Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Efficacy of hormonal and mental treatments with MMPI in FtM individuals: cross-sectional and longitudinal studies

Authors: Hiroyuki Oda, Toshihiko Kinoshita

Published in: BMC Psychiatry | Issue 1/2017

Login to get access

Abstract

Background

Cross-sex hormone treatment (CSHT) is an important option for gender dysphoria (GD) individuals to improve the quality of life. However, in Japan, sex reassignment surgery (SRS) and CSHT for GD had been discontinued until 1998 (over 30 years). After resumption, the number of GD individuals wishing treatment rapidly increased. On the other hand, the number of medical institutions available for evaluation was limited. For this reason, hormonal treatment has been administered to GD individuals requiring the prompt start of CSHT in the absence of mental health assessment by specialists. In this study, we examined the efficacy of CSHT and psychotherapy.

Methods

The participants were 155 female-to-male (FtM) individuals who consulted our gender identity clinic, and were definitively diagnosed. A cross-sectional study was conducted by dividing them into two groups: groups with and without CSHT on the initial consultation (Group CSHT: n = 53, Group no-CSHT: n = 102). In all participants, Minnesota Multiphasic Personality Inventory (MMPI) and blood hormone tests were performed on the initial consultation. In addition, CSHT was combined with psychotherapy for a specific period in Group no-CSHT, and FtM individuals in whom an additional MMPI test could be conducted (Group combined treatment (CT), n = 14) were enrolled in a longitudinal study.

Results

In the cross-sectional study, there was no significant difference on the MMPI test. In the longitudinal study, there were improvements in the clinical scales other than the Mf scale on the MMPI test. In Group CT, the D, Sc, and Si scale scores on the initial consultation were significantly higher than in Group CSHT. However, there was no clinical scale with a significantly higher value after the start of treatment. The Pd scale score was significantly lower.

Conclusions

CSHT improved mental health. Psychotherapy-combined CSHT may further improve it.

