Másodközlés: A nem bináris nemi hovatartozás orvosi megítélésének szakirodalmi áttekintése
Absztrakt
A transznemű és nem bináris (köztes) személyek és fiatalok testi és lelki egészsége kevéssé kutatott terület hazánkban. A diagnosztikai eszközök és a felismerés esélye korlátozott, ami különösen veszélyeztetetté teszi e rejtőzködő csoportot. Az újabb diagnosztikai besorolás (Betegségek Nemzetközi Osztályozása, BNO-11) által javasolt ’nemi inkongruencia’ tartós és jelentős eltérés a személy megélt identitása és testi megjelenése között. Az összhang hiánya önmagában nem indikálja diagnózis felállítását, viszont a mentális egészségi nehézségek és az önsértő magatartás gyakoribb előfordulása indokolttá teszi az orvosi ellátást és segítségnyújtást a mindennapi háziorvosi gyakorlatban is.
Hivatkozások
Somorjai N. Current issues in providing healthcare for sexual and gender minority individuals. [A nemi kisebbségekhez tartozó személyek orvosi ellátásának aktuális kérdései.] Orv Hetil. 2021; 162: 1267–1274. [Hungarian]
Bálint E, Dombos T. Awkward silence. LGBTI people in the Hungarian healthcare system. [Kínos csend. LMBTI emberek a magyar egészségügyi rendszerben.] Háttér Társaság, Budapest, 2021. [Hungarian]
Lee JG, Ylioja T, Lackey M. Identifying lesbian, gay, bisexual, and transgender search terminology: a systematic review of health systematic reviews. PLOS ONE 2016; 11: e0156210.
DR Z PHD Gender Specialist (Internet). Natalia P Zhikhareva, Beverly Hills, CA, 2024. Available from: https://drzphd.com/ [accessed: July 7, 2024]; https://www.youtube.com/@DRZPHD [accessed: July 7, 2024].
McGuire JK, Beek TF, Catalpa JM, et al. The Genderqueer Identity (GQI) Scale: Measurement and validation of four distinct subscales with trans and LGBQ clinical and community samples in two countries. Int J Transgend. 2018; 20: 289–304.
Háttér Society. LMBTQI Glossary. [Háttér Társaság: LMBTQI Szószedet.] Available from: https://hatter.hu/archivum/kultura-es-mozgalom/lmbtqi-szoszedet [accessed: Sept 30, 2024]. [Hungarian]
Scheim AI, Bauer GR. Sex and gender diversity among transgender persons in Ontario, Canada: results from a respondent-driven sampling survey. J Sex Res. 2015; 52: 1–14.
Roberts AL, Rosario M, Corliss HL, et al. Childhood gender nonconformity: a risk indicator for childhood abuse and post- traumatic stress in youth. Pediatrics 2012; 129: 410–417.
MacMullin LN, Bokeloh LM, Nabbijohn AN, et al. Examining the relation between gender nonconformity and psychological well-being in children: the roles of peers and parents. Arch Sex Behav. 2021; 50: 823–841.
Fiani CN, Han HJ. Navigating identity: experiences of binary and non-binary transgender and gender non-conforming (TGNC) adults. Int J Transgend. 2018; 20: 181–194.
Hungarian Medical Bibliography. Transsexuality. [Magyar Orvosi Bibliográfia – Transsexualitás.] Állami Egészségügyi Ellátó Központ, Budapest. Available from: https://mob.aeek.hu/sim- plesearch.jsp?WHAT=2&TOS,H=transsexualit%E1s [accessed: Sept 30, 2024]. [Hungarian]
Füredi J, Németh A, Kéri Sz. (eds.) Abridged handbook of psychiatry. 3rd ed. [Németh A, Füredi J. (szerk.) A pszichiátria rövidített kézikönyve. Harmadik kiadás.] Medicina Könyvkiadó, Budapest, 2011. [Hungarian]
Simon L. Gender identity disorders. In: Németh A, Füredi J. (eds.) The Hungarian manual of psychiatry. 6th edition. [A nemi identitás zavarai. In: Németh A, Füredi J. (szerk.) A pszichiátria magyar kézikönyve. 6. kiadás.] Medicina Könyvkiadó, Budapest, 2021; pp. 370–376. [Hungarian]
Butler SS. Sexual and gender minority mental health among older adults. In: Rothblum ED. (ed.) The Oxford handbook of sexual and gender minority mental health. Oxford University Press, Oxford, 2020; pp. 245–255.
Winter S, Diamond M, Green J, et al. Transgender people: health at the margins of society. Lancet 2016; 388: 390–400.
Flores AR, Herman JL, Gates GJ, et al. How many adults identify as transgender in the United States? Williams Institute, Los Angeles, CA, 2016.
