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Transsexualism: Clinical Features and Legal Issues

Year 2015, Volume: 7 Issue: 4, 436 - 447, 15.08.2015
https://doi.org/10.5455/cap.20150208051330

Abstract

Although the epidemiological data is generally obtained from the patients that applied for gender reassignment surgery, it is known that transsexualism is not seen as rarely as it was estimated in the past and should be evaluated in detail because of its psychological and social consequences. Etiology remains to be unclear and biological and psychosocial factors are thought to be responsible for its development. Gender identity stabilizes approximately in 3-4 ages and it is impossible to change it after these ages. For this reason the aim of treatment approaches is to improve the conformity of individuals to their identity and life, but not to change the gender identity. The World Professional Association for Transgender Health [WPATH] published a guideline including standards of care [SOC] and SOC provide clinical guidance in follow-up and treatment of transsexual individuals. There is a detailed code in civil law about gender reassignment but when this code implemented strictly, the use of it is very limited and it is clear that a new arrangement is needed in this issue.

 

References

  • APA (1980) Diagnostic and Statistical Manual of Mental Disorders, 3rd ed (DSM-III). Washington, DC: American Psychiatric Association.
  • APA (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, DC, American Psychiatric Association.
  • APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed, (DSM 5). Washington, DC, American Psychiatric Association.
  • Auer MK, Fuss J, Höhne N, Stalla GK, Sievers C (2014) Transgender transitioning and change of self-reported sexual orientation. PLoS One, 9:e110016.
  • Baba T, Endo T, Honnma H, Kitajima Y, Hayashi T, Ikeda H et al (2007) Association between polycystic ovary syndrome and female-to-male transsexuality. Hum Reprod, 22:1011–1016.
  • Beemyn G (2013) A presence in the past: a transgender historiography. J Womens Hist, 4:113-121.
  • Bockting, WO (2008) Psychotherapy and the real-life experience: from gender dichotomy to gender diversity. Sexologies, 17:211– 224.
  • Bockting, WO, Knudson G, Goldberg, JM (2006) Counseling and mental health care for transgender adults and loved ones. Int J Transgend, 9:35-82.
  • Bradley SJ, Zucker KJ (1997) Gender identity disorder: a review of the past ten years. J Am Acad Child Adolesc Psychiatry, 36:872- 880.
  • Canat S, Evrengöl A (1986) Çocuklarda ve ergenlerde atipik cinsel rol davranışı. Nöroloji, Nöroşiruji, Psikiyatri Dergisi 3:203-206.
  • Cohen-Kettenis PT, Gooren LJG (1999) Transsexualism: a review of etiology, diagnosis and treatment. J Psychosom Res, 46:315– 333.
  • Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J et al. (2012) Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgend, 13:165-232.
  • Çuhadaroğlu F, Kaplan İ, Özgen G, Öztürk MO, Rezaki M, Uluğ, B (1993). Dünya Sağlık Örgütü ICD-10 Ruhsal ve Davranışsal Bozukluklar Sınıflandırılması. Ankara, Türkiye Sinir ve Ruh Sağlığı Derneği.
  • de Vries ALC, Cohen-Kettenis PT, Delemarre-van de Waal HA (2006) Clinical management of gender dysphoria in adolescents. Int J Transgend, 9:83–94.
  • de Vrie ALC, Noens ILJ, Cohen-Kettenis PT, van Berckelaer-Onnes IA, Doreleijers TA (2010) Autism spectrum disorders in gender dysphoric children and adolescents. J Autism Dev Disord, 40:930–936.
  • Fraser L (2009) Depth psychotherapy with transgender people. Sex Relation Ther, 24:126-142.
  • Gabbard GO (2009) Gabbard's Treatments of Psychiatric Disorders, 4th edition. Arlington, American Psychiatric Publishing.
