In Italy, some people with gender dysphoria have poor access to care. They are people who rarely go to the attending physician or rarely go to specialist visits of any kind for fear or embarrassment, neglecting their general health condition. The alarm was raised by the experts of the Endocrinologists Association (Ame) which since 2014 has set up a ‘dedicated’ interdisciplinary working group and which, with the collaboration of Consulcesi Club, has created a professional training course dedicated to doctors and operators sanitary.
“A complex phenomenon that in the last period has aroused a lot of media interest but which remains unknown to most, for this reason it is important to create culture and create awareness, starting right from the medical and health class”, explains Stefania Bonadonna, endocrinologist, coordinator of the group of work of the Ame on gender dysphoria and teacher of the Ecm course. In these times we have heard so much about homotransphobia and gender dysphoria as it relates to the issues brought into discussion by the Zan Ddl – underlines a note – but there is no adequate training about the concepts and situations these terms represent.
Dysphoria, transgender, what does that mean? In the collective imagination, gender identity is conceived as a binary system in which the male and female gender are opposed. Introducing us is Antonio Prunas psychologist expert in gender dysphoria and one of the authors of the Ecm course of Consulcesi. In reality, gender identity can be imagined as a spectrum in which masculine and feminine are placed at the extremes and, between these two poles, an infinite variety of possible gender identities and expressions. In a non-binary system, contamination between genders, fluctuations or fluid movements between genders or belonging to no gender are possible. On this conceptual basis, the definitions of Cisgender (a person feels they belong to the gender assigned at birth), and transgender, are born, which are people whose gender they feel they belong to does not coincide with that assigned to them at birth.
What is meant by gender dysphoria instead? In some cases, the person may experience an inconsistency between the gender assigned to him at birth and the one he identifies with. This sense of incongruity can lead to significant discomfort that does not allow the person to live a fully satisfying life: we then speak of gender dysphoria. For example, imagine a person assigned male at birth who instead perceives himself as a female subject and who presents discomfort and suffering towards his own body. Overcoming this inconsistency occurs through a psychological path of self-awareness and often through gender affirmative medical interventions that may include hormonal and / or surgical therapies. Unfortunately, doctors trained in these treatments are still too few in Italy.
In Italy there are only clinical records and binary death certificates and there are no epidemiological data, explains Bonadonna. On the basis of international studies that speak of a population between 0.5 and 2.8%, in Italy, for 60 million residents one can think of a number between 240,000 and 1,696,000, in continuous growth.
But feeling like a man or a woman, regardless of your body, will no longer be considered a mental illness. In fact, the World Health Organization has just moved gender dysphoria from the list of mental illnesses to the very general one of sexual health disorders. This is one of the many historical updates wanted by the WHO in its new and eleventh version of the International Statistical Classification of Diseases also Related Health Problems (ICD-11), the list that contains all the pathologies and health conditions. Bonadonna says again: “It is a fundamental step. The declassification as a mental illness will have to help eliminate all forms of discrimination against transgender people and improve access to care. “