Sex Orientat Gend Divers. 2015;2(1):78–85.
  11. Cohen-Kettenis PT, Van Goozen SHM. Sex reassignment of adolescent transsexuals: A follow-up study. J Am Acad Child Adolesc Psychiatry. 1997;36(2):263–271.
  12. Deogracias JJ, Johnson LL, Meyer-Bahlburg HFL et al. The gender identity/gender dysphoria questionnaire for adolescents and adults. J Sex Res. 2007;44(4):370–379.
  13. Sjoberg MD, Walch SE, Stanny CJ. Development and initial psychometric evaluation of the Transgender Adaptation and Integration Measure (TG AIM). Int J Transgenderism. 2006;9(2):35–45.
  14. Kozee HB, Tylka TL, Bauerband LA. Measuring transgender individuals’ comfort with gender identity and appearance: Deve-lopment and Validation of the Transgender Congruence Scale. Psychol Women Q. 2012;36(2):179–196.
  15. Bauerband LA, Galupo MP. The Gender Identity Reflection and Rumination Scale: Development and psychometric evaluation. J Couns Dev. 2014;92(2):219–231.
  16. Hakeem A, Črnčec R, Asghari-Fard M et al. Development and validation of a measure for assessing gender dysphoria in adults: The Gender Preoccupation and Stability Questionnaire. Int J Transgenderism. 2016;17(3–4):131–140.
  17. Holt NR, Huit TZ, Shulman GP et al. Trans Collaborations Clinical Check-In (TC3): Initial validation of a clinical measure for transgender and gender diverse adults receiving psychological services. Behav Ther. 2019;50(6):1136–1149.
  18. Jones BA, Bouman WP, Haycraft E, Arcelus J. The Gender Congruence and Life Satisfaction Scale (GCLS): Development and validation of a scale to measure outcomes from transgender health services. Int J Transgenderism. 2019;20(1):63–80.
  19. McGuire JK, Berg D, Catalpa JM et al. Utrecht Gender Dysphoria Scale — Gender Spectrum (UGDS-GS): Construct validity among transgender, nonbinary, and LGBQ samples. Int J Transgender Health. 2020;21(2):194–208.
  20. Bockting WO, Miner MH, Swinburne Romine RE et al. The transgender identity survey: A measure of internalized transphobia. LGBT Health. 2020;7(1):15–27.
  21. Perrotta G. Gender dysphoria: definitions, classifications, neurobiological profiles, and clinical treatments. Int J Sex Reprod Health Care. 2020;3:42–50.
  22. Sperber MA. The “as if” personality and transvestism. Psychoanal Rev. 1973;60:605–612.
  23. Chiland C. The psychoanalyst and transsexual patient. Int J Psychoana. 2000;81:21–35.
  24. Hoening J, Kenna JC, Youd A. Surgical treatment for transsexualism. Acta Psychiatr Scand. 1971;47:106–136.
  25. Meyer JK. Clinical variants among applicants for sex reassignment. Arch Sex Behav. 1974;3:527–558.
  26. Steiner BW. Gender dysphoria: Development, research, management. New York: Plenum Press; 1985. 430 р.
  27. Gosselin C, Wilson G. Sexual variations. New York: Simon and Schuster; 1980. 169 р.
  28. Lev AI. Transgender emergence. New York-London-Oxford: The Haworth Clinical Practice Press; 2004. 500 р.
  29. Cohen-Kettenis PY, Pfäfflin F. Transgenderism and intersexuality in childhood and adolescence: Making choices. Link: SAGE Publication; 2003. https://sk.sagepub.com/books/transgenderism-and-intersexuality-in-childhood-and-adolescence (access date: 04.03.2022).
  30. Perrotta G. Suicidal risk: definition, contexts, differential diagnosis, neural correlates and clinical strategies. J Neurosci Neurol Surg. 2020;6:114.
  31. Marshall E, Claes L, Bouman WP et al. Non-suicidal self-injury and suicidality in trans people: A systematic review of the literature. Int Rev Psychiatry. 2016;28:58–69.
  32. Day JK, Fish JN, Perez-Brumer A et al. Transgender youth substance use disparities: Results from a population-based sample. J Adolesc Health. 2017;61:729–735.
  33. Vincent B. Breaking down barriers and binaries in trans healthcare: the validation of non-binary people. Int J Transgenderism. 2019;20(2–3):132–137.
  34. Belkin AI. Biologicheskie i social’nye faktory, formirujushhie polovuju identifikaciju (po dannym izuchenija lic, perenesshih smenu pola). In: Sootnoshenie biologicheskogo i social’nogo v cheloveke. М.: Knizhnaya fabrika No. 1; 1975. p. 777–790. (In Russ.)
  35. Turban JL, Loo SS, Almazan AN, Keuroghlian AS. Factors leading to “Detransition” among transgender and gender diverse people in the United States: A mixed-methods analysis. LGBT Health. 2021;8(4):273–280.

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Copyright (c) 2022 Kirey-Sitnikova Y., Burtsev E.A.

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