Endocrine Abstracts

Introduction: The demand of health care for people with gender incongruence (IG) has grown exponentially especially in young population. Due to this, there is a growing number of studies that show psychological conflicts and social functioning in those individuals who have not received gender-affirming treatment with medical intervention (pubertal block, hormone or surgical treatment) and social intervention. However, the data published so far do not represent the European countries, they are an adult population and without a control group.

Aims: To assess the prevalence of psychomorbidity among transgender youth before gender-affirmative treatment.

Methods: Prospective observational study comparing young people between 13–21 years of age cared by GI, evaluated before starting hormonal treatment and at puberal stage at least 2–3 Tanner tested by levels of E2, testosterone, FSH and LH. Direct clinical interview and standardized tests were carried out: low self-esteem, social phobia, emotional inestability, suicidal ideation, suicide attempts and self-harm. The results were compared with those obtained in a population subjected to stress due to sexual orientation (cisgenders): ‘homosexuals, lesbians and bisexuals’ (LGTB) between 15 and 21 years. The follow-up was in the ‘Gender Identity Unit of the Doctor Peset University Hospital’ between 2014 and 2016. Those in prepubertal stage and/or who did not meet criteria for treatment initiation were excluded from the study.

Results: A total of 82 interviews were evaluated: 41 in each comparable age group. 51% of individuals with IG developed low self-esteem compared to 34% in the LGTB group (P=0.118); 83% moderate-high emotional instability and 44% LGTB group (P<0.001); 17% in the IG group developed social anxiety and 34% in LGBT individuals (P=0.077. The prevalence of suicidal ideation was 46% and 20% (P<0.001), with suicide attempt of 20% compared to 5% (P=0.043) and/or self-injury in 29% compared to 5% (P=0.003) in the group of individuals with IG with respect to the LGTB group, respectively. The risk of presenting psychomorbidities in the GI group regarding the LGTB group was evaluated through an odds ratio with a result of 2.26 times more risk.

Conclusions: – Low self-esteem and emotional instability are the most prevalent psychomorbidity in both groups; the latter is more frequent in the group with IG.

– Serious conflicts: attempts, suicidal ideation and self-harm are more prevalent in the group with IG.

– The group of individuals with GI present 2.26 times more risk of developing psychomorbidity than the LGTB group.