Roberto Vitelli

Adult Attachment and Transgender Identity in the Italian Context: Clinical Implications and Suggestions for Further Research

ABSTRACT Introduction: Although attachment theory has been recognized as one of the main references for the study of the general well-being, little research has been focused on the attachment styles of transgender people. Attachment styles are deeply influenced by the earliest relationships with caregivers, which, for gender-nonconforming children, are often characterized by parental rejection. Consequently, transgender children and adults likely internalize societal stigma, developing internalized transphobia. The current research was aimed to explore the link between adult attachment and internalized transphobia. Method: Twenty-five male-to-female (MtF) and 23 female-to-male (FtM) transgender people participated in the survey filling in two self-report questionnaires: the Attachment Style Questionnaire and the Transgender Identity Survey. A cluster analysis, t-test, and multiple regression analysis were conducted to explore the link between attachment styles and internalized transphobia. Results: A greater prevalence of secure attachment styles was detected. Participants with secure attachment styles reported higher levels of positive transgender identity than those with insecure attachment styles. Secure attachment styles significantly affect positive transgender identity, while insecure attachment styles influence internalized transphobia. Conclusions: A clinical focus on the redefinition of the internal working models of transgender people can inform psychologically focused interventions that transgender people can benefit from.

Gender Identity Disorder and Attachment Theory: The Influence of the Patient's Internal Working Models on Psychotherapeutic Engagement and Objective. A Study Undertaken Using the Adult Attachment Interview

ABSTRACT Until now, studies related to gender identity disorder (GID) in adult patients carried out within the framework of attachment theory have been scarce. The current research project aimed to explore the theme related to the specific nature of the current states of mind with respect to attachment in adult male patients suffering from GID, and to evaluate simultaneously the level of psychopathology associated with conditions of GID. The first 18 patients suffering from GID, who came to the Functional Area of Psychology of the Clinical Department of Neuroscience and Behaviour of the “Federico II” University Hospital between 2005 and 2007 to psychological assistance for problems connected to gender dysphoria, were registered in sequential order. The following tests were administered to all patients: (a) investigation of case histories and motivation, (b) Minnesota Multiphasic Personality Inventory (MMPI-2), and (c) Adult Attachment Interview. The results show an increase, among people with GID, of insecure conditions of the mind and of unresolved/disorganized conditions of the mind with respect to traumas or losses. Results obtained by MMPI-2 confirm the absence of other psychopathological conditions previously reported in the scientific literature. Based on the results of our exploratory research, we discuss how psychological intervention could have a dual objective of improving the possibility of access to a fuller and more satisfying emotional-relational life and of allowing an adequate working-through of complex traumatic events, which appear to affect the life experiences of individuals with GID and, often, seem not to have been adequately worked through.

Defensive functioning in MtF and FtM transsexuals

In spite of the potential clinical utility of defense mechanisms in the assessment of gender identity disorder patients as candidates to sex reassignment surgery, there is paucity of research in this field. The aim of the present study is therefore to ascertain whether the defensive profile of MtF and FtM transsexuals seeking sex reassignment surgery can be defined more primitive, immature and maladaptive than that of the two control groups. We compared the defensive profiles as assessed through the REM-71 (Steiner et al., 2001) of 104 MtF transsexuals, 46 FtM transsexuals and two control groups of males and females. Our results show that MtF transsexuals present an overall more primitive defensive array than that of both control groups, while FtMs show a profile not dissimilar from that of both control groups. Our results support the hypothesis that MtF transsexuals are characterized by higher proneness to psychopathology than the general population and show a more immature level of psychological functioning than FtM transsexuals.

Internalized Transphobia, Resilience, and Mental Health: Applying the Psychological Mediation Framework to Italian Transgender Individuals

Transgender and gender nonconforming (TGNC) people are a highly-stigmatized population. For this reason, they might internalize society’s normative gender attitudes and develop negative mental health outcomes. As an extension of the minority stress model, the psychological mediation framework sheds light on psychological processes through which anti-transgender discrimination might affect mental health. Within this framework, the current study aimed at assessing in 149 TGNC Italian individuals the role of internalized transphobia as a mediator between anti-transgender discrimination and mental health, considering resilience as the individual-level coping mechanism buffering this relationship. The results suggest that both indicators of internalized transphobia (i.e., shame and alienation) mediate the relationship between anti-transgender discrimination and depression, while only alienation mediates the relationship between anti-transgender discrimination and anxiety. Furthermore, the results suggest that the indirect relation between anti-transgender discrimination and anxiety through alienation is conditional on low and moderate levels of resilience. Findings have important implications for clinical practice and psycho-social interventions to reduce stigma and stress caused by interpersonal and individual stigma.

Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria

The current study investigated attachment representations and complex trauma in a sample of gender dysphoric adults. Although it has been proven that the psychological wellbeing of gender diverse persons is largely mediated by family acceptance and support, research on their relationships with parental figures is scarce. A total of 95 adults took part in the study. The attachment distribution was as follows: 27% secure, 27% insecure and 46% disorganized. Regarding early traumas, 56% experienced four or more traumatic forms. Further, gender dysphoric adults showed significantly higher levels of attachment disorganization and polyvictimisation, relative to controls. Comparisons of subgroups, defined by natal gender, showed that trans women, compared to control males, had more involving and physically and psychologically abusive fathers, and were more often separated from their mothers; trans men, relative to female controls, had more involving mothers and were more frequently separated from and neglected by their fathers. The research has several implications for treatment, clinical health psychology, family support and education.

Psychotherapy and counselling in Italy: A situation still in the phase of definition

Abstract This paper reflects on the state of psychotherapy and counselling in Italy, with specific attention to the situation within the public services. With regard to psychotherapy, several aspects of the current legislative status quo as well as the diffusion of this form of treatment are considered through two studies, one carried out in a region of the north of Italy and the other in a region of the south. After underlining the absence of precise epistemological, practical and legislative recognition of the activities that can be included under the heading of counselling, some of the principal practical areas where counselling is proving valuable in the Italian context are more closely examined.

Parenting Desire and Minority Stress in Lesbians and Gay Men: A Mediation Framework

Despite the rapid increase in lesbian and gay (LG) people who desire and decide to become parents, LG childless individuals may encounter serious obstacles in the parenthood process, such as minority stress. Notwithstanding, the psychological processes by which prejudice events might affect the desire to become parents are still understudied. As an extension of the minority stress theory, the psychological mediation framework sheds light on these psychological processes, as it encompasses a more clinical view of stress. Within this framework, the current study aimed at assessing the role of prejudice events in affecting parenting desire in 290 childless Italian LG individuals (120 lesbians and 170 gay men), as well as the role of internalized heterosexism and sexual orientation concealment in mediating the relationship between prejudice events and parenting desire. The results suggest that only in lesbians prejudice events were negatively associated with parenting desire, and that sexual orientation concealment and internalized heterosexism were also negatively associated with parenting desire. Furthermore, sexual orientation concealment, and not internalized heterosexism, mediated the relationship between prejudice events and parenting desire in lesbians, but not gay men. The findings have important implications for clinical practice.

Omofobia e transfobia in un campione di studenti di Scienze Motorie: Implicazioni per gli insegnanti di educazione fisica e gli allenatori

I contesti sportivi sono permeati da stereotipi sessuali e di genere che vengono utilizzati per preservare la superiorita maschile e relegare cio che non lo e ad uno status inferiore. Questi stereotipi sono profondamente radicati nello sport anche perche vengono costantemente rinforzati dagli allenatori che, nelle pratiche sportive, spesso trasmettono valori eteronormativi. Il presente studio e finalizzato ad esplorare la conoscenza, le opinioni e gli atteggiamenti sulle questioni sessuali e di genere di 181 studenti di Scienze Motorie, comparati con quelli di 169 studenti di Psicologia, Medicina e Sociologia. Tutti i partecipanti hanno risposto a delle domande relative all’omofobia e alla transfobia e i dati sono stati analizzati attraverso il Test di Student e dei modelli di regressione lineare. I risultati indicano che gli studenti di Scienze Motorie presentano livelli inferiori di conoscenza sulle questioni sessuali e di genere e cio e risultato associato a piu alti livelli di atteggiamenti omofobici e transfobici. I risultati suggeriscono il bisogno di implementare percorsi specifici di formazione nei corsi di laurea con il fine di destrutturare gli stereotipi e i pregiudizi sessuali e di genere.