Nolan IT, Kuhner CJ, Dy GW. Demographic and temporal trends in transgender identities and gender confirming surgery. Transl Androl Urol. 2019; 8: 184–190.
Zhang Q, Goodman M, Adams N, et al. Epidemiological considerations in transgender health: a systematic review with focus on higher quality data. Int J Transgend Health 2020; 21: 125–137.
Adrigán E, Sarkadi B. Boys and girls. Issues of gender identity in the clinic. [Fiúk és lányok. A nemi identitás kérdései a klinikumban.] Serdülő- és Gyermek-pszichoter. 2022; 15: 5–7. [Hungarian]
S. Nagy Z. The role of early trauma in development. In: Árkovits A, Terenyi Z, Varga SK. (eds.) Trauma kaleidoscope. [A korai trauma szerepe a fejlődés alakulásában. In: Árkovits A, Terenyi Z, Varga SK. (szerk.) Trauma-kaleidoszkóp.] Oriold Kiadó, Budapest, 2023; pp. 111–131. [Hungarian]
Shelton J, Winkelstein J. Librarians and social workers: working together for homeless LGBTQ youth. YALS 2014; 13: 20–24.
Coleman E, Radix AE, Bouman WP, et al. Standards of care for the health of transgender and gender diverse people. Version 8. Int J Transgend Health 2022; 23(Suppl 1): S1–S259.
Lemma A. The body one has and the body one is: understanding the transsexual’s need to be seen. Int J Psychoanal. 2013; 94: 277–292.
Hős G. Information on the recommended practice for the treatment of transgender patients. [Tájékoztatás a transznemű páciensekkel kapcsolatos bánásmód javasolt gyakorlatáról.] Magy Urol. 2018; 30: 92–93. [Hungarian]
Kuper LE, Nussbaum R, Mustanski B. Exploring the diversity of gender and sexual orientation identities in an online sample of transgender individuals. J Sex Res. 2012; 49: 244–254.
Rowlett JD, Patel D, Greydanus DE. Homosexuality. In: Greydanus DE, Wolraich ML. (eds.) Behavioral pediatrics. Springer, New York, NY, 1992; pp. 37–40.
Hopwood M, Cama E, de Wit J, et al. Stigma, anxiety, and depression among gay and bisexual men in mixed-orientation marriages. Qual Health Res. 2020; 30: 622–633.
Coyne CA, Sajwani A, Chen D. Gender and its variation in youth. In: Feldman HM, Elias ER, Blum NJ, et al. (eds.) Developmental-behavioral pediatrics, 5th edition. Elsevier, New York, NY, 2022; pp. 757–764.
Janeway H, Coil CJ. Emergency care for transgender and gender-diverse children and adolescents. Pediatr Emerg Med Pract. 2020; 17: 1–20.
Turban JL, Ehrensaft D. Research review. Gender identity in youth: treatment paradigms and controversies. J Child Psychol Psychiatry 2018; 59: 1228–1243.
Goldhammer H, Crall C, Keuroghlian AS. Distinguishing and addressing gender minority stress and borderline personality symptoms. Harv Rev Psychiatry 2019; 27: 317–325.
Pantalone DW, Sloan CA, Carmel A. Dialectical behavior therapy for borderline personality disorder and suicidality among sexual and gender minority individuals. In: Pachankis JE, Safren SA. (eds.) Handbook of evidence-based mental health practice with sexual and gender minorities. Oxford University Press, New York, NY, 2019.
Bouzy J, Brunelle J, Cohen D, et al. Transidentities and autism spectrum disorder: a systematic review. Psychiatry Res. 2023; 323: 115176.
Strang JF, van der Miesen AI, Fischbach AL, et al. Common intersection of autism and gender diversity in youth: clinical perspectives and practices. Child Adolesc Psychiatr Clin N Am. 2023; 32: 747–760.
Goetz TG, Adams N. The transgender and gender diverse and attention deficit hyperactivity disorder nexus: a systematic review. J Gay Lesbian Ment Health 2024; 28: 2–19.
Strang JF, Kenworthy L, Dominska A, et al. Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Arch Sex Behav. 2014; 43: 1525–1533.
Kohnepoushi P, Nikouei M, Cheraghi M, et al. Prevalence of suicidal thoughts and attempts in the transgender population of the world: a systematic review and meta-analysis. Ann Gen Psychiatry 2023; 22: 28.
Marconi E, Monti L, Marfoli A, et al. A systematic review on gender dysphoria in adolescents and young adults: focus on suicidal and self-harming ideation and behaviours. Child Adolesc Psychiatry Ment Health 2023; 17: 110.