Trial registration

The study was reviewed and approved by the Ethics Committee of Kansai Medical University (A comprehensive treatment for gender dysphoria: No. 0314 registered date 10th December 2003), and was approved at UMIN000028102 on 6th July 2017 as retrospectively registered.
Literature
1.
Yamauchi T. Diagnosis of gender identity disorder: basic and clinical aspects of gender identity disorder. 2nd rev ed. Shinkoh Igaku Shuppan: Tokyo; 2004.
2.
World Health Organization. The ICD-10 classification of mental and behavioral disorders: clinical descriptions and diagnostic guideline. Geneva: World Health Organization; 1992.
3.
American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington: American Psychiatric Association; 2013.CrossRef
4.
WPATH (The World Professional Association for Transgender Health). The standards of care for the health of transsexual, transgender, and gender nonconforming people; 7th ed. 2010. http://​www.​wpath.​org/​.
5.
Zucker KJ, Lawrence AA. Epidemiology of gender identity disorder: recommendations for the standards of care of the world professional Association for Transgender Health. International Journal of Transgenderism. 2009;11:8–18.CrossRef
6.
De Cuypere G, Van Hemelrijck M, Michel A, Carael B, Heylens G, Rubens R, Monstrey S. Prevalence and demography of transsexualism in Belgium. European Psychiatry. 2007;22:137–41.
7.
Olyslager F, Conway L. On the calculation of the prevalence of transsexualism. Paper presented at the world professional Association for Transgender Health 20th international symposium. Chicago: Illinois; 2010.
8.
Sato T, Saito K, et al. Estimated investigation of the number of GID. Japanese Journal of Gender Identity Disorder. 2014;7:73–5.
9.
Special Committee for Gender Identity Disorder of the Japanese Society of Psychiatry and Neurology. Report and recommendations on gender identity. Seishin Shinkeigaku Zasshi. 1997;99:533–40.
10.
Special Committee for Gender Identity Disorder of the Japanese Society of Psychiatry and Neurology. The guidelines for diagnosis and treatment for gender identity disorder. Seishin Shinkeigaku Zasshi. 2012;114:1250–66.
11.
Costa R, Colizzi M. The effect of cross-sex hormonal treatment on gender dysphoria individuals’ mental health: a systematic review. Neuropsychiatr Dis Treat. 2016;12:1953–66.CrossRefPubMedPubMedCentral
12.
Newfield E, Hart S, Dibble S, Kohler L. Female-to-male transgender quality of life. Qual Life Res. 2006;15:1447–57.CrossRefPubMed
13.
Gorin-Lazard A, Baumstarck K, Boyer L, Maquigneau A, et al. Is hormonal therapy associated with better quality of life in transsexuals?: a cross-sectional study. J Sex Med. 2012;9:531–41.CrossRefPubMed
14.
Gomez-Gil E, Zubiaurre-Elorza L, Esteva I, et al. Hormone-treated transsexuals report less social distress, anxiety and depression. Psychoneuroendocrinology. 2012;37:662–70.CrossRefPubMed
15.
Colizzi M, Costa R, Todarello O. Transsexual patients’ psychiatric comorbidity and positive effect of cross-sex hormonal treatment on mental health: results from alongitudinal study. Psychoneuroendocrinology. 2014;39:65–73.CrossRefPubMed
16.
Beatrice J. A psychological comparison of heterosexuals, transvestites, preoperative transsexuals, and postoperative transsexuals. J Nerv Ment Dis. 1985;173:358–65.CrossRefPubMed
17.
Hunt DD, Hampson JL. Follow-up of 17 biologic male transsexuals after sex-reassignment surgery. Am J Psychiatry. 1980;137:432–8.CrossRefPubMed
18.
Lothstein L. The aging gender dysphoria (transsexual) patient. Archives Sex Behav. 1979;8:431–44.CrossRef
19.
Tsoi W, Kok L, Long F. Male transsexualism in Singapore: a description of 56 cases. Br J Psychiatry. 1977;131:405–9.CrossRefPubMed
20.
Caron GR, Archer RP. MMPI and Rorschach characteristics of individuals approved for gender reassignment surgery. Assessment. 1997;4:229–41.CrossRefPubMed
21.
Cole CM, O’Boyle M, Emory LE, Meyer WJ. Comorbidity of gender dysphoria and other major psychiatric diagnoses. Archives Sex Behav. 1997;26:13–26.CrossRef
22.
Greenberg RP, Laurence L. A comparison of the MMPI results for psychiatric patients and male applicants for transsexual surgery. J Nerv Ment Dis. 1981;169:320–3.CrossRefPubMed
23.
Hunt DD, Carr JE, Hampson JL. Cognitive correlates of biologic sex and gender identity in transsexualism. Archives Sex Behav. 1981;10:65–77.CrossRef
24.
Miach PP, Berah EF, Butcher JN, Rouse S. Utility of the MMPI–2 in assessing gender dysphoric patients. J Personality Assess. 2000;75:268–79.CrossRef
