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Master's Dissertation
DOI
https://doi.org/10.11606/D.17.2020.tde-20062017-211054
Document
Author
Full name
Maria Rita Lerri
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2015
Supervisor
Committee
Lara, Lucia Alves da Silva (President)
Giami, Alain
Romão, Adriana Peterson Mariano Salata
Title in Portuguese
Caracterização de pacientes portadores de transtorno de identidade de gênero
Keywords in Portuguese
Caracterização
Disforia de gênero
Medicina sexual
Sexualidade
Transexualidade
Transtorno de identidade de gênero
Tratamentos farmacológicos
Abstract in Portuguese
O transtorno de identidade de genero (TIG) caracteriza-se pela sensacao de pertencer ao genero oposto ao genero atribuido no nascimento. O objetivo foi apresentar a caracterizacao social, afetiva e emocional de pacientes portadores de TIG, em acompanhamento no Ambulatorio de Estudos em Sexualidade Humana (AESH) da Faculdade de Medicina de Ribeirao Preto/USP. Utilizou-se um questionario semiestruturado para acessar os aspectos sociodemograficos e os aspectos emocionais. O risco para ansiedade e depressao, foi acessado utilizando-se a Escala Hospitalar de Ansiedade e Depressao (HAD). Estudo transversal, com amostra de conveniencia, composta por portadores de TIG em seguimento no AESH, no periodo de marco de 2013 a junho de 2014. Foram incluidos 44 transexuais, sendo 36 (82%) trans-mulher e 8 (18%) trans-homem, com idade media de 27,05±8,9 (18-59) anos sendo 30 (68%) brancos, 14 (32%) pardos/negros, 41 (93%) residem no nordeste do estado de Sao Paulo (SP), 2 (4,5%) no sudeste de SP e 1 (2,5%) no sudeste de Minas Gerais. Oito (18%) cursaram ensino fundamental, trinta (68%) o ensino medio, 6 (14%) ensino superior, 36 (82%) recebem de 1-5 salarios/mes, 8 (18%) estao desempregados, 24 (55%) referem uso de substancias (alcool, cocaina, maconha e cigarro), 39 (88,5%) se automedicavam com hormonios. A sexarca ocorreu entre 10-19 anos para 34 (77%) dos sujeitos, 25 (67%) tem um companheiro. Trinta e nove (88,5%) sujeitos sentem-se discriminados e todos referiram sentirem-se discriminados socialmente, 24 (61,5%) referem discriminacao no trabalho, 14 (36%) sentem-se discriminados pela familia, 7 (18%) nos estabelecimentos de saude. Trinta e dois (72,5%) sujeitos relataram uma ou mais tentativas de suicidio. Os fatores motivadores verbalizados foram discriminacao em 26 (81,5%), nao aceitacao familiar em 15 (47%) e nao aceitacao do proprio corpo em 21 (67%) sujeitos. A idade das tentativas foi de 10-19 anos em 18 (41%), e com mais de 19 em 14 (3%) da amostra. Quarenta e tres (98%) referiram sintomas de ansiedade e 36 (82%) de depressao. A principal razao para a busca por tratamento foi a terapia hormonal. A regressao logistica nao evidenciou influencia da idade na tentativa de suicidio. Os transexuais adolescentes e os adultos jovens tiveram, respectivamente, 5,28 e 3,81 vezes mais chances de tentar o suicidio em relacao aqueles com idade maior de 30 anos, porem o resultado nao foi significativo. Houve associacao significativa entre a variavel com quem mora e o escore de risco para depressao, sendo que, quem mora com parceiro tem uma frequencia menor de depressao em relacao as outras categorias (p=0,03). Da mesma forma, houve associacao significativa entre o estado civil e o escore sugestivo de depressao sendo que, os casados tem menor frequencia de risco para depressao em relacao as outras categorias (p=0,03). Os portadores de TIG avaliados no presente estudo sao, na maioria, mulheres transexuais, de classe media, empregados e possuem escolaridade media. Apresentam altos indices de ansiedade, depressao e tentativas de suicidio. Viver com um parceiro na condicao de casado foi um fator de protecao contra a depressao, o que corrobora estudos anteriores que apontam a importancia da relacao afetiva como fonte de apoio emocional para a populacao transexual.
Title in English
Characterization of patients with Gender Identity Disorder
Keywords in English
Characterization
Drug treatments
Gender dysphoria
Gender identity disorder
Sexual medicine
Sexuality
Transsexuality
Abstract in English
The gender identity disorder (TIG) is characterized by the feeling of belonging to the opposite sex to sex birth. The aim was to present the social characterization, affective and emotional patients with TIG followed at outpatient Studies in Human Sexuality (aesh), Faculty of Medicine of Ribeirao Preto/USP. We used a semi-structured questionnaire to access the sociodemographics aspects and emotional aspects. The risk for anxiety and depression, was accessed using the Hospital Anxiety and Depression Scale (HAD). Cross-sectional study with a convenience sample, composed of TIG patients followed up at aesh, from March 2013 to June 2014, were included 44 transsexuals, 36 (82%) trans-woman and 8 (18%) trans-man, with a mean age of 27.05 ± 8.9 (18-59) years and 30 (68%) white, 14 (32%) mulatto/Black, 41 (93)% live in the northwest of Sao Paulo (SP), 2 (4.5%) in the southeast of SP and 1 (2.5%) in the southeastern Minas Gerais. Eight (18%) attended elementary school, 30 (68%) high school, 6 (14%) higher education, 36 (82%) receive wages from 1-5/month, 8 (18%) are unemployed, 24 (55%) reported substance use (alcohol, cocaine, marijuana and cigarettes), 39 (88.5%) self-medicate with hormones. The first sexual intercourse occurred between 10-19 years to 34 (77%) subjects, 25 (67%) have a companion. Thirty-nine (88.5%) subjects feel discriminated against and all said they felt discriminated against socially, 24 (61.5%) reported discrimination at work, 14 (36%) feel discriminated against by the family, 7 (18 %) in health facilities. Thirty-two (72.5%) subjects reported one or more suicide attempts. The motivating factors verbalized were: discrimination 26 (81.5%), not family acceptance 15 (47%) and non- acceptance of one's body 21 (67%). The age of the attempts was 10 and 19 in 18 (41%) and more than 19 in 14(3%) of sample, 43 (98%) had symptoms of anxiety and 36 (82%) of depression. The principal reason for seeking treatment is hormonal therapy. Logistic regression showed no influence of age on suicide attempt. Transgender adolescents and young adults were, respectively, 5.28 times and 3.81 times more likely to attempt suicide compared with those older than 30 years, but the result was not significant. There was a significant association between the variable live with partner and the risk score for depression and, who lives with partner have a lower frequency of depression in relation to other categories (p=0.03). Similarly, there was a significant association between marital status and the evocative score of depression and, married has a lower rate of risk for depression in relation to other categories (p=0.03). Holders of TIG evaluated in this study are mostly transgender women, middle-class, are employed and have average education, however, have high rates of anxiety, depression and suicide attempts. Living with a partner in the married state was a protective factor against depression, which corroborates previous studies that show the importance of affective relationship as a source of emotional support for the transexual population.
 
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Publishing Date
2020-01-14
 
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