Zhikhareva NP. On your terms. Gender transition redefined for adults. DR Z Consulting, Los Angeles, CA, 2023.
Marraccini ME, Ingram KM, Naser SC, et al. The roles of school in supporting LGBTQ+ youth: a systematic review and ecological framework for understanding risk for suicide-related thoughts and behaviors. J Sch Psychol. 2022; 91: 27–49.
Charlton BM, Potter J, Keuroghlian AS, et al. Development of a mentor training curriculum to support LGBTQIA + health professionals. J Clin Transl Sci. 2024; 8: e44.
Somorjai N. Homosexuality. LGBTI children and adolescents in pediatric outpatient care. [Homoszexualitás. LMBTI-gyermekek és -serdülők a házi gyermekorvosi ellátásban.] Hírvivő 2017; 22: 24–27. [Hungarian]
Centers for Disease Control and Prevention [Internet]. US Department of Health and Human Services, Washington, DC, 2015. Health disparities among LGBTQ youth. Available from: https://www.cdc.gov/healthyyouth/disparities/health-disparities-among-lgbtq-youth.htm [accessed: July 7, 2024].
National Institute of Mental Health. Mental health statistics: suicide. 2018. Available from: https://www.nimh.nih.gov/health/ statistics/suicide [accessed: July 8, 2024].
Wexelbaum R, Hoover J. Gifted and LGBTIQ: a comprehensive research review. Int J Talent Develop Creativity 2014; 2: 73–86.
Human Rights Campaign. Growing up LGBT in America: HRC Youth survey report key findings. Available from: https://www.aamc.org/about-us/equity-diversity-inclusion/lgbt-health-resources/growing
-lgbt-america [Last accessed: 2014.]
Hoover J, Larson J, Baker T. Bullying, school climate, social climate and intellectual development: implications for the lives of high-achieving, creative students. Int J Talent Develop Creativity 2013; 1: 33–43.
Lee Badgett MV, Waaldijk K, van der Meulen Rodgers Y. The relationship between LGBT inclusion and economic development: macro-level evidence. World Development 2019; 120: 1–14.
Claahsen-van der Grinten H, Verhaak C, Steensma T, et al. Gender incongruence and gender dysphoria in childhood and adolescence-current insights in diagnostics, management, and follow- up. Eur J Pediatr. 2021; 180: 1349–1357.
Park RH, Liu YT, Samuel A, et al. Long-term outcomes after gender-affirming surgery: 40-year follow-up study. Ann Plast Surg. 2022; 89: 431–436.
de Vries AL, Steensma TD, Doreleijers TA, et al. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011; 8: 2276–2283.
Santi D, Spaggiari G, Marinelli L, et al. Gender-affirming hormone treatment: friend or foe? Long-term follow-up of 755 transgender people. J Endocrinol Invest. 2024; 47: 1091–1100.
Dhejne C, Lichtenstein P, Boman M, et al. Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PLoS ONE 2011; 6: e16885.
Pap E. Transgender adolescents with chronic mental health problems on the verge of transition? In: The tolerable uncertainty of the future. The 17th Conference of the Journal of Psychotherapy. [Krónikus mentális problémákkal élő transznemű kamaszok a tranzíció küszöbén? In: A jövő elviselhető bizonytalansága. A Pszichoterápia folyóirat 17. Konferenciája, Budapest, 2023. május 12–13.]. MentalPort Kft., Budapest, 2023; 60. [Hungarian]
Frankowski BL, American Academy of Pediatrics Committee on Adolescence. Sexual orientation and adolescents. Pediatrics 2004; 113: 1827–1832.
Hungarian Medical Bibliography. Suicide. [Magyar Orvosi Bibliográfia. Öngyilkosság.] Állami Egészségügyi Ellátó Központ, Budapest. Available from: https://mob.aeek.hu/simplesearch.js p?TOSRCH=%F6ngyilkoss%E1g&WHAT=2&PAGE=9 [accessed: July 10, 2024]. [Hungarian]
Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129: 674–697.
Zeluf G, Dhejne C, Orre C, et al. Health, disability and quality of life among trans people in Sweden – a web-based survey. BMC Public Health 2016; 16: 903. Erratum: BMC Public Health 2016; 16: 1085.
Hidasi B. TransCare 2014. Documentation of discrimination of trans* people in health care in Hungary. [TransCare 2014: a transz* embereket egészségügyben érő diszkrimináció dokumentálása Magyarországon.] Transvanilla Transznemű Egyesület, Budapest, 2014. [Hungarian]
Transgender Europe. Guidelines to human rights-based transspecific healthcare. [Útmutató az emberi jogokon alapuló transz- specifikus egészségügyi ellátáshoz.] Transvanilla Egyesület, Budapest, 2021. [Hungarian]