  • Green R (2000) Family cooccurrence of “gender dysphoria”: ten sibling or parent-child pairs. Arch Sex Behav, 29:499–507.
  • Green R, Fleming D (1990) Transsexual surgery follow-up: status in the 1990s. Annu Rev Sex Res, 1:163–174.
  • Hage JJ, Karim RB (2000) Ought GIDNOS get nought? treatment options for nontranssexual gender dysphoria. Plast Reconstr Surg, 105:1222–1227.
  • Hare L, Bernard P, Sanchez F, Baird P, Vilain E, Kennedy T, et al. (2009) Androgen receptor repeat length polymorphism associated with male-to-female transsexualism. Biol Psychiatry, 65:93–96.
  • HBIGDA (Harry Benjamin International Gender Dysphoria Association) (2001) Standards of Care for Gender Identity Disorders, Version 6. Mineapolis, MN, Harry Benjamin International Gender Dysphoria Association .
  • Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, Gooren LJ, Meyer III WJ, Spack NP et al (2009). Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 94:3132–3154.
  • Henningsson S, Westberg L, Nilsson S, Lundström B, Ekselius L, Bodlund O, et al (2005) Sex steroid-related genes and male-to- female transsexu-alism. Psychoneuroendocrinology, 30:657–664.
  • Hepp U, Kraemer B, Schnyder U, Miller N, Delsignore A (2005) Psychiatric comorbidity in gender identity disorder. J Psychosom Res, 58:259-261.
  • Köroğlu E, Güleç C (2007) Psikiyatri Temel Kitabı, İkinci Baskı. Ankara, Hekimler Yayın Birliği.
  • Landen M, Rasmussen P (1997) Gender identity disorder in a girl with autism–a case report. Eur Child Adolesc Psychiatry, 6:170– 173.
  • Lev AI (2009) The ten tasks of the mental health provider: recommendations for revision of The World Professional Association for Transgender Health’s standards of care. Int J Transgend, 11:74–99.
  • Michel A, Mormont C, Legros JJ (2001) A psycho-endocrinological overview of transsexualism. Eur J Endocrinol, 145:365-376.
  • Mukaddes NM (2002) Gender identity problems in autistic children. Child Care Health Dev, 28:529–532.
  • Özsungur B (2010). Cinsel kimlik gelişimi ve cinsel kimlik bozukluğunda psikososyal değişkenler: gözden geçirme. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 17:163-174.
  • Öztürk MO, Uluşahin A (2008) Ruh Sağlığı ve Bozuklukları, 11. Baskı. Nobel Tıp Kitabevleri, Ankara.
  • Pfaefflin F (1993) Regrets after sex reassignment surgery. J Psychol Human Sex, 5:69–85.
  • Rameez Z (2008) Schizophrenia and gender identity disorder. Psychiatric Bull, 32:316-317.
  • Sadock BJ, Sadock VA (2008) Kaplan and Sadock's Concise Textbook of Clinical Psychiatry, 3rd Edition. Philadelphia, Lippincott Williams Wilkins.
  • Sungur M, Yalnız Ö (1999) Transseksüalite: ilgili kavramlar ve cinsiyet düzenleme girişimleri. Klinik Psikiyatri Dergisi, 1:49-54.
  • Terada S, Matsumoto Y, Sato T, Okabe N, Kishimoto Y, Uchitomi Y (2011) Suicidal ideation among patients with gender identity disorder. Psychiatry Res, 190:159-162.
  • Tokdemir M, Isır AB, Dülger E, Coşkun A (2009) Gaziantep Üniversitesi Adli Tıp Ana Bilim Dalına 2008 yılında başvurmuş ilk cinsiyet değişikliği olgusu. e-Journal of New World Sciences Academy, 4:18-25.
  • Turan Başara G (2012) Türk Medeni Kanunu’nun 40’ıncı maddesi kapsamında cinsiyet değişikliği ve hukuki sonuçları. Türkiye Barolar Birliği Dergisi, 103:245-266.
  • Will MR, Öztan B (1993) Hukukun sebebiyet verdiği bir acı: transseksüellerin hukuki durumu. Ankara Üniversitesi Hukuk Fakültesi Dergisi 43:227-268.
  • Zhou JN, Hofman MA, Gooren LJG, Swaab DF (1995) A sex difference in the human brain and its relation to transsexuality. Nature, 378:68–70.
  • Zucker KJ (2004) Gender identity development and issues. Child Adolesc Psychiatr Clin North Am, 13:551–568.

Transseksüalizm: Klinik Özellikleri ve Yasal Konular

Year 2015, Volume: 7 Issue: 4, 436 - 447, 15.08.2015
https://doi.org/10.5455/cap.20150208051330

