2019, Number 1
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Salud Mental 2019; 42 (1)
Transgender identity and cryptorchidism: A case study
Real QT, Robles GR, Medina-Mora ME, Jorge JC, Vázquez Pérez L
Language: English
References: 36
Page: 51-57
PDF size: 353.88 Kb.
ABSTRACT
Introduction. There is a wide range of possible combinations in relation to sex at birth, gender identity, and
sexual orientations. Specific medical and psychological treatment needs may also vary depending on these
combinations.
Objective. In order to promote interventions that focus on the perceived needs of those directly
involved, the aim of the present case study is to describe the clinical and life experiences of a 43-year old transgender
woman with cryptorchidism and examine the interplay between this relative common testicular problem
at birth, gender identity, and sexual orientation formation processes from her own perspective.
Method. An
in-depth interview was conducted at a specialized care centre in Mexico City, Mexico. The interview was audio
recorded and transcribed for a content analysis.
Results. The case under analysis was assigned to the male
sex and identified herself as a transgender woman and lesbian. Although it is not possible to conclude that
her gender identity or sexual orientation is related to her antecedent of cryptorchidism, as she reflected on her
related negative experiences, she concluded that her gender identity and sexual orientation trajectories, as well
as her life in general, would have been completely different if there were no clinical interventions in her early
development.
Discussiona and conclusion. The present case could have been benefited from not receiving
early treatment for her cryptorchidism. There is an urgent need for the development of standardized protocols
or algorithms for physical and mental health care professionals, which focus on supportive guidance rather than
adjustment to parental and medical expectations.
REFERENCES
American Academy of Pediatrics. (2000). Committee on Genetics, Section on Endocrinology, Section on Urology. 2000. Evaluation of the newborn with developmental anomalies of the external genitalia. Pediatrics, 106(1), 138-142.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC.
American Urological Association. (2014). Evaluation and treatment of cryptorchidism: AUA guideline. American Urological Association.
Berkowitz, G., Lapinski, R., Dolgin, S., Gazella, J., Bodian, C., & Holzman, I. (1993). Prevalence and natural history of cryptorchidism. Pediatrics, 92(1):44- 49. PMID: 8100060
Bockting, W. O., Benner, A., & Coleman, E. (2009). Gay and bisexual identity development among female-to-male transsexuals in North America: Emergence of a transgender sexuality. Archives of Sexual Behavior, 38(5), 688-701. doi: 10.1007/s10508-009-9489-3
Bradley, S. & Zucker, K. (1997). Gender Identity Disorder: A review of the past 10 years. Journal of the American Academy of Child & Adolescent Psychiatry, 36(7), 872-880. doi: 10.1097/00004583-199707000-00008
Brinkmann, L., Schuetzmann, K., & Richter-Appelt, H. (2007). Gender assignment and medical history of individuals with different forms of intersexuality: evaluation of medical records and the patients’ perspective. The Journal of Sexual Medicine, 4, 964-980. doi: 10.1111/j.1743-6109.2007.00524.x
Cabral, M. (2009). Interdicciones: Escrituras de la intersexualidad en castellano. M. Cabral, Editor. Argentina: Annarés Editorial. Retrieved from: www.mulabi.org/ Interdicciones2.pdf Comité Nacional de Endocrinología. (2001). Recomendaciones para el diagnóstico y tratamiento de la criptorquidia. Archivos Argentinos de Pediatría, 99(4), 372- 374.
Comité Nacional de Endocrinología. (2009). Tendencias actuales en el tratamiento y seguimiento de la criptorquidia. Archivos Argentinos de Pediatría, 107(2), 176-180.
Connolly, N. K. (1959). Maldescent of the testis. American Surgery, 25, 405-420.
Cytryn, L., Cytryn, E., & Rieger, R. (1967). Psychological Implications of Cryptorchism. Journal of American Academy of Child and Adolescent Psychiatry, 6(1), 131-165. doi.org/10.1016/S0002-7138(09)61294-2
Docimo, S., Silver, R., & Cromie, W. (2000). The Undescended Testicle: Diagnosis and Management. American Family Physician, 62(9), 2037-2044.
Ferguson, L. & Agoulnik, A. (2013). Testicular Cancer and Cryptorchidism. Frontiers in Endocrinology (Lausanne), 4(32), 1-9. doi: 10.3389/fendo.2013.00032
Galifer, R. B., Kalfa, N., & Guibal, M. P. (2004). What a hidden testicule can hide? or the clinical traps of cryptorchidism. Archives de Pédiatrie, 11(4), 350-359. doi: 10.1016/j.arcped.2003.11.015
Garnelo, L. & Caamaño B. (2005). Criptorquidia. Guías clínicas, 5(26), 1-3.
