DIFFERENCES IN TRANSSEXUAL AND HOMOSEXUAL TENDENCIES IN SCHIZOPHRENIA AND INTELLECTUAL DISABILITIES

Within the framework of the study of gender-role deviations in mental illness, conducted by the authors, an analysis of differences in sexual behavior and gender identity in such forms of pathology as schizophrenia and intellectual disability (MR - mental retardation) is presented. The article presents the results of the study of gender identity disorders (GID) in men with schizophrenia and men with ID, presents pathopsychological examples of GID. The study is based on the assumption that both in schizophrenia and in mental retardation, the pathogenesis of transsexualism inherent in these mental disorders is due to the violation of semi-dymorphic brain structures, which qualitatively change the nature of sexual behavior and gender identity. However, the phenomenology of these disorders will depend on the nature and specifics of the pathology, which determines its pathopsychological picture. Based on the analysis of the current state of the problem and the data of our own research, it was found that the disorder of sexual behavior and gender identity in schizophrenia has the form of typical schizophrenic patterns that take the form of metaphysical interpretation, pretentiousness, delusional ideas, etc., that do not contain proper sexual erotic component and is not implemented by the behavior inherent in persons of the opposite sex. This does not allow us to speak about the true transsexual tendencies in schizophrenia and true GID. There are grounds to regard the features of GID in schizophrenia as a separate clinical and psychological phenomenon caused by the influence of the general schizophrenic process. With MR, the key factor of which is retardation, there is a psychologically expressed homosexuality and true transsexual tendencies, accompanied by corresponding inner experiences. The article is important for the pathopsychological differential diagnosis of transsexualism from other mental disorders occurring with EPI, and may contribute to expanding views on the origin of transsexualism.

Gender Identity Disorders: Current Medical and Social Paradigm and the ICD-11 Innovations

Introduction. This article presents a review of current concepts of gender identity under normal and pathological conditions. Aim. To analyse the impact of the medical and social paradigm shift for clinical practice. Results and discussion. The modern academic literature devoted to gender identity disorders is characterized by a variety of terminology, a shift in emphasis from clinical judgement to a socially beneficial normocentric approach and a relatively few advanced, evidence-based research. There is also a lack of evidence for the gender theory underlying the new approach, which raises serious doubts about the validity of the medical and social paradigm revision. In the same time, the position of Russian psychiatrists remains to be more clinically oriented. Conclusion. Patients who declare the desire to reassign their gender have to be assessed by psychiatrists for differential diagnosis to exclude a mental disorder. In such cases, the destigmatization of mental disorders is more critical than the depathologization of gender identity disorders.

Non-binary gender identity and transgendence beyond psychiatric discourse

An analysis of the problem of non-binary gender identity and transgender shows that the professional position of psychiatrists and psychologists is often based on selfish gender when subjectivity begins to be seen in psychiatric diagnostics due to a rigid binary gender setting. Modern research proves the existence of gender diversity and a spectrum of gender identity. All this allows us to state that the phenomenon of so-called gender identity disorders goes beyond the psychopathological context. The psychiatrists use of the binary approach does not correspond to rapidly changing public ideas about the norm and pathology of human behavior.

Psychiatric Disorders in Female Psychosexual Disorders—A Nationwide, Cohort Study in Taiwan

Background: We aimed to investigate whether females with psychosexual disorders (PSD) were associated with the risk of affective and other psychiatric disorders. Methods: A total of 2,240 enrolled individuals, with 560 PSD patients and 1,680 non-PSD subjects (1:3) matched for age and index year, from the Longitudinal Health Insurance Database, retrieved from the National Health Insurance Research Database, between 2000-2015 in Taiwan. The multivariate Cox regression model was used to compare the risk of developing psychiatric disorders during the 15 years of follow-up. Results: There were 98 in the PSD cohort (3444.66 per 100,000 person-year) and 119 in the non-PSD cohort (736.07 per 100,000 person-year) that developed psychiatric disorders. The multivariate Cox regression model revealed that, after the adjustment of age, monthly income, urbanization level, geographic region, and comorbidities, the adjusted hazard ratio (HR) was 9.848 (95% CI= 7.298 — 13.291, p < 0.001). Sexual dysfunctions (adjusted HR = 6.448), paraphilia (adjusted HR = 33.366), and gender identity disorders (adjusted HR = 12.286) were associated with the overall psychiatric disorders. Conclusions: Female patients with PSD were associated with the risk of psychiatric disorders. This finding could be a refiner for clinicians about the mental health problems in the PSD patients.

Making Trans-Gender Healthcare a Priority in India- Journey towards Social Inclusion

Introduction: Transgender includes trans-men and trans-women, persons with intersex variations, gender-queers, and persons with socio-cultural identities. Any normal parent expects a binary outcome out of the nine months long pregnancy, however, for some, life changes when the expected outcome is different. Objective: The article tends to understand the life of transgender/Hijra in India with respect to specific healthcare needs along with constitutional mechanism to extend them their legal rights. Method: The researcher reviewed available literature to analyse the issues and challenges in accessing healthcare services by the transgender community. Grey literature and qualitative methods like consultation/ interviews with communities and subject experts were also done to supplement the study outcomes. Results: The study shows that after a long movement, transgender were formally given recognition in 21st century in India. Currently, we have a number to begin with. WHO’s ICD-11 included “gender identity disorders” as “gender incongruence” in its new chapter on sexual health. Interactions with key experts and community reveals different specific needs of transgender population. Conclusion: Five points as way forward to improve health care accessibility of transgender in India: Creating an enabling environment before the next Census in India; addressing stigma and other issues that make transgender people vulnerable to health risks; extending equal human and legal rights to transgender; revising the medical curriculum so as to include a chapter on transgender health; and No Me Without Me.

The Future of Disability Rights Protections for Transgender People

The Americans with Disabilities Act and its predecessor, Section 504 of the Rehabilitation Act of 1973 (“Section 504”), protect people from discrimination based on disability, but not if the disability is one of three archaic medical conditions associated with transgender people: “transvestism,” “transsexualism,” and “gender identity disorders not resulting from physical impairments.” This Article describes the origins of transgender exclusion and discusses why a growing number of federal courts find this exclusion does not apply to gender dysphoria, a new and distinct medical diagnosis. Further, the Authors define the future of disability rights protections for transgender people.