Body satisfaction and physical appearance in gender dysphoria

Gender dysphoria (GD) is often accompanied by dissatisfaction with physical appearance and body image problems. The aim of this study was to compare body satisfaction with perceived appearance by others in various GD subgroups. Data collection was part of the European Network for the Investigation of Gender Incongruence. Between 2007 and 2012, 660 adults who fulfilled the criteria of the DSM-IV gender identity disorder diagnosis (1.31:1 male-to-female [MtF]:female-to-male [FtM] ratio) were included into the study. Data were collected before the start of clinical gender-confirming interventions. Sexual orientation was measured via a semi-structured interview whereas onset age was based on clinician report. Body satisfaction was assessed using the Body Image Scale. Congruence of appearance with the experienced gender was measured by means of a clinician rating. Overall, FtMs had a more positive body image than MtFs. Besides genital dissatisfaction, problem areas for MtFs included posture, face, and hair, whereas FtMs were mainly dissatisfied with hip and chest regions. Clinicians evaluated the physical appearance to be more congruent with the experienced gender in FtMs than in MtFs. Within the MtF group, those with early onset GD and an androphilic sexual orientation had appearances more in line with their gender identity. In conclusion, body image problems in GD go beyond sex characteristics only. An incongruent physical appearance may result in more difficult psychological adaptation and in more exposure to discrimination and stigmatization

Effect of medical interventions on gender dysphoria and body image : a follow-up study.

Objective: The aim of this study from the European Network for the Investigation of Gender Incongruence is to investigate the status of all individuals who had applied for gender confirming interventions from 2007 to 2009, irrespective of whether they received treatment. The current article describes the study protocol, the effect of medical treatment on gender dysphoria and body image, and the predictive value of (pre) treatment factors on posttreatment outcomes. Methods: Data were collected on medical interventions, transition status, gender dysphoria (Utrecht Gender Dysphoria Scale), and body image (Body Image Scale for transsexuals). In total, 201 people participated in the study (37% of the original cohort). Results: At follow-up, 29 participants (14%) did not receive medical interventions, 36 hormones only (18%), and 136 hormones and surgery (68%). Most transwomen had undergone genital surgery, and most transmen chest surgery. Overall, the levels of gender dysphoria and body dissatisfaction were significantly lower at follow-up compared with clinical entry. Satisfaction with therapy responsive and unresponsive body characteristics both improved. High dissatisfaction at admission and lower psychological functioning at follow-up were associated with persistent body dissatisfaction. Conclusions: Hormone-based interventions and surgery were followed by improvements in body satisfaction. The level of psychological symptoms and the degree of body satisfaction at baseline were significantly associated with body satisfaction at follow-up

Psychiatric Impact of Organized and Ritual Child Sexual Abuse: Cross-Sectional Findings from Individuals Who Report Being Victimized

Organized and ritual child sexual abuse (ORA) is often rooted in the child’s own family. Empirical evidence on possible associations between ORA and trauma-related symptoms in those who report this kind of extreme and prolonged violence is rare. The aim of our study was to explore socio-demographic and clinical characteristics of the individuals reporting ORA experiences, and to investigate protective as well as promotive factors in the link between ORA and trauma-related symptom severity. Within the framework of a project of the Independent Inquiry into Child Sexual Abuse in Germany, we recruited 165 adults who identified themselves as ORA victims via abuse- and trauma-specific networks and mailing lists, and they completed an anonymous online survey. We used variance analyses to examine correlations between several variables in the ORA context and PTSD symptoms (PCL-5) as well as somatoform dissociation (SDQ-5). Results revealed a high psychic strain combined with an adverse health care situation in individuals who report experiences with ORA. Ideological strategies used by perpetrators as well as Dissociative Identity Disorders experienced by those affected are associated with more severe symptoms (η2p = 0.11; η2p = 0.15), while an exit out of the ORA structures is associated with milder symptoms (η2p = 0.11). Efforts are needed to improve health care services for individuals who experience severe and complex psychiatric disorders due to ORA in their childhood

Religiosity, sexual myths, sex taboos, and pornography use: A cross-national comparison of Polish and German university students

The study aimed to compare pornography use of students in two culturally different European countries – Poland and Germany, and to investigate associations with religiosity, sexual myths, and sex taboos. Data were collected in an online survey among German (n = 1303) and Polish (n = 1135) university students aged 18-26 years. Polish students were more religious, showed a greater acceptance of sexual myths, and reported a higher level of sex taboos in their origin families. Polish students were younger at their first contact with pornography, while German students used pornographic materials more often. Results suggested a link between sociocultural background, especially religiosity, and pornography engagement. The relationship between pornography use and religiosity was ambiguous. On the one hand, attending church was negatively associated with age at first contact and pornography use. On the other hand, the association of intrinsic religiosity with pornography use proved to be contradictory: it was correlated with a lower frequency of pornography use for females and with a higher frequency for males. The agreement with common sexual myths was related to a higher frequency of pornography use. There was no association between the level of sex taboos and pornography use

Heterosexuelle Normalität oder sexuelle Lebensqualität? Behandlungsziele im Wandel

Der Artikel hinterfragt kritisch die in der Medizin verbreitete Vorstellung, dass Personen mit Intersexualität nur dann eine befriedigende Sexualität leben können, wenn ihre Geschlechtsorgane chirurgisch möglichst dem weiblichen oder männlichen Geschlecht angepasst werden, sodass »heterosexueller« Geschlechtsverkehr möglich wird. Ergebnisse der Hamburger Studie zu Intersexualität bestätigen den bisherigen Forschungsstand, dass die sexuelle Lebensqualität von Personen mit Intersexualität deutlich geringer ist als diejenige von Menschen mit eindeutigem Geschlecht. Somit ist das Ziel der Medizin, Personen mit Intersexualität mittels geschlechtsangleichender Operationen eine möglichst »nonnale« psychosexuelle Entwicklung zu ermöglichen, bisher nicht erreicht worden. Die Autorinnen und Autoren plädieren dafür, den heterosexistischen Diskurs in der medizinischen Behandlung von Personen mit Intersexualität zu überdenken und vielmehr die sexuelle Lebensqualität der betroffenen Menschen ins Zentrum zu rücken. Dies umfasst weit mehr als »heterosexuelles« Funktionieren und steht in einem Zusammenhang mit psychosozialen Faktoren wie beispielsweise positiven Bindungserfahrungen in der Kindheit oder einer tragenden Partnerschaft

The psychosocial impact of hair loss among men: a multinational European study

ABSTRACT Objective: Hair plays an important role in determining self-image, social perceptions, and psychosocial functioning. The objectives of this survey were to identify the impact of hair loss on the self-image of men in five European countries and their level of concern about hair loss with regard to image and personal attractiveness. Moreover, we evaluated participants’ use of treatments for hair loss and whether treatment success was associated with psychological benefit. Research design and methods: A structured questionnaire of closed-ended questions was administered by telephone in major cities in Germany, France, Italy, Spain, and the United Kingdom. Random sampling was used, and eligible respondents were men from 18 to 45 years old. Results: Of the 1536 men responding to the telephone survey, 729 (47%) reported hair loss; these men are the subject of this report. Over 70% of these men reported hair to be an important feature of image, and 62% agreed that hair loss could affect self-esteem. The realization that they were losing hair was linked to concern about losing an important part of personal attractiveness (43% of men), fear of becoming bald (42%), concern about getting older (37%), negative effects on social life (22%), and feelings of depression (21%). Reduced self-confidence in personal attractiveness was also reported by 38% of men who were not in stable romantic relationships. Less than 10% of men were currently pursuing treatment for hair loss, and three out of four had never pursued treatment for hair loss, either at present or in the past. Those few men who pursued treatment and reported success (n = 73) also reported psychosocial benefits as a result: from 43% to 59% experienced improvements in parameters of self-esteem and perception of personal attractiveness. Reliance on self-reporting of hair loss and use of nonvalidated instruments to measure psychological outcomes are important study limitations. Conclusions: The results of this survey indicate a gap between the need for treatment of hair loss and initiation of such treatment among men in five European countries. Further research is needed into the factors affecting men's willingness to seek treatment for hair loss