Hughes, I., Houk, C., Ahmed, S., Lee, P., Lawson Wilkins Pediatric Endocrine Society (LWPES)/European Society for Pediatric Endocrinology (ESPE) Consensus Group. (2006). Consensus statement on management of intersex disorders. Journal of Pediatric Urology, 2(3), 148-162. doi: 10.1016/j.jpurol.2006.03.004
Hyderi, A., Angel, J., Madison, M., Perry, L. A., & Hagshenas, L. (2016). Transgender patients: Providing sensitive care. The Journal of Family Practice, 65(7), 450- 61. Jorge, J. C. (2010). La embriología del género y modelos moleculares emergentes para explicar la diferenciación sexual. Sexología, 15(2), 37-49. English version:
Jorge, J. C. 2010. The embryology of gender. Journal of LGBT Youth, 7, 310- 319.
Jorge, J. C. & Agramonte, A. (2013). Standards of care for congenital adrenal hyperplasia: a call for change in the Caribbean region. Sexuality Research and Social Policy, 10(3), 233-241. doi: 10.1007/s13178-013-0110-0
Kessler, S. (1997). Meanings of gender variability. Chrysalis: The Journal of Transgressive Gender Identities, 2(5), 33-38.
Lamas, M. (2012). Transexualidad: identidad y cultura. México: Universidad Nacional Autónoma de México. Retrieved from: http://biblio.unam.mx:8070/ index.php/novedades/adquisiciones-tesis/109-t9
Leidolf, E. M., Curran, M., & Scout-Bradford J. (2008). Intersex mental health and social support options in pediatric endocrinology training programs. Journal of Homosexuality, 54(3), 233-42. doi: 10.1080/00918360801982074
Masi, G., Millepiedi, S., Brovedani, P., Favilla, L., & Mucci, M. (1999). Psychopathological aspects of cryptorchidism in children and adolescents. Child Psychiatry and Human Development, 30(2), 75-85. doi: 10.1023/A:1021946201023
Mayer, K., Bradford, J., Makadon, H., Stall, R., Goldhammer, H., & Landers, S. (2008). Sexual and gender minority health: what we know and what needs to be done. American Journal of Public Health, 98(6), 989-995. doi: 10.2105/ AJPH.2007.127811
Mayo Clinic. (2017). Undescended testicle. Treatment. Retrieved from: https://www. mayoclinic.org/diseases-conditions/undescended-testicle/diagnosis-treatment/ drc-20352000
Nagar, H. & Haddad, R. (1997). Impact of early orchidopexy on testicular growth. British Journal of Urology, 80(2), 334-335. doi: 10.1046/j.1464-410X.1997. t01-1-00301.x
Pan American Health Organization. (2011). The Right of Young People to Health and Gender Identities: Findings, Trends, and Targets for Public Health Action. Washington: Pan American Health Organization.
Reiner, W. & Gearhart, J. (2004). Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth. New England Journal of Medicine, 350(4), 333-341. doi: 10.1056/NEJMoa022236
Reisner, S., Poteat, T., Keatley, J. A., Cabral, M., Mothopeng, T., Dunham, E., … Baral, S. (2016). Global health burden and needs of transgender populations: a review. Lancet, 388(10042), 412-436. doi: 10.1016/S0140-6736(16)00684-X
Robles, R., Fresán, A., Vega-Ramírez, H., Cruz-Islas, J., Rodríguez-Pérez, V., Domínguez-Martínez, T., & Reed, G. M. (2016). Removing transgender identity from the classification of mental disorders: a Mexican field study for ICD-11. Lancet Psychiatry, 3(9), 850-859. doi: 10.1016/S2215-0366(16)30165-1
Secretaría de Salud. (2014). Diagnóstico y tratamiento del testículo no descendido. México: Secretaría de Salud.
Steensma, T. D., Biemond, R., de Boer, F., & Cohen-Kettenis, P. T. (2011). Desisting and persisting gender dysphoria after childhood: a qualitative follow-up study. Clinical Child Psychology and Psychiatry, 16(4), 499-516. doi: 10.1177/1359104510378303
Subhrajit, C. (2014). Problems Faced by LGBT People in the Mainstream Society: Some Recommendations. International Journal of Interdisciplinary and Multidisciplinary Studies, 1(5), 317-331.
Sumfest, J. & Kim, E. D. (2018). Cryptorchidism Treatment and Management. Drug and Diseases, Urology. Retrieved from: https://emedicine.medscape.com/ article/438378-treatment
United Nations Programme on HIV/AIDS. (2014). The gap report 2014. Transgender people. Geneva: United Nations. Retrieved from: http://www.unaids.org/sites/ default/files/media_asset/08_Transgenderpeople.pdf
World Health Organization. (1992). The ICD-10 classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.