AIM

1. PSYCHOLOGICAL, MEDICAL AND SURGICAL MANAGEMENT IN GENDER IDENTITY DISORDERS: A PICTURE OF EUROPEAN CENTERS Mariateresa MOLO*, Chiara CRESPI*, Valentina MINECCIA* * Fondazione Carlo Molo Onlus, Turin – Italy * Gender Team C.I.D.I.Ge.M., Turin – Italy AIM IN THE OCCASION OF THE FIRST EUROPEAN MEETING ON TRANSSEXUALISM HELD IN TURIN ON MAY 2012, A QUESTIONNAIRE WAS SENT TO SOME EUROPEAN CENTERS DEALING WITH TRANS PEOPLE. THE AIM OF THIS QUESTIONNAIRE WAS TO GET A PICTURE OF THE EUROPEAN SITUATION ABOUT CARE AND TREATMENTS OFFERED TO TRANSSEXUAL, TRANSGENDER AND GENDER NON CONFORMING PEOPLE (WPATH 7TH VERSION OF STANDARDS OF CARE, SEPTEMBER 2011). QUESTIONNAIRE THE QUESTIONNAIRE USED IS COMPOSED OF 36 ITEMS TO INVESTIGATE CRITERIA OF TAKING IN CHARGE, DIAGNOSIS, REAL LIFE EXPERIENCE, MEDICAL AND SURGICAL TREATMENTS, NUMBER AND QUALIFICATION OF PROFESSIONALS. T1 T2 T3 T4 T5 DIAGNOSIS HORMONAL TREATMENT RELA LIFE EXPERIENCE Sex Reassignment Surgery FOLLOW UP TRANSFORMATION PROGRAMME T1 DIAGNOSIS T2 HORMONAL TREATMENT PSYCHOLOGICAL EVALUATION FOR HORMONAL TREATMENT IS MANDATORY FOR ALL THE EUROPEAN CENTERS • SELF DIAGNOSIS No center accepts self diagnosisexcept • World Profesisonal Association for Transgender Health ( WPATH) Standards of Carefollowed by: T3 REAL LIFE EXPERIENCE • IN EVERY CENTER THE LENGTH IS ALMOST 12 MONTHS • PSYCHOTERAPY BEFORE S.R.S. IS RACCOMANDED BY EVERY CENTER EXCEPT • KIND OF PSYCHOTERAPY: INDIVIDUAL OR GROUP • PSYCHOLOGICAL OR PSYCHIATRIC EVALUATION, BEFORE S.R.S., IS MANDATORY FOR ALL CENTERS YES, but only some criteria NO YES • ITALY follows National Standards of Care by O.N.I.G.(Gender Identity National Observatory) TESTS DSMIV-TR ICD 10 CLINICAL INTERVIEW • DIAGNOSTIC TOOLS SERVICES DIRECTED TO CHILDREN AND ADOLESCENTS WITH ATYPICAL GENDER IDENTITY ORGANIZATION (A.G.I.O.) MtF • T4 SURGERY • HORMONAL TREATMENT IS FREE OF CHARGE IN EUROPEAN CENTERS WITH SOME DIFFERENCES IN ITALIAN GENDER TEAMS • S.R.S. IS UNDER N.H.S. FOR EACH COUNTRY • MOST OF CENTERS OFFER • FREE OF CHARGE MAMMOPLASTY UNDER SPECIFIC CONDITIONS • (IN ITALY IT IS FREE OF CHARGE IN SOME CENTRES) • LASER IS FREE OF CHARGE ONLY IN • NO CENTERS OFFER FREE OF CHARGE VOCAL CORD SURGERY EXCEPT • AND, IN SOME CASES, FtM PENILE PROSTHESISIS FREE OF CHARGE EXCEPT FOR T5 FOLLOW UP After S.R.S. follow up is done by not by CONCLUSIONS • ALL CENTERS SHARE THE GENERAL INTERNATIONAL STANDARDS OF CARE, EVEN IF THERE ARE SPECIFIC DIFFERENCES IN EACH COUNTRY RELATED TO CULTURAL ASPECTS • IT IS IMPORTANT UNDERLINE THAT ALL THESE EUROPEAN GENDER TEAMS DO NOT ACCEPT THE SELF DIAGNOSIS PRINCIPLE BUT THEY HIGHLIGHT THE NEED OF PSYCHOLOGICAL OR PSYCHIATRIC EVALUATION BEFORE BOTH THE HORMONAL TREATMENT AND THE SURGERY • MOST OF EUROPEAN GENDER TEAMS ARE PUBLIC • IN ITALY THE PSYCHOTERAPY DURING R.L.E. IS STILL A MATTER OF DEBATE AMONG DIFFERENT CENTERS