Abstract

Yapılan epidemiyolojik çalışma verileri daha çok cinsiyet değiştirme ameliyatları için başvuran kişilerden elde edilen transseksüalitenin geçmişte düşünüldüğü kadar nadir olmadığı ve gerek psikolojik gerekse toplumsal sonuçları nedeniyle üzerinde önemle durulması gerektiği bilinmektedir. Etiyolojisi tam olarak aydınlatılamamış olup biyolojik ve psikososyal faktörlerin etiyolojide birlikte rol oynadığı düşünülmektedir. 3-4 yaş civarında yerleşen cinsel kimliğin bu yaştan sonra değiştirilmesi olanaksızdır. Bu nedenle uygulanacak tedavilerde amaç cinsel kimliği değiştirmek değil kişinin kimliğine ve yaşantısına uyumunu arttırmak olmalıdır. Dünya Profesyonel Transseksüel Sağlığı Birliği (The World Professional Association for Transgender Health [WPATH]) bakım standartlarını (Standards of Care [SOC]) içeren bir kılavuz yayınlamıştır ve bu kılavuz transseksüel bireylerin takip ve tedavilerine dair öneriler sunmaktadır. Medeni kanunda cinsiyet değiştirme ile ilgili madde oldukça ayrıntılı olmakla birlikte maddeye sıkı sıkıya bağlı kalındığında kullanım alanı oldukça dardır ve bu konuda yeni bir düzenlemeye ihtiyaç duyulduğu açıktır.

 

References

  • APA (1980) Diagnostic and Statistical Manual of Mental Disorders, 3rd ed (DSM-III). Washington, DC: American Psychiatric Association.
  • APA (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision (DSM-IV-TR). Washington, DC, American Psychiatric Association.
  • APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed, (DSM 5). Washington, DC, American Psychiatric Association.
  • Auer MK, Fuss J, Höhne N, Stalla GK, Sievers C (2014) Transgender transitioning and change of self-reported sexual orientation. PLoS One, 9:e110016.
  • Baba T, Endo T, Honnma H, Kitajima Y, Hayashi T, Ikeda H et al (2007) Association between polycystic ovary syndrome and female-to-male transsexuality. Hum Reprod, 22:1011–1016.
  • Beemyn G (2013) A presence in the past: a transgender historiography. J Womens Hist, 4:113-121.
  • Bockting, WO (2008) Psychotherapy and the real-life experience: from gender dichotomy to gender diversity. Sexologies, 17:211– 224.
  • Bockting, WO, Knudson G, Goldberg, JM (2006) Counseling and mental health care for transgender adults and loved ones. Int J Transgend, 9:35-82.
  • Bradley SJ, Zucker KJ (1997) Gender identity disorder: a review of the past ten years. J Am Acad Child Adolesc Psychiatry, 36:872- 880.
  • Canat S, Evrengöl A (1986) Çocuklarda ve ergenlerde atipik cinsel rol davranışı. Nöroloji, Nöroşiruji, Psikiyatri Dergisi 3:203-206.
  • Cohen-Kettenis PT, Gooren LJG (1999) Transsexualism: a review of etiology, diagnosis and treatment. J Psychosom Res, 46:315– 333.
  • Coleman E, Bockting W, Botzer M, Cohen-Kettenis P, DeCuypere G, Feldman J et al. (2012) Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. Int J Transgend, 13:165-232.
  • Çuhadaroğlu F, Kaplan İ, Özgen G, Öztürk MO, Rezaki M, Uluğ, B (1993). Dünya Sağlık Örgütü ICD-10 Ruhsal ve Davranışsal Bozukluklar Sınıflandırılması. Ankara, Türkiye Sinir ve Ruh Sağlığı Derneği.
  • de Vries ALC, Cohen-Kettenis PT, Delemarre-van de Waal HA (2006) Clinical management of gender dysphoria in adolescents. Int J Transgend, 9:83–94.
  • de Vrie ALC, Noens ILJ, Cohen-Kettenis PT, van Berckelaer-Onnes IA, Doreleijers TA (2010) Autism spectrum disorders in gender dysphoric children and adolescents. J Autism Dev Disord, 40:930–936.
  • Fraser L (2009) Depth psychotherapy with transgender people. Sex Relation Ther, 24:126-142.
  • Gabbard GO (2009) Gabbard's Treatments of Psychiatric Disorders, 4th edition. Arlington, American Psychiatric Publishing.
  • Green R (2000) Family cooccurrence of “gender dysphoria”: ten sibling or parent-child pairs. Arch Sex Behav, 29:499–507.
  • Green R, Fleming D (1990) Transsexual surgery follow-up: status in the 1990s. Annu Rev Sex Res, 1:163–174.
  • Hage JJ, Karim RB (2000) Ought GIDNOS get nought? treatment options for nontranssexual gender dysphoria. Plast Reconstr Surg, 105:1222–1227.
  • Hare L, Bernard P, Sanchez F, Baird P, Vilain E, Kennedy T, et al. (2009) Androgen receptor repeat length polymorphism associated with male-to-female transsexualism. Biol Psychiatry, 65:93–96.
  • HBIGDA (Harry Benjamin International Gender Dysphoria Association) (2001) Standards of Care for Gender Identity Disorders, Version 6. Mineapolis, MN, Harry Benjamin International Gender Dysphoria Association .
  • Hembree WC, Cohen-Kettenis P, Delemarre-van de Waal HA, Gooren LJ, Meyer III WJ, Spack NP et al (2009). Endocrine treatment of transsexual persons: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 94:3132–3154.
  • Henningsson S, Westberg L, Nilsson S, Lundström B, Ekselius L, Bodlund O, et al (2005) Sex steroid-related genes and male-to- female transsexu-alism. Psychoneuroendocrinology, 30:657–664.
  • Hepp U, Kraemer B, Schnyder U, Miller N, Delsignore A (2005) Psychiatric comorbidity in gender identity disorder. J Psychosom Res, 58:259-261.
  • Köroğlu E, Güleç C (2007) Psikiyatri Temel Kitabı, İkinci Baskı. Ankara, Hekimler Yayın Birliği.
  • Landen M, Rasmussen P (1997) Gender identity disorder in a girl with autism–a case report. Eur Child Adolesc Psychiatry, 6:170– 173.
  • Lev AI (2009) The ten tasks of the mental health provider: recommendations for revision of The World Professional Association for Transgender Health’s standards of care. Int J Transgend, 11:74–99.
  • Michel A, Mormont C, Legros JJ (2001) A psycho-endocrinological overview of transsexualism. Eur J Endocrinol, 145:365-376.
  • Mukaddes NM (2002) Gender identity problems in autistic children. Child Care Health Dev, 28:529–532.
  • Özsungur B (2010). Cinsel kimlik gelişimi ve cinsel kimlik bozukluğunda psikososyal değişkenler: gözden geçirme. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 17:163-174.
  • Öztürk MO, Uluşahin A (2008) Ruh Sağlığı ve Bozuklukları, 11. Baskı. Nobel Tıp Kitabevleri, Ankara.
  • Pfaefflin F (1993) Regrets after sex reassignment surgery. J Psychol Human Sex, 5:69–85.
  • Rameez Z (2008) Schizophrenia and gender identity disorder. Psychiatric Bull, 32:316-317.
  • Sadock BJ, Sadock VA (2008) Kaplan and Sadock's Concise Textbook of Clinical Psychiatry, 3rd Edition. Philadelphia, Lippincott Williams Wilkins.
  • Sungur M, Yalnız Ö (1999) Transseksüalite: ilgili kavramlar ve cinsiyet düzenleme girişimleri. Klinik Psikiyatri Dergisi, 1:49-54.
  • Terada S, Matsumoto Y, Sato T, Okabe N, Kishimoto Y, Uchitomi Y (2011) Suicidal ideation among patients with gender identity disorder. Psychiatry Res, 190:159-162.
  • Tokdemir M, Isır AB, Dülger E, Coşkun A (2009) Gaziantep Üniversitesi Adli Tıp Ana Bilim Dalına 2008 yılında başvurmuş ilk cinsiyet değişikliği olgusu. e-Journal of New World Sciences Academy, 4:18-25.
  • Turan Başara G (2012) Türk Medeni Kanunu’nun 40’ıncı maddesi kapsamında cinsiyet değişikliği ve hukuki sonuçları. Türkiye Barolar Birliği Dergisi, 103:245-266.
  • Will MR, Öztan B (1993) Hukukun sebebiyet verdiği bir acı: transseksüellerin hukuki durumu. Ankara Üniversitesi Hukuk Fakültesi Dergisi 43:227-268.
  • Zhou JN, Hofman MA, Gooren LJG, Swaab DF (1995) A sex difference in the human brain and its relation to transsexuality. Nature, 378:68–70.
  • Zucker KJ (2004) Gender identity development and issues. Child Adolesc Psychiatr Clin North Am, 13:551–568.
There are 42 citations in total.

Details

Primary Language Turkish
Journal Section Review
Authors

Necla Keskin

Gamze Yapça This is me

Lut Tamam

Publication Date August 15, 2015
Published in Issue Year 2015 Volume: 7 Issue: 4

Cite

AMA Keskin N, Yapça G, Tamam L. Transseksüalizm: Klinik Özellikleri ve Yasal Konular. Psikiyatride Güncel Yaklaşımlar - Current Approaches in Psychiatry. August 2015;7(4):436-447. doi:10.5455/cap.20150208051330

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