Study title, author and year | Participant information | Aims | Intervention type | Outcome measures | Main findings | Follow-up |
Andy: A boy who thought he needed to be a girl, Zienst, A.B (2003)33 | Seven-year-old male assigned at birth. | To demonstrate the multidetermined functions of feminine identifications and strivings in a boy with a diagnosable gender identity disorder. | Psychoanalysis. | None stated. | Andy through the course of psychoanalysis ‘resolved’ cross-gender feelings and continued life as male. | Continued life as male, despite having anxiety about being referred to as ‘gay’. |
Gender identity disorder in a girl: insights from adoption, Gilmore, K (1995)34 | Female assigned at birth initially presented at age six to analyst. | To offer insights into gender identity disorder in girls, through the examination of aetiological factors. | Psychoanalysis. | None stated. | Participant’s gender was the result of disruption in attachment from mother, impacting the oedipal stage of development. Through course of analysis a ‘shift’ in the fantasy of being a boy was resolved to feminine identifications. | No follow-up. |
Four Year Remission of transsexualism after comorbid obsessive compulsive disorder improved with self-exposure therapy, Marks, I.M, and Mataix-Cols, D. (199 7)35 | Male assigned at birth, identified as female since 15. Presented to therapist at 42 with OCD, had attended GIS since 32/33. | None stated. | Self-exposure therapy. | None stated. | Through therapy, 63 days later, self-rated OCD had improved by 90%, transsexuality and homosexuality also remitted as researchers evidenced ‘masturbation three times a week to heterosexual images’. By 17 months’ post discharge feelings of anxiety, depression and anxiety were 98% better and identity still male. | At 6 years follow-up participant’s identification as transgender had ‘recurred’ 2 years prior. Returned to oestrogen 11 months prior to follow-up and was awaiting gender affirmation surgery. |
A developmental, biopsychosocial model for the treatment of children with gender identity disorder. Zucker et al (2012)36 | 7 children aged under 10 years used as clinical case examples of treatments used by Toronto’s gender identity clinic to resolve gender dysphoria in gender diverse youth. | To give summary of treatment protocols by the Centre for Addiction and Mental Health in Toronto, Canada. To give descriptions of assessment and multifactorial formulation in treatment of gender dysphoric youth. | Various treatments; open-ended play psychotherapy. Parent counselling, parent-guided interventions in naturalistic environments, psychotropic medication for co-occurring psychopathology. | Based on parent’s wishes. If the parent wishes for the child to be comfortable in their natal sex, the therapeutic intervention is centred on this goal. Prevention of transsexualism is a treatment goal for those who are believed to ‘desist’ from gender dysphoria into adulthood. | It is of Zucker et al’s belief that gender identity disorder had remitted in the majority of their clients, through the use of their interventions. | Mention is made of those who did go on to transition; however, emphasis is placed on other mental health problems and addictions. ‘Another natal female was originally seen for assessment at the age of 12 years and followed up at the age of 26 … However, he struggled with severe alcohol abuse, abused recreational drugs, had been frequently arrested for getting into fights while intoxicated, and was occasionally suicidal.’ |
OCD, obsessive compulsive disorder; GIS, Gender Identify Service.