Prevalence, Incidence, and Sex Ratio of Transsexualism in the Autonomous Region of Madrid (Spain) According to Healthcare Demand.

In recent years, different studies have provided estimates of the prevalence of transsexualism with very diverse results. The purpose of this study was to ascertain the prevalence, incidence, and sex ratio of transsexualism in the autonomous region of Madrid (Spain). A total of 1234 patients who attended from 2007 to the end of 2015 in the only Gender Identity Unit (GIU) in Madrid were analyzed. Sixty-three patients were excluded for various reasons; thus, 1171 could be included: 803 male-to-female (MtF) and 368 female-to-male (FtM) transsexual patients. Transsexualism was diagnosed based on the ICD-10, World Health Organization, 1992, and/or gender identity disorder based on the DSM-IV-TR, American Psychiatric Association, 2000. The demographic statistics were calculated on the basis of the population over 15 years old of Madrid. Based on healthcare demand, the prevalence of transsexualism was 22.1 in 100,000 inhabitants: 31.2 for MtF and 12.9 for FtM, making the MtF/FtM ratio approximately 2.2:1. The incidence rate was 2.5 in 100,000 inhabitants, representing an annual average of 130 demands. Although transsexualism occurs in all countries with different rates of prevalence, in our area, this prevalence was higher than reported from other European countries. We believe that two main circumstances might influence this high prevalence: the easy accessibility and the absence of a waiting list to the GIU, and the permissive social and legal climate and openness of Spain, especially in Madrid.

Body image in persons with gender dysphoria.

BACKGROUND: For subjects with gender dysphoria, body image is an important aspect of their condition. These people sometimes exhibit a strong desire to change their primary and secondary sexual characteristics. In addition, idealization of beauty has grown in importance and it may increase body dissatisfaction. The aim of this paper is to analyze whether body dissatisfaction in people with gender dysphoria is similar to that in clinical population or if it is more similar to that which may appear in general population. We also looked at gender differences in body dissatisfaction. METHODS: A set of questionnaires was administered to patients with gender dysphoria: Eating Attitudes Test (EAT- 26), body dissatisfaction sub-scale of Eating disorder inventory-two (EDI-2) and IMAGEN questionnaire. RESULTS: In the case of body dissatisfaction subscale of Eating disorder inventory-two with a cut-off 11; body dissatisfaction in our sample was close to the level presented in clinical population. However, using cut-off points 14 and 16, they exhibited a body dissatisfaction level that was similar to the general population. The same occurred for the IMAGEN questionnaire. No gender differences were found when looking at the level of dissatisfaction. CONCLUSIONS: The data seem to indicate that people with gender dysphoria would be at an intermediate point in relation to body dissatisfaction between general population and clinical population; in both female and male transsexuals. It seems that some level of body dissatisfaction may be perceived in relation to the ideal of beauty, but this dissatisfaction is significantly lower than in clinical populations.

INTRODUCCIÓN : Para las personas con disforia de género, la imagen corporal es un aspecto fundamental en su condición. Estas personas a veces manifiestan un fuerte deseo de cambiar sus caracteres sexuales primarios y secundarios. Además, socialmente el ideal de belleza ha ido cobrando cada vez más importancia pudiendo incrementar la insatisfacción corporal. El objetivo de este trabajo es analizar si la insatisfacción corporal en personas con disforia de género es similar a la que presenta la población clínica o si está más cerca de la que pudiera presentar la población general, así como la diferencia por géneros. MÉTODOS: Se administraron a personas con disforia de género una batería de cuestionarios en los que se incluyeron el Test de Actitudes hacia la Alimentación, la subescala de insatisfacción corporal del Inventario para los Trastornos de Alimentación y el cuestionario IMAGEN. RESULTADOS: En el caso de la subescala de insatisfacción corporal del Inventario para los Trastornos de Alimentación, con un punto de corte 11 la insatisfacción corporal de nuestra muestra estaría cercana al nivel de la población clínica. Sin embargo, usando los puntos de corte 14 y 16 si presentarían una insatisfacción corporal cercana a la población general, lo mismo para el IMAGEN. No se encontraron diferencias por géneros respecto al nivel de insatisfacción. CONCLUSIONES: Los datos parecen apuntar a que las personas con disforia de género estarían en un punto intermedio en lo que se refiere a insatisfacción corporal entre la población general y la población clínica, tanto transexuales femeninas como masculinos. Parece ser que hay cierta insatisfacción corporal que pueden percibir en relación al ideal de belleza pero esta insatisfacción es bastante menor que la que pueden tener poblaciones clínicas.