25.
Michel A, Ansseau M, Legros JJ, Pitchot W, Cornet JP, Mormont C. Comparisons of two groups of sex-change applicants based on the MMPI. Psychol Rep. 2002;91:233–40.CrossRefPubMed
26.
Tsushima WT, Wedding D. MMPI results of male candidates for transsexual surgery. J Personality Assess. 1979;43:385–7.CrossRef
27.
Blanchard R, Clemmensen LH, Steiner BW. Gender reorientation and psychosocial adjustment in male-to-female transsexuals. Arch Sex Behav. 1983;12(6):503–9.CrossRefPubMed
28.
Leavitt F, Berger JC, Hoeppner JA, Northrop G. Presurgical adjustment in male transsexuals with and without hormonal treatment. J Nerv Ment Dis. 1980;168(11):693–7. 22CrossRefPubMed
29.
Gomez-Gil E, Vaidal-Hagemeijer A. Manel Salamero-bar. MMPI-2 characteristics of transsexuals requesting sex reassignment: comparison of patients in Prehormonal and Presurgical phases. J Personality Assess. 2008;90(4):368–74.CrossRef
30.
Bonierbale M, Baumstarck K, Maquigneau A, et al. MMPI-2 profile of French transsexuals: the role of sociodemographic and clinical factors. A cross-sectional design Sci Rep. 2016;6:24281.PubMed
31.
Oda H, Kitashiro A, Yamada K, et al. Efforts of gender clinic at Kansai medical university. Modern Physician. 2005;4:409–13.
32.
American Psychiatric Association. Diagnostic and statistical manual of mental disorder. 4th ed. Arlington: American Psychiatric Association; 2000. Text Revision
33.
Lothstein LM. Psychological testing with transsexuals: a 30-years review. J of Personal Assess. 1984;48:500–7.CrossRef
34.
Gorin-Lazard A, Baumstarck K, Boyer L, et al. Hormonal therapy is associated with better self-esteem, mood, and quality of life in transsexuals. J Nerv Ment Dis. 2013;201(11):996–1000.CrossRefPubMed
35.
Fisher AD, Castellini G, Bandini E, et al. Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria. J Sex Med. 2014;11(3):709–19.CrossRefPubMed
36.
Gómez-Gil E, Zubiaurre-Elorza L, de Antonio IE, Guillamon A, Salamero M. Determinants of quality of life in Spanish transsexuals attending a gender unit before genital sex reassignment surgery. Qual Life Res. 2014;23(2):669–76.CrossRefPubMed
37.
Gómez-Gil E, Vidal-Hagemeijer A, Salamero M. MMPI-2 characteristics of transsexuals requesting sex reassignment: comparison of patients in prehormonal and presurgical phases. J Pers Assess. 2008;90(4):368–74.CrossRefPubMed
38.
Heylens G, Verroken C, De Cock S, T’Sjoen G, De Cuypere G. Effects of different steps in gender reassignment therapy on psychopathology: a prospective study of persons with a gender identity disorder. J Sex Med. 2014;11(1):119–26.CrossRefPubMed
39.
Colizzi M, Costa R, Todarello O. Dissociative symptoms in individuals with gender dysphoria: is the elevated prevalence real? Psychiatry Res. 2015;226(1):173–80.CrossRefPubMed
40.
Colizzi M, Costa R, Pace V, Todarello O. Hormonal treatment reduces psychobiological distress in gender identity disorder, independently of the attachment style. J Sex Med. 2013;10(12):3049–58.CrossRefPubMed
41.
Slabbekoorn D, Goozen SHV, Gooren LJ, Cohen-Kettenis PT. Effects of cross-sex hormone treatment on emotionality in transsexuals. Int J Transgend. 2001;5(3):2–18.
42.
Oda H, Katagami T, Yamada H, et al. Effects of hormonal replacement therapy on mental state of FTM. Jpn J Sexology. 2011;29:51–7.
Metadata
Title
Efficacy of hormonal and mental treatments with MMPI in FtM individuals: cross-sectional and longitudinal studies
Authors
Hiroyuki Oda
Toshihiko Kinoshita
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1423-y

Other articles of this Issue 1/2017

BMC Psychiatry 1/2017 Go to the issue

Research article

Emotional crisis in a naturalistic context: characterizing outpatient profiles and treatment effectiveness

Research article

Cultural adaptation and validity of the Malay version of the brief psychiatric rating scale (BPRS-M) among patients with schizophrenia in a psychiatric clinic

Research article

Depression differed by midnight cortisol secretion, alexithymia and anxiety between diabetes types: a cross sectional comparison

Research article

Potential diagnostic markers of olanzapine efficiency for acute psychosis: a focus on peripheral biogenic amines

Research article

Suicide attempts in U.S. Army combat arms, special forces and combat medics

Study protocol

Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING]: study protocol of a non-inferiority randomized trial