Trastorno de identidad de género: Parte I. Definición, epidemiología, etiología, rol del endocrinólogo en diagnóstico y tratamiento / Gender identity disorders: definition, etiology,epidemiology and role of the endocrinologist in theirmanagement

Gender identity disorders (GID) or transsexuality have been a latent issue in Chile 20 years after the first sex reassignment treatment in 1973. Sexual minority groups have posed the problem and even present a bill for civil sexual change. Since the nineties, the number of consultants due to gender identity problems has increased steadily, including children and adolescents. The lack of medical expertise in the area, requires urgent training programs. The first part of this manuscript will deal with the definition, epidemiology, etiology and role of the endocrinologist in the process of sexual reassignment among patients with gender identity disorders. We review sexual differentiation, brain sexual dimorphism and Sexual Development Disorders (SDD) aiming to understand the neurobiological causes of GID and to perform a better differential diagnosis with Sexual Development Disorders. GID are not a psychiatric disease. However the suffering caused by stigmatization, exclusion andabuse generate emotional problems (gender dysphoria). SDD has a genetic and hormonal basis in most cases. Its clinical expression at birth can cause an erroneous civil sex assignation or a discordant civil sex with the sexual identity of the person when there is a surgical correction. GIS without gender dysphoria was excluded as a mental disease from DSM-V and it will also be excluded from the eleventh version of the international classification of diseases. It will maintained as a condition that should be differentiated from SDD and whose treatment should be financed by health systems.

Actualizaciones en terapia sexual / Update in sex therapy

Dada la relevancia que ha presentado históricamente la terapia sexual, a partir de Masters y Johnson y el desarrollo de sus abordajes en disfunciones sexuales, se realiza una revisión del estado actual de las teorías, tratamientos y técnicas de los últimos 24 años en materia. Los hallazgos indican que las investigaciones son relativamente escasas y que los modelos explicativos no han sido suficientemente desarrollados por los psicólogos investigadores. Aún así todos los datos apuntan a señalar que una amplia variedad de técnicas y tratamientos específicos para disfunciones sexuales resultan eficaces. Por último, habría que destacar la necesidad de que la psicología mantenga su presencia en el área y continué investigando en conjunto con otras ciencias, de modo de mantenerse vigente y sumar esfuerzos en un terreno especialmente importante para los individuos.

Transtorno de identidade sexual: um estudo psicopatológico de transexualismo masculino e feminino / Sexual identity disorder: a psychopathological study of male-to-female and female-to-male transsexuals

Esse estudo propôs-se avaliar presença de transtornos de eixo I, personalidade e caracterizar demograficamente 33 transexuais (masculinos e femininos). Outros objetivos foram comparar Depressão e Transtornos de Personalidade após dois anos de psicoterapia grupal e estruturar um temário específico para ela. Foram aplicados: SCID-I/P, Beck, Hamilton e Entrevista Estruturada para Distúrbios da Personalidade pelo DSM-III-R. As características demográficas gerais não variaram nos grupos. Não houve nenhum diagnóstico psiquiátrico prevalente. Houve predomínio de sintomas depressivos e não de quadros clínicos de depressão. Quanto aos transtornos e traços de personalidade, nenhum dado estatisticamente significativo foi encontrado. Temas para psicoterapia foram estabelecidos./This study aimed to evaluate the presence of personality disorders of axis I as well as to characterize demographically 33 transsexuals (male and female). Other objectives were to compare depression and personality disorders after two years of group therapy and structure a specific theme list to it. SCID-I/P, Beck, Hamilton and Structured Interview for Personality disorders by the DMS-III-R were applied...