Prevalencia de hiperandrogenismo y síndrome de ovario poliquístico en transexuales de mujer a hombre / Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals

INTRODUCCIÓN: La prevalencia de hiperandrogenismo (HA), que incluye el síndrome de ovario poliquístico (SOP), es alta en los pacientes transexuales de mujer a hombre (TMH). Este hecho se ha relacionado con el síndrome metabólico (SM), lo que parece aumentar la morbimortalidad cardiovascular a lo largo del tratamiento hormonal cruzado (THC). OBJETIVOS: Determinar la prevalencia de HA y SOP en pacientes TMH antes del inicio del THC, y su asociación con el SM y sus componentes, la insulinorresistencia (IR) y otros factores de riesgo cardiovascular (RCV). MATERIALES Y MÉTODOS: Setenta y siete TMH fueron valorados clínica y analíticamente para HA antes de iniciar el THC. También se determinaron los factores de RCV, la IR y otros parámetros del SM. RESULTADOS: La prevalencia de HA fue del 49,4% (el 73,7% de ellos con SOP [criterios de Rotterdam]), y del total de la muestra el 36,4% presentaron SOP. La prevalencia global de SM fue del 38,4 y 51,7% (criterios ATP-III e IDF, respectivamente). Los pacientes con HA frente a aquellos sin HA presentaban SM (criterios ATP-III e IDF, respectivamente) en el 36,8 y 57,9% frente al 25,6 y 41% (p < 0,0001 y p < 0,01, respectivamente). El 54,5% de los pacientes tenía normopeso (índice de masa corporal [IMC] 18,5-24,9 kg/m2), el 26% sobrepeso (IMC 25-29,9 kg/m2) y el 19,5% eran obesos (IMC ≥ 30 kg/m2). Al ajustar por el IMC la comparación de parámetros hormonales, metabólicos y antropométricos mostró diferencias estadísticamente significativas en los valores de glucemia, HOMA-IR y perímetro abdominal (p < 0,001), así como en los de colesterol-HDL (HDL) (p = 0,033), pero no en las concentraciones de testosterona total o de testosterona libre calculada. Del total de la muestra el 27,3% presentaron niveles de HDL por debajo de 50mg/dl. CONCLUSIONES: El HA y el SOP son muy prevalentes en la población TMH. HA y SOP se relacionan con el desarrollo temprano de SM, IR y otros factores de RCV, de consecuencias desconocidas en la edad adulta

INTRODUCTION: Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy. OBJECTIVES: To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors. MATERIALS AND METHODS: Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed. RESULTS: Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p < 0.0001 and P < 0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m-2), 26% were overweight (BMI 25-29.9 kg.m-2), and 19.5% were obese (BMI ≥ 30 kg.m-2). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P < 0.001 for all), as well as HDL cholesterol (HDL) (P = 0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL. CONCLUSIONS: Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood

Prevalence of hyperandrogenism and polycystic ovary syndrome in female to male transsexuals.

INTRODUCTION: Prevalence of hyperandrogenism (HA), including the polycystic ovary syndrome (PCOS), in female-to-male transsexuals (FMT) is high. This has been related to metabolic syndrome (MS), which appears to increase cardiovascular morbidity and mortality throughout cross-sex hormone (CSH) therapy. OBJECTIVES: To assess the prevalence of HA and PCOS in FMT patients before the start of CSH therapy, and their association to MS and its components, insulin resistance (IR) and other cardiovascular risk (CVR) factors. MATERIALS AND METHODS: Seventy-seven FMTs underwent clinical and biochemical assessment for HA before the start of CSH therapy. CVR, IR, and other MS parameters were also assessed. RESULTS: Prevalence of HA was 49.4% (73.7% were cases of PCOS [Rotterdam criteria]), and prevalence of PCOS in the overall sample was 36.4%. Prevalence of MS was 38.4% and 51.7% according to ATP-III and IDF criteria respectively). MS (according to ATP-III and IDF criteria respectively) was found in 36.8% and 57.9% as compared to 25.6% and 41% of patients with and without HA respectively (p<0.0001 and P<0.01 respectively). Of total patients, 54.5% had normal weight (body mass index [BMI] 18.5-24.9 kg.m(-2)), 26% were overweight (BMI 25-29.9 kg.m(-2)), and 19.5% were obese (BMI ≥ 30 kg.m(-2)). After adjusting for BMI, the comparison of hormonal, metabolic, and anthropometric parameters showed statistically significant differences in plasma glucose, HOMA-IR, and abdominal circumference (P<0.001 for all), as well as HDL cholesterol (HDL) (P=0.033), but not in total testosterone or calculated free testosterone levels. In the total sample, 27.3% had HDL levels less than 50mg/dL. CONCLUSIONS: Overall HA, and PCOS in particular, are highly prevalent in FMTs. HA and PCOS are related to early development of SM, IR, and other CVR factors with unknown consequences in adulthood.

Perfil psicológico de personas transexuales en tratamiento / Psychological profile of transgender people under treatment

Introducción: La transexualidad es un campo emergente dentro de la atención sanitaria. Por ello, está llena de tópicos. Dos de los mitos más extendidos acerca de las personas transexuales es que presentan graves alteraciones psicopatológicas y que son personas sumamente infelices. Objetivo: El objetivo principal de esta investigación fue estudiar el perfil psicológico de los pacientes transexuales. Especialmente, se quiso comprobar la presencia de rasgos psicopatológicos en el perfil de personalidad. Por otro lado, también se deseaba evaluar la presencia de problemas de depresión. Un segundo objetivo fue buscar diferencias en el perfil según el sexo (transexuales de hombre a mujer o de mujer a hombre). Material y método: El presente estudio tuvo un diseño transversal. Los pacientes fueron seleccionados consecutivamente por orden de acceso a la unidad de trastornos de identidad de género al inicio del estudio. La muestra se formó con 121 pacientes de la Unidad de Trastornos de Identidad de Género de Madrid. Todos acabaron el estudio. El criterio de entrada fue tener el diagnóstico de transexualidad. Se les aplicaron test psicológicos: la Entrevista diagnóstica de identidad de género, el Cuestionario general de salud de Goldberg, el Cuestionario de competencia emocional, la Escala de bienestar psicológico, la Escala de satisfacción con la vida, la Escala de felicidad subjetiva, el nuevo Inventario de personalidad NEO y el Inventario clínico multiaxial de Millon III. Resultados: Se encontró un alto bienestar psicológico. No se encontraron alteraciones psicopatológicas significativas. Se encontraron pocas aunque llamativas diferencias por sexos. Finalmente, apareció un único factor significativo en su perfil de personalidad. Conclusiones: Las personas transexuales no tienen un perfil psicopatológico de personalidad, y hay pocas pero significativas diferencias por sexos (AU)

Introduction: Transsexualism is an emergent field in healthcare and consequently is plagued by stereotypes. Two of the most widespread misconceptions are that transgender people have serious psychopathological disorders and that they are less happy than the general population. Objective: The main aim of this study was to characterize the psychological profile of transgender people and, in particular, the presence of psychopathological features in their personality profile. The presence of depressive features was also investigated. A second aim was to assess the differences in psychological profile between the s exes (female-to-male or male-to-females transgender people). Material and Method: A cross-sectional study was carried out. The patients were selected consecutively according to their order of access to the Gender Identity Disorder Unit (GIDU) of Madrid at the beginning of the study. The sample was composed of 121 patients from the GIDU. All patients completed the study. The access criterion was a diagnosis of transsexualism. The patients were administered the following psychological tests: Gender Identity Diagnosis Interview, the General Health Questionnaire (GHQ-28), Emotional Competence Questionnaire, Psychological well-being Scale, Life Satisfaction Scale, Subjective Happiness Scale, the NEO Personality Inventory (NEO-PI) and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Outcomes: The subjects showed a high level of well-being. No serious psychopathological alterations were found. Differences between sexes were few but striking. Only one significant factor was found in the subjects’ personality profile. Conclusions: Transgender people do not have a psychopathological personality profile. The differences between sexes are few but important (AU)

Guía de entrevista para el análisis funcional de conductas en personas transexuales / No disponible

No disponible

Síndromes clínicos, personalidad y procesos de recuperación del estrés: estudio en muestras ocupacionales / Clinical syndromes, personality and recovery from stress: a study in occupational samples

