Psychiatric Comorbidities in Transsexualism: Study of a Lebanese Transgender Population

INTRODUCTION:

The question of whether gender dysphoria is associated with psychiatric comorbidity has been addressed in several studies. Several cohort studies have shown that psychiatric comorbidity is one of the main features of poor prognosis following sex change therapy. Gender dysphoria is rare, with an estimated prevalence of 0.001% to 0.002% globally. The literature shows a high prevalence of psychiatric comorbidities in people with gender dysphoria, and that they are more common in male to female transsexuals. Data on long-term mortality show that transsexuals present a 51 % increase in mortality compared to the general population. This is mainly attributed to a six-fold increase in the number of suicides and a higher rate of psychiatric disorders and risky behaviors leading to HIV infection and substance abuse.

PURPOSE:

Assess psychiatric comorbidity in a population of Lebanese transgender individuals and compare it to the general population. The hypothesis of our study is that the Lebanese transgenders suffer from more psychiatric comorbidities than the general population. Our second objective was to determine the specific mental health needs of this population in order to adapt our services to their medical needs and their specific concerns.

METHODS:

Our objective was to acquire 20 transgender participants and 20 control subjects. We chose a snowball sampling method. The evaluation consisted of three questionnaires including a general demographic questionnaire, the MINI 5.0.0 Arabic version for axis I disorders and the SCID-II for axis II disorders.

RESULTS:

The mean age of both groups was 23.55 years. Fifty-five percent (n=11) transgender participants had active suicidal thoughts against 0 % in controls. Within the group of transgender, 45 % (n=9) had a major depressive episode, 5 % (n=1) had a generalized anxiety disorder, 5 % (n=1) had a posttraumatic stress disorder and 10 % (n=2) had a major depressive episode with comorbid posttraumatic stress disorder. We noted a significant difference between the two groups regarding the presence of suicidal ideation (P=0.000) and the presence of axis I disorders (P=0.039).

DISCUSSION:

In our study, we noted demographic and economic characteristics specific to the population of transgender individuals. We found a significant difference in the level of education, economic status and household composition. Transgender individuals suffer from more psychiatric pathologies compared to the general population. This may be due to social and familial discrimination and ostracism. These results demonstrate the vulnerability of this population. An awareness program for mental health professionals is essential in order to adapt care to the specific needs of this population. A list of non "transphobic" mental health professionals should be established.

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By:  Ibrahim C1, Haddad R2, Richa S3.

• 1Hôtel-Dieu de France, faculté de médecine, université Saint-Joseph, Beyrouth, Liban.
• 2Faculté de médecine, université Saint-Joseph, Beyrouth, Liban.
• 3Hôtel-Dieu de France, faculté de médecine, université Saint-Joseph, Beyrouth, Liban; Faculté de médecine, université Saint-Joseph, Beyrouth, Liban. Electronic address: sami.richa@usj.edu.lb.
• Encephale. 2016 Mar 23. pii: S0013-7006(16)00043-9. doi: 10.1016/j.encep.2016.02.011.  

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