El adolescente con incongruencia de género. Un modelo italiano de enfoque integrado

Fabiana Santamaria, Alessandra Delli Veneri, Paolo Valerio

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Resumen

Este trabajo fue presentado en el 7mo Coloquio Internacional Transidentidades, género y cultura. Las variaciones de género en la edad de desarrollo son cada vez más frecuentes y hoy en día se consideran, desde una perspectiva despatologizadora, una de las posibles expresiones de la identidad de género de un individuo. El itinerario de afirmación de género en Italia comienza con el asesoramiento psicológico de un psicólogo clínico, experto en la variación de género en la infancia, que forma parte de uno de los centros italianos reconocidos para la afirmación de género. Las solicitudes de evaluaciones psicológicas proceden actualmente de padres de niños cada vez más pequeños, a veces incluso en el umbral de la pubertad. La AIFA (Agenzia Italiana del Farmaco) publicó en 2019 una Determinación que prevé el uso gratuito de fármacos dirigidos a bloquear la pubertad para menores diagnosticados de Disforia de Género por un equipo de especialistas formado por un psicólogo clínico, un neuropsiquiatra infantil, un endocrinólogo pediátrico y un bioeticista. Estos especialistas deben evaluar al adolescente y pueden decidir, de acuerdo con los padres del menor, iniciar una terapia hormonal destinada a bloquear la pubertad. Esta  puede ser interrumpida, en cualquier momento que los adolescentes deseen no continuar con ella. La implicación de la familia y de la institución educativa son cruciales para crear espacios protegidos e informados en el que adolescentes puedan expresar su identidad sin sentirse amenazados ni penalizados.

Abstract

This work was presented at the 7th International Colloquium on Transidentities, Gender, and Culture. Gender variations during developmental age are increasingly common and are now considered, from a depathologizing perspective, as one of the possible expressions of an individual's gender identity. The gender affirmation pathway in Italy begins with psychological counseling from a clinical psychologist who is an expert in childhood gender variation and is part of one of the recognized Italian centers for gender affirmation. Requests for psychological evaluations currently come from parents of increasingly younger children, sometimes even on the threshold of puberty. In 2019, the AIFA (Italian Medicines Agency) published a Determination that provides for the free use of puberty-blocking drugs for minors diagnosed with Gender Dysphoria by a team of specialists composed of a clinical psychologist, a child neuropsychiatrist, a pediatric endocrinologist, and a bioethicist. These specialists must evaluate the adolescent and, in agreement with the minor's parents, can decide to initiate hormonal therapy aimed at blocking puberty. This therapy can be discontinued at any time if the adolescents wish not to continue with it. The involvement of the family and the educational institution is crucial to creating protected and informed spaces where adolescents can express their identity without feeling threatened or penalized.

Palabras clave

Adolescencias, afirmación de género, disforia de género, bienestar psicofísico

Referencias

Coleman E, Radix AE, Bouman WP, et al. Standards of care for the health of transgender and gender diverse people. Versión 8. Int J Transgend Health [serie en Internet]. 2022;23 Supl 1:S1-S259. Disponible en: https://doi.org/10.1080/26895269.2022.2100644/

Ehrensaft D. The gender creative child: Pathways for nurturing and supporting children who live outside gender boxes. The Experiment. 2016.

Ehrensaft D. Exploring gender expansive expressions. En: Keo-Meier C, Ehrensaft D, editores. The gender affirmative model: An interdisciplinary approach to supporting transgender and gender expansive children. American Psychological Association. 2018.

Rael CT, Martinez M, Giguere R, Bockting W, MacCrate C, Mellman W, et al. Transgender women’s concerns and preferences on potential future long-acting biomedical HIV prevention strategies: The case of injections and implanted medication delivery devices (IMDDs). AIDS and Behavior [serie en Internet]. 2019;24(5):1452-62. Disponible en: https://doi.org/10.1007/s10461-019-02703-5/

De Vries AL, Cohen-Kettenis PT. Clinical management of gender dysphoria in children and adolescents: The Dutch Approach. Journal of Homosexuality. 2012;59:301-20.

Menvielle E. A comprehensive program for children with gender variant behaviors and gender identity disorders. 2012.