Introducción: el estrés se manifiesta con intensidad y efectos diferentes en las distintas personas. En muchos casos crea graves problemas de salud o empeora el pronóstico de ciertas enfermedades. Se ha relacionado el estrés con múltiples enfermedades como cáncer, enfermedades cardiovasculares o enfermedades infecciosas. El ámbito laboral puede ser una fuente de estrés crónico. Se han descrito múltiples variables que supuestamente modulan el estrés. Objetivos: ordenar la relación entre algunas de estas variables. Se postula en este trabajo un modelo según el cual los rasgos psicopatológicos de personalidad deben estar relacionados con una de esas variables moduladoras y, por tanto, con la capacidad del sujeto para recuperarse del estrés. Diseño: se utilizó un diseño transversal descriptivo. Participantes: la muestra estuvo formada por un total de 108 participantes voluntarios, 15 conductores de autobuses urbanos de Madrid, 44 auxiliares de vuelo de la compañía Iberia y 49 camareros de bares de la Comunidad de Madrid. Rechazaron participar en el estudio solo 4 conductores de autobús, ningún auxiliar de vuelo ni camarero. Intervención: se aplicó los tests RESTQ-WORK de Kallus y Jiménez y MCMI de Millon a una muestra de 108 trabajadores (conductores de autobús, camareros de bar y auxiliares de vuelo). Resultados: se verificó la hipótesis mediante un análisis de regresión jerárquica múltiple para cada variable dependiente. Los niveles de significación fueron diferentes para cada variable independiente de cada paso de cada regresión, pero siempre estadísticamente significativos. Discusión: los datos obtenidos son compatibles con el modelo propuesto. El modelo que relaciona síndromes clínicos, recuperación del estrés y estructuras básica de la personalidad parece ser útil para comprender los efectos del estrés laboral.

Introduction. Stress manifests itself with different intensity and effects on different people. In many cases it leads to serious health problems or may worsen the prognosis of certain diseases. Stress has been linked to many conditions such as cancer, cardiovascular diseases and infectious diseases. The workplace can be a source of chronic stress. Many variables have been described that allegedly modulate stress response. Aim. To rank the relationship between some of these variables. A model is presented in this study whereby psychopathological personality traits should be related to one of those modulating variables and thus, with the subject's ability to recover from stress. Design. A cross-sectional descriptive design was used. Participants. The sample consisted of 108 volunteers: 15 drivers of Madrid city buses, 44 Iberia flight attendants and 49 waiters in bars in the Community of Madrid. Only 4 bus drivers refused to participate. All flight attendants and waiters consented to be included in the study. Intervention. Tests RESTQ-WORK of Kallus and Jiménez and MCMI of Millon were applied to a sample of 108 workers (bus drivers, bar tender and flight attendants). Outcomes. The hypothesis was verified through Hierarchical Multiple Regression Analysis for each dependant variable.

Comparación de un programa libre de drogas y uno de mantenimiento con metadona en adictos a opiáceos / Comparison between a free drugs program with a methadone conservative program in opiates addicts

El problema del consumo de heroína no ha disminuido en los últimos años de forma significativa,pero los tratamientos aplicados no resultan demasiado eficaces. Eso ha hechoque se incremente el número de tratamientos con agonistas opiáceos. Sin embargo aquí sepone a prueba un programa libre de drogas (P.L.D.) basado en los principios de la modificaciónde conducta, con apoyo sociosanitario y el uso de antagonistas (naltrexona) durantela desintoxicación y durante el proceso de deshabituación y se compara con un programade mantenimiento con metadona (P.M.M). El P.L.D. Resulta ser superior en disminuciónde consumo de heroína, benzodiacepinas y cocaína y en tasa de retención en tratamiento,no hallándose diferencias en anfetaminas y resulta inferior en consumo de cannabis. Sesugieren futuras líneas de investigación con otras variables dependientes de tipo psicológicoy en P.M.M. con apoyo psicológico

The problem of heroine consumption hasn’t decrease significantly in latest years, butthe applied treatments are not effective enough. That made increase the number of treatmentswith opiates agonists. However, we test here a free drugs program (FDP) based onprinciples of modifying behaviour with health and social support and the use of antagonists(naltrexone) during disposing and also during the disaccustom process and we compareit with a methadone conservative program (MCP). The FDDP worked better indecreasing heroine, benzodiazepines and cocaine consumption and in retention rate duringtreatment, there were no differences in amphetamines and it worked less in cannabis consumption.We suggest future ways of research with other variables depending of psychological type and in MCP with psychological support (AU)