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

Aim:Many studies have shown that adolescents with gender incongruence have an increased risk of psychopathological conditions compared to their cisgender peers. These conditions include internalizing and eating disorders, self-harm, and suicidal ideation. Some authors have emphasized the role of personality and mentalization in the well-being of these individuals, suggesting that good personality functioning and strong mentalization skills can act as protective factors against psychopathology. Methods:The aim of this study is to describe the psychological functioning and psychopathological comorbidities in a sample of 40 transgender adolescents accessing psychiatric services and compare them with a sample of cisgender inpatient adolescents. We examined depression, anxiety, and personality disorders in both samples. In the clinical sample, we used the SWAP-200 to further investigate aspects of personality and assessed eating disorders, body image, self-harm behaviors, mentalization, and epistemic trust. Results:Our findings indicate that a) transgender adolescents are more frequently subjected to bullying compared to cisgender peers, b) there are no statistically significant differences between transgender and cisgender samples in the evaluated psychopathological dimensions and c) the transgender sample shows a high prevalence of symptoms related to eating disorders, body dissatisfaction, and self-cutting. Multivariate regressions revealed a statistically significant correlation between: being bullied and internalizing symptoms; body dissatisfaction, mentalization ability, and depressive symptoms; and epistemic trust and general psychological maladjustment. In terms of personality assessment, the PID-5 results show that the most represented domains are negative affect, detachment, and disinhibition. The SWAP-200 PD scores indicate that the most represented personality disorders are Schizoid, Schizotypal, and Avoidant, while the Q score suggests that the most represented disorders are Avoidant, Narcissistic, and Schizoid. Discussion:Our results demonstrate no statistically significant difference in the psychopathological profiles of both samples. Bullying experiences, high levels of bodily dissatisfaction, poor mentalization skills and lower levels of epistemic trust correlate negatively with the psychopathological aspects observed in transgender adolescents.