Psychopatological data and mental functioning in a sample of patients with gender dysphoria

Introduction: Many studies have shown that adolescents with gender incongruence have, compared to cis-gender peers, an increase in psychopathological conditions, like internalizing and eating disorders, self-harm and suicidal ideation. The most common explanation for this phenomenon is that those mental health issues are secondary to factors such as family rejection or consequence of social stigma or minority stress. Some authors, on the other hand, highlighted that good personality functioning and good mentalization skills can be protective factors against psychopathology. However, it has been found that transgender adolescents are more similar than different when compared to adolescents referred for other mental health concerns. Objective: Describe the psychological functioning, psychopathological aspects and personality disorders in a sample of Italian transgender adolescents accessing psychiatric services; Make a comparison with a sample composed by cisgender inpatients adolescents; Analyze the correlation between the functioning of these patients and the quality of the support received from the society, external stressors like discrimination and bullying, the body dissatisfaction, the ability of mentalization and epistemic trust. Sample: 21 AFAB transgender (i.e., with any gender identity that differed from their sex assigned at birth) inpatients adolescents (12-18 y); 21 AFAB cisgender inpatients adolescents (12-18 y). Results and Conclusions: (a) In the transgender sample there is a high prevalence of symptoms related to depressive and anxious disorders, eating disorders, bodily dissatisfaction and self-cutting; (b) No statistically significant differences (p value >.05) between transgender and cisgender samples in all the evaluated psychopathological dimensions (depressive and anxious symptoms, personality aspects and diagnosis of axis 1 disorders); (c) Regarding personality aspect, in the transgender sample avoidant personality disorder is the most represented; (d) Transgender adolescents are more frequently exposed to bullying than cisgender peers (p value 0,02); (e) Multivariate regressions showed that being bullied, a high level of bodily dissatisfaction, poor mentalization skills and a worse epistemic trust correlate negatively with the psychopathological aspects of transgender adolescents.