Dresher J. L’evoluzione delle controversie sulla presa in carico dei giovani con disforia di genere. Congresso Internazionale Osservatorio Nazionale Identità di Genere (ONIG); 2022; Nápoles, Italia.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (Edition Five TR Text Revision). Washington, D.C.: American Psychiatric Association; 2022.

Valerio P, Santamaria F. Bambini e adolescenti con varianze di genere. Mimesis/quaderni di bioetica. 2016.

Ristori J. Modelli di presa in carico della Disforia di Genere in Età Evolutiva. En: Dettore D, Ristori J, Antonelli P, al cuidado de. La Disforia di Genere in Età Evolutiva. Roma: Alpes Italia; 2015.

Santamaria F. Bambini e adolescenti gender variant: chi sono veramente? En: Valerio P, Scandurra C, Amodeo AL, al cuidado de. Appunti sul genere. Col. «Etica e buone prassi nella professione di psicologo». Edizioni Ordine Psicologi della Campania; 2015.

Drescher J. Gender identity diagnoses: History and controversies. En: Kreukels BPC, Steensma TD, De Vries ALC, editores. Gender dysphoria and disorders of sex development: Progress in Care and Knowledge. New York: Springer Science + Business Media; 2014. p. 137-50.

Santamaria F, Delli Veneri A, Parisi I, Valerio P. Accettare l'impensabile. Riflessioni sul lavoro psicologico con genitori di bambini e adolescenti gender variant. Minori e Giustizia. 2014;3:29-36.

Santamaria F, Valerio P. Bambini e adolescenti intersessuali. Quali dilemmi? La Camera Blu. 2013;(9):52-65.

Fisher AD, Ristori J, Bandini E, Giordano S, Mosconi M, Jannini EA, et al. Medical treatment in gender dysphoric adolescents endorsed by SIAMS-SIE-SIEDP-ONIG. Journal of Endocrinological Investigation. 2014;37(7):675-87. doi: 10.1007/s40618-014-0077-6.

Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema SE, Mayer WJ, Murad MH, et al. Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Nov 1;102(11):3869-903. doi: 10.1210/jc.2017-01658

Lev AI, Gottlieb AR. Families in transition: Parenting gender diverse children, adolescents, and young adults. Columbia University Press; 2019.

Lev AI. Transgender emergence: Therapeutic guidelines for working with gender-variant people and their families. New York: The Haworth Clinical Practice Press; 2004.

Malpas J. Between pink and blue: A multi-dimensional family approach to gender non-conforming children and their families. Family Process. 2011;50(4).

Gale L. Out and proud affirmation guidelines: Practice guidelines for equity in gender and sexual diversity. Childrens’ Aid Society of Toronto; 2012.

Gianola M. Giovanotti femmenelle e signurine masculine. Fondazione Genere Identità Cultura; 2016.

Vantieghem W, Van Houtte M. (2020). The impact of gender variance on adolescents' wellbeing: Does the school context matter? J Homosex. 2020;67(1):1-34. doi: 10.1080/00918369.2018.1522813. Epub 2018 Oct 26. PMID: 30362925.

Russo T, Valerio P. Transgenderism and gender identity: From nosographic manuals to contexts. A focus on Italian universities. Rivista Sperimentale di Freniatria e Medicina Legale delle Alienazioni Mentali. 2019;2:79-111.

Scandurra C, Picariello S, Amodeo AL. Minority stress in a sample of Italian gender variant people: Effects of stigma and resilience on mental health. Mediterranean Journal of Clinical Psychology. 2016;4(2):92 (Supl. 4/2 A).

Scandurra C, Amodeo AL, Bochicchio V, Valerio P, Frost D. Psychometric characteristics of the Transgender Identity Survey in an Italian sample: A measure to assess positive and negative feelings towards transgender identity. International Journal of Transgenderism. 2017;18(1):53-65.

Amodeo AL, Vitelli R, Scandurra C, Picariello S, Valerio P. Adult attachment and transgender identity in the Italian context: Clinical implications and suggestions for further research. International Journal of Transgenderism. 2015;16(1):49-61. doi: 10.1080/15532739.2015.1022680

Dettore D, Ristori J, Antonelli P, al cuidado de. La disforia di genere in età evolutiva. Roma: Alpes Italia; 2015.

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