Psychiatria Fennica (Nov 2019)
EXPERIMENTAL TREATMENT OF GENDER DYSPHORIA IN PATIENTS WITH NON-BINARY GENDER IDENTITIES: A RETROSPECTIVE REGISTER STUDY AND QUALITY CONTROL
Abstract
The number of people with non-binary gender experience seeking gender-affirming treatment is rising in Finland as in other European countries. The treatments vary, and there is no long-term follow-up data on the benefits of the treatments orthe stability of non-binary gender experience. The aim of this study was to evaluate the clinical outcome of empirical gender-affirming treatment among non-binary individuals who were examined in Helsinki University Hospital’s Gender Identity Clinic during the period 2010–2018. 50 individuals were included in the study (43 were natal females and 7 natal males) and were sent a questionnaire which 39 individuals completed forming a follow-up group, i.e. respondents. All the patients’ psychiatric diagnoses were reviewed. It was found that 8% of patients had no other psychiatric diagnosis in addition to gender disorder diagnosis, and 50% had three or more psychiatric diagnoses, most commonly depression (76%) or anxiety disorder (48%). Neuropsychiatric diagnoses were assigned to 20% and eating disorders to 16%. The use of psychiatric services prior to the examination period was high, in line with the prevalence of psychiatric morbidity. Health-related quality of life (HRQoL) was measured by using the 15D. The results were compared with an age- and gender-standardized sample of the general Finnish population. The mean 15D score among the follow-up group was significantly lower than among the general population. There was no statistically significant difference in the mean 15D score at the beginning of the examination period and at follow-up, suggesting that the treatment of gender dysphoria may not have a large effect on overall HRQoL. The respondents experienced the gender-affirming treatment to be beneficial, and the non-binary gender identity had remained stable among 32 (82%) respondents. The results of this study show that among these non-binary individuals, gender-affirming treatment alleviated gender dysphoria. Moreover, the treatments did not cause any concerning disbenefits, such as regret or unacceptable somatic complications. More research is urgently needed on the effectiveness of gender-affirming treatment among non-binary individuals.
