Elin Skagerberg

Young people with features of gender dysphoria: Demographics and associated difficulties.

This article presents the findings from a cross-sectional study on demographic variables and associated difficulties in 218 children and adolescents (Mean ageu2009=u200914u2009years, SDu2009=u20093.08, rangeu2009=u20095–17 years), with features of gender dysphoria, referred to the Gender Identity Development Service (GIDS) in London during a 1-year period (1 January 2012–31 December 2012). Data were extracted from patient files (i.e. referral letters, clinical notes and clinician reports). The most commonly reported associated difficulties were bullying, low mood/depression and self-harming. There was a gender difference on some of the associated difficulties with reports of self-harm being significantly more common in the natal females and autism spectrum conditions being significantly more common in the natal males. The findings also showed that many of the difficulties increased with age. Findings regarding demographic variables, gender dysphoria, sexual orientation and family features are reported, and limitations and implications of the cross-sectional study are discussed. In conclusion, young people with gender dysphoria often present with a wide range of associated difficulties which clinicians need to take into account, and our article highlights the often complex presentations of these young people.

Measuring Empathizing and Systemizing with a Large US Sample

A large number of people completed one of two versions of the empathizing quotient (EQ) and systemizing quotient (SQ). One version had the negatively phrased items all re-worded. These re-worded items were answered more rapidly than the original items, and for the SQ produced a more reliable scale. Subjects gave self-assessments of empathizing and systemizing, and these were moderately correlated, r≈.6, with their respective quotients. Females had on average higher empathizing scores and males had on average higher systemizing scores. If a female-male pair was chosen at random, the female would have the higher empathizing score about two-thirds of the time, and the males would have the higher systemizing score about two-thirds of the time.

Self-Harming Thoughts and Behaviors in a Group of Children and Adolescents with Gender Dysphoria

ABSTRACT This article presents the findings from an audit on self-harm in 125 children and adolescents referred to the Gender Identity Development Service in London. Data concerning self-harming thoughts and behaviors before attending the service were extracted from documents in the patient files and from clinician reports. The findings indicated that suicide attempts and self-harming were more common over the age of 12. Overall, thoughts of self-harm were more common in the natal males whereas actual self-harm was more common in the natal females. The number of suicide attempts did not differ significantly between the two genders. The implications of these findings are discussed. Limitations of the study are also discussed which include that the data was only collected over an 8-month period and that it was extracted from patient files and from clinician reports.

Brief Report: Autistic Features in Children and Adolescents with Gender Dysphoria

This paper looks at the association between gender dysphoria (GD), scores on the Social Responsiveness Scale (SRS), and reported diagnoses of autism spectrum disorder (ASD). Parents of 166 young people presenting with GD (Mean agexa0=xa014.26, SDxa0=xa02.68) completed the SRS. Information concerning an ASD diagnosis was also extracted from the patient files. 45.8xa0% fell within the normal range on the SRS and of those 2.8xa0% had an ASD diagnosis. 27.1xa0% fell within the mild/moderate range and of those 15.6xa0% had an ASD diagnosis and 6.7xa0% an ASD query. 27.1xa0% fell within the severe range and of those 24.4xa0% had an ASD diagnosis and 26.7xa0% an ASD query. No difference was found in autistic features between the natal females and males.

Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria

INTRODUCTIONnPuberty suppression by gonadotropin-releasing hormone analogs (GnRHa) is prescribed to relieve the distress associated with pubertal development in adolescents with gender dysphoria (GD) and thereby to provide space for further exploration. However, there are limited longitudinal studies on puberty suppression outcome in GD. Also, studies on the effects of psychological support on its own on GD adolescents well-being have not been reported.nnnAIMnThis study aimed to assess GD adolescents global functioning after psychological support and puberty suppression.nnnMETHODSnTwo hundred one GD adolescents were included in this study. In a longitudinal design we evaluated adolescents global functioning every 6 months from the first visit.nnnMAIN OUTCOME MEASURESnAll adolescents completed the Utrecht Gender Dysphoria Scale (UGDS), a self-report measure of GD-related discomfort. We used the Childrens Global Assessment Scale (CGAS) to assess the psychosocial functioning of adolescents.nnnRESULTSnAt baseline, GD adolescents showed poor functioning with a CGAS mean score of 57.7 ± 12.3. GD adolescents global functioning improved significantly after 6 months of psychological support (CGAS mean score: 60.7 ± 12.5; P < 0.001). Moreover, GD adolescents receiving also puberty suppression had significantly better psychosocial functioning after 12 months of GnRHa (67.4 ± 13.9) compared with when they had received only psychological support (60.9 ± 12.2, P = 0.001).nnnCONCLUSIONnPsychological support and puberty suppression were both associated with an improved global psychosocial functioning in GD adolescents. Both these interventions may be considered effective in the clinical management of psychosocial functioning difficulties in GD adolescents.

Internalizing and Externalizing Behaviors in a Group of Young People with Gender Dysphoria

ABSTRACT The aim of the current paper was to examine externalizing and internalizing behaviors in adolescents with gender dysphoria. One hundred forty-one young people (84 natal females and 57 natal males, M age = 15.13, SD = 1.70) attending the Gender Identity Development Service in London completed the Youth Self Report form at the end of the assessment period (4 to 6 sessions). The main findings indicated that, overall, the adolescents showed significantly more internalizing than externalizing behaviors. Using cutoff points provided by Achenbach and Rescorla (2001), the mean internalizing score fell within the clinical range and the mean externalizing score within the normal range. There was also a significant positive relationship between these two behaviors both in the natal females and the natal males. The natal males presented with significantly more internalizing behaviors than the natal females; however, no significant difference was observed between the genders in terms of the number of externalizing behaviors and total problems. We discuss the implications of these findings with regard to clinical work.

Families changing families: The protective function of multi-family therapy for children in education

The Marlborough Family Education Centre (MFEC) uses a specific multi-family group approach with families where children exhibit (primarily) conduct problems and function poorly in school. Research indicates that failure to intervene with these children carries great potential cost to both the family and society. Outcomes for 50 families receiving intervention from the MFEC were compared with a control group of 28 who had access to a range of interventions, but not the multi-family group approach pioneered by the MFEC. Data on child and family social, emotional and behavioural functioning were collected at the point of referral, and at 6 and 12 months. Parents of children receiving support from the MFEC reported statistically and clinically significant improvements in their children that were maintained at 12 months whereas there was no change in the control group. In addition, measures of family functioning were fairly stable for the MFEC group, while the control group showed significant deterioration over the same time period. Other results were not significant. These findings are interpreted within the context of early intervention. The methodological limitations of the study are considered and suggestions for future research are outlined.

A therapeutic group for young people with diverse gender identifications

Young people are presenting to specialist gender services in higher numbers than before and many with significant psychosocial difficulties. Negative experiences of stigma, difficult peer relationships and discrimination exacerbate distress and psychological difficulties, negatively impacting wellbeing and resilience. Social support is advocated as a means of supporting young people with diverse gender identifications, such as through peer support groups. This article describes the establishment of a young persons’ group in 2011 within the United Kingdom’s Gender Identity Development Service (GIDS), for those attending the service as a means of enabling their coping with difficult experiences and facilitating their wellbeing and resilience through effective social support. The group was evaluated using qualitative and quantitative measures and has subsequently run each year. Now in its sixth year, the authors reflect on their learning and experiences.

In Response to Kenneth J. Zucker's Comment Regarding “Correcting for Continuity in 2 × 2 Chi-Square Tests”

Replies to the comments made by Kenneth J. Zucker (see record 2014-12202-001) on the authors original article (see record 2013-28991-004). The authors thank Zucker for helpful comments on their paper and for scrutinizing their statistics. Zucker correctly notes that the chi-square value of 2.69 is, in fact, non-significant and the chi-square for the second calculation is 5.00, which is significant at p < 0.05. The authors apologize for these errors and thank Zucker for the correction. Regarding the use of Yates correction, there remains much debate about whether it should be used.