Corrigendum: The impact of the COVID-19 pandemic on the lives of people with Gender Dysphoria.

[This corrects the article DOI: 10.3389/fpubh.2022.878348.].

A speech therapy for transgender women: an updated systematic review and meta-analysis.

BACKGROUND: We systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the fundamental frequency gain of the voice, regarding the type of vocal sample collected, and we compared the effectiveness of the treatments. In addition, the study design, year, country, types of techniques used, total therapy time, and vocal assessment protocols were analyzed. METHODS: We searched the PubMed, Lilacs, and SciELO databases for observational studies and clinical trials, published in English, Portuguese, or Spanish, between January 2010 and January 2023. The selection of studies was carried out according to Prisma 2020. The quality of selected studies was assessed using the Newcastle-Ottawa scale. RESULTS: Of 493 studies, 31 were deemed potentially eligible and retrieved for full-text review and 16 were included in the systematic review and meta-analysis. Six studies performed speech therapy and ten studies phonosurgery. The speech therapy time did not influence the post-treatment gain in voice fundamental frequency (p = 0.6254). The type of sample collected significantly influenced the post-treatment voice frequency gain (p < 0.01). When the vocal sample was collected through vowel (p < 0.01) and reading (p < 0.01), the gain was significantly more heterogeneous between the different types of treatment. Phonosurgery is significantly more effective in terms of fundamental frequency gain compared to speech therapy alone, regardless of the type of sample collected (p < 0.01). The average gain of fundamental frequency after speech therapy, in the /a/ vowel sample, was 27 Hz, 39.05 Hz in reading, and 25.42 Hz in spontaneous speech. In phonosurgery, there was a gain of 71.68 Hz for the vowel /a/, 41.07 Hz in reading, and 39.09 Hz in spontaneous speech. The study with the highest gain (110 Hz) collected vowels, and the study with the lowest gain (15 Hz), spontaneous speech. The major of the included studies received a score between 4 and 8 on the Newcastle-Ottawa Scale. CONCLUSION: The type of vocal sample collected influences the gain result of the fundamental frequency after treatment. Speech therapy and phonosurgery increased the fundamental frequency and improved female voice perception and vocal satisfaction. However, phonosurgery yielded a greater fundamental frequency gain in the different samples collected. The study protocol was registered at Prospero (CRD42017078446).

The Impact of the COVID-19 Pandemic on the Lives of People With Gender Dysphoria.

Objective: To analyze the impact on the psychological and social aspects caused by the COVID-19 pandemic in individuals diagnosed with Gender Dysphoria (GD). Methods: Google Forms inventory was sent via WhatsApp, including qualitative and quantitative questions evaluating three life dimensions denominated as Sociodemographic, Economic, and COVID-19 pandemic. It was applied in two periods: At the beginning of the pandemic (June-2020) (P1) and one year later (June-2021) (P2). The inventory also included questions about economic dimensions before the pandemic for individual comparison purposes (P0). 48 individuals (28 transsexual women, 20 transsexual men) participated in both periods. Results: 77.1% (n = 37) lived in Rio Grande do Sul, 50.0% (n = 24) refereed incomplete high school; Monthly Income increased significantly between the periods (P0) and (P1). Emergence aid approval was significantly higher in (P2), 56.3% (n = 27), compared to (P1), 39.6% (n = 19). A statistically significant difference was detected in the feeling of depression in the (P2) among the cases that requested Emergency Aid. Conclusion: The studied population presented deterioration regarding their condition of social vulnerability in relation to formal employment, access to health services, and mental health.

Heterogeneity in gender dysphoria in a Brazilian sample awaiting gender-affirming surgery: a data-driven analysis.

BACKGROUND: Population heterogeneity and the lack of clinical and sociodemographic information in transgender individuals with gender dysphoria (GD) remains a challenge for specialized services in mental health and surgical procedures. It aimed to identify and describe profiles in a sample waiting for gender-affirming surgery. METHODS: A sample of 100 outpatients with GD was assessed through a structured interview, Emotion Regulation Difficulty Scale (DERS), Ruminative Response Scale (RRS), Depression, Anxiety and Stress Scale (DASS-21) and Life Satisfaction scale (SWLS). Cluster analysis was used to identify different profile categories. RESULTS: Two subgroups with different profiles were identified: with less clinical severity (LCS) and with high clinical severity (HCS) on emotional dysregulation, acute symptoms of depression, anxiety, stress and association with mental rumination. The HCS cluster had greater vulnerability in terms of psychiatric history, use of psychotropic drugs, HIV positive, child abuse and suicidal behavior. CONCLUSION: Different profiles were found regarding the vulnerability to mental health in a sample of transgender people with GD who seek a public hospital service for the same clinical-surgical objective. Longitudinal studies are essential to monitor the impact of these contrasts and to target personalized therapeutic approaches in the prevention of psychiatric disorders.

Prevalence of Gender Dysphoria in Southern Brazil: A Retrospective Study.

To ensure that public health services provide comprehensive and inclusive health care to the general population, it is important for countries to estimate how many of their citizens experience gender dysphoria and wish to receive specialized hormone treatment or gender-affirming surgery. The aim of this study was to estimate the prevalence of individuals with gender dysphoria seeking transgender health care in a public teaching hospital in southern Brazil. In this retrospective follow-up study, we analyzed the medical records and sociodemographic data of individuals aged > 15 years living in Rio Grande do Sul, Brazil, that enrolled in a specialized program to receive hormone therapy and gender-affirming surgery between 2000 and 2018. This study is the first to attempt estimating the prevalence of gender dysphoria in Rio Grande do Sul; it describes novel data on the clinical profile of individuals with gender dysphoria treated in a public hospital specialized in providing transgender health care. Prevalence estimates were calculated based on statewide annual population data in the study period. Of 934 identified individuals, 776 (601 trans women and 175 trans men) were included in this study. The overall prevalence of individuals with gender dysphoria was 9.3 per 100,000 individuals (95% CI: 8.6 to 9.8). Meanwhile, there were 15 trans women per 100,000 people (95% CI: 14 to 16) and 4.1 trans men per 100,000 people (95% CI: 3.5 to 4.8). There was a progressive increase in the number of people seeking hormone therapy and gender-affirming surgery during the study period. Future research is needed to determine the size of the trans population in other regions of Brazil and to expand the knowledge regarding gender dysphoria to allow for the development of effective public policies for people with gender dysphoria.

Corrigendum: Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil.

[This corrects the article DOI: 10.3389/fpsyt.2021.627661.].

Factors Associated With Ruminative Thinking in Individuals With Gender Dysphoria.

This study aimed to examine psychosocial factors and medical history as well as symptoms of depression, anxiety, and stress associated with ruminative thinking in transgender people with gender dysphoria (GD) before undergoing gender affirmation surgery (GAS). This study evaluated 189 participants with GD (111 trans women and 78 trans men) from a specialized service for GAS in southern Brazil. Semi-structured interviews were conducted, and participants were asked to complete self-report questionnaires. We recovered participants' sociodemographic and psychosocial data (e.g., history of sexual abuse, expulsion from home, and history of drug use) and data regarding their clinical history (e.g., medication, history of suicidal ideation and attempted suicide, and HIV status). Further, we implemented the Depression, Anxiety and Stress Scale (DASS-21) to examine participants' psychological state, as well as the Ruminative Response Scale (RRS) to assess ruminative thinking, which includes brooding and reflection. The predictor variables were those that exhibited a minimum level of significance of p ≤ 0.05 in multivariate linear regression. The ruminative thinking scores for trans women were higher than those of trans men (Brooding p = 0.014; Reflection p = 0.052).In the multivariate model, suicidal ideation, moderate depression, and severe/very severe anxiety were associated with both brooding and reflection. Feminine gender identity and stress symptoms moderated only brooding, while anxiety symptoms moderated only reflection. Our findings show that trans women had the highest ruminative thinking scores, and that depression, anxiety, stress, and suicidal ideation were associated with ruminative thinking in total sample. Psychological symptoms should be examined in the context of gender affirmation surgery to minimize the possibility of adverse mental health outcomes. Follow-up studies are required to measure ruminative thinking levels more accurately and to identify its predictors.

Male-to-Female Gender-Affirming Surgery: 20-Year Review of Technique and Surgical Results.

Purpose: Gender dysphoria (GD) is an incompatibility between biological sex and personal gender identity; individuals harbor an unalterable conviction that they were born in the wrong body, which causes personal suffering. In this context, surgery is imperative to achieve a successful gender transition and plays a key role in alleviating the associated psychological discomfort. In the current study, a retrospective cohort, we report the 20-years outcomes of the gender-affirming surgery performed at a single Brazilian university center, examining demographic data, intra and postoperative complications. During this period, 214 patients underwent penile inversion vaginoplasty. Results: Results demonstrate that the average age at the time of surgery was 32.2 years (range, 18-61 years); the average of operative time was 3.3 h (range 2-5 h); the average duration of hormone therapy before surgery was 12 years (range 1-39). The most commons minor postoperative complications were granulation tissue (20.5 percent) and introital stricture of the neovagina (15.4 percent) and the major complications included urethral meatus stenosis (20.5 percent) and hematoma/excessive bleeding (8.9 percent). A total of 36 patients (16.8 percent) underwent some form of reoperation. One hundred eighty-one (85 percent) patients in our series were able to have regular sexual intercourse, and no individual regretted having undergone GAS. Conclusions: Findings confirm that it is a safety procedure, with a low incidence of serious complications. Otherwise, in our series, there were a high level of functionality of the neovagina, as well as subjective personal satisfaction.

Descriptive Study of Transgender Youth Receiving Health Care in the Gender Identity Program in Southern Brazil.

Since 2014, the Gender Identity Program (PROTIG) of Hospital de Clínicas de Porto Alegre (HCPA) has been assisting transgender youth seeking gender-affirmative treatment offered at a public health-care service specializing in gender in southern Brazil. This article aims to analyze sociodemographic and clinical data regarding the diagnoses of gender dysphoria and gender incongruence, psychiatric comorbidities, and clinical aspects of a sample of transgender youths seeking health care in the gender identity program. The research protocol consisted of a survey of the data collected in the global psychological evaluation performed at the health-care service for youths diagnosed with gender incongruence and their caretakers. Participating in this research were 24 transgender youths between 8 and 16 years old with diagnostic overlap of gender dysphoria [Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)] and gender incongruence [International Classification of Diseases, 11th Revision (ICD-11)] and 34 of their caregivers. Of the young people, 45.8% were positive for some psychiatric comorbidity throughout their lives, with almost half (45.4%) having two or more psychiatric comorbidities in addition to gender dysphoria. The mental health professionals comprising affirmation care teams face the challenge of adapting the care protocols to the uniqueness of each demand by developing individualized forms to promote healthy development. This can be done by focusing not only on medical and physical interventions for gender affirmation but also on the promotion of mental health and general emotional well-being. Thus, the gender affirmation model, which advocates for global assessment and personalized guidance, proved to be adequate. Nevertheless, access to multidisciplinary health services specializing in gender is essential for promoting the general well-being of the population of transgender youth.

Use of the House-Tree-Person Projective Drawings and Parental Styles Inventory in the Global Psychological Evaluation of Transgender Youth Who Seek Healthcare at the Gender Identity Program.

The present study explores data collected in the psychological evaluation of transgender youth and their families who seek healthcare at the Gender Identity Program. Great psychosocial changes mark the transition from infancy to adulthood. Transgender youth may have these aspects of their developmental stage potentialized. A study was conducted with 23 transgender youth (mean age = 14 ± 2.38 years) and their caregivers. Eleven of the youngsters were assigned male at birth, while 12 were assigned female. The research protocol consisted of a survey and systematization of the data collected in the initial global psychological evaluation performed at the healthcare facility, including house-tree-person (HTP) projective drawings and the parental styles inventory. The present study aimed to explore the data collected during the psychological evaluation of youngsters diagnosed with gender incongruence, relating the HTP projective drawing technique to parental styles and gender trajectories. The results indicate two key points. One evidenced that parental styles could be either preventive or risk components in maintaining adequate socialization in these young people but not in affecting the level of gender dysphoria. The other was that coherence is introduced in the person's perception of his or her projected self-image and his or her expressed gender as he/she becomes more comfortable in expressing his/her gender identity. Treating youngsters inherently brings ethical issues to clinical practice. Thus, global psychological evaluation tailored to this population is a fundamental resource that the psychology professional can use in consultations with youngsters because this tool brings a global understanding about the natural development cycle, facilitating the formulation of therapeutic conducts and exchanges within interdisciplinary transgender health care teams.

A Retrospective Review of Medical Records of Laboratory-Tested Sexually Transmitted Infections of Transsexual Men from Southern Brazil.

The present study assessed the prevalence of sexually transmitted infections (STIs) in 90 transsexual men (female-to-male transsexual persons) from southern Brazil. A retrospective review of the medical records of all transsexual men who visited an outpatient clinic in Rio Grande do Sul from 1998 to 2017 was performed. Although the sample had a high prevalence of risk factors for contracting STIs, such as drug use, one-third of the participants had never been tested for STIs and, when screened, it was mostly for HIV, but not for syphilis or other STIs. Based only on laboratory-tested transsexual men, the prevalence of syphilis and hepatitis C was 3.4% and 1.6%, respectively, which is higher than the general population. It is clear that health professionals need to broaden their understanding of transsexual men, acknowledging STIs as a possible diagnosis.

Childhood Maltreatment Linked with a Deterioration of Psychosocial Outcomes in Adult Life for Southern Brazilian Transgender Women.

A history of childhood maltreatment (HCM) has been associated with detrimental psychiatric outcomes. This is particularly true for transgender, for whom there is initial evidence that HCM may be associated with psychiatric morbidity. Our study aimed to further characterize the relationship between HCM and the development of mental disorder in adult life, based on a sample of Brazilian transgender women. Cross-sectional data were collected from a consecutive sample of 289 transgender women who attended the Hospital Clínicas clinic for gender dysphoria, in Porto Alegre, between 1998 and 2014. Our results demonstrated a greater risk of deteriorating mental health amongst participants who had experienced HCM. Given the disproportionally high rate of HCM in transgender persons, we advocate for greater assistance for transgender persons.

Perceptual-Auditory and Acoustical Analysis of the Voices of Transgender Women.

Voice is an important gender marker in the transition process as a transgender individual accepts a new gender identity. The objectives of this study were to describe and relate aspects of a perceptual-auditory analysis and the fundamental frequency (F0) of male-to-female (MtF) transsexual individuals. A case-control study was carried out with individuals aged 19-52 years who attended the Gender Identity Program of the Hospital de Clínicas of Porto Alegre. Vocal recordings from the MtF transgender and cisgender individuals (vowel /a:/ and six phrases of Consensus Auditory Perceptual Evaluation Voice [CAPE-V]) were edited and randomly coded before storage in a Dropbox folder. The voices (vowel /a:/) were analyzed by consensus on the same day by two judge speech therapists who had more than 10 years of experience in the voice area using the GRBASI perceptual-auditory vocal evaluation scale. Acoustic analysis of the voices was performed using the advanced Multi-Dimensional Voice Program software. The resonance focus and the degrees of masculinity and femininity for each voice recording were determined by listening to the CAPE-V phrases, for the same judges. There were significant differences between the groups regarding a greater frequency of subjects with F0 between 80 and 150 Hz (P = 0.003), and a greater frequency of hypernasal resonant focus (P < 0.001) in the MtF cases and greater frequency of subjects with absence of roughness (P = 0.031) in the control group. The MtF group of individuals showed altered vertical resonant focus, more masculine voices, and lower fundamental frequencies. The control group showed a significant absence of roughness.

Adaptation and Validation of the Brazilian DASE and TUD Scales for Cocaine/Crack Users / Adaptação e Validação Brasileira das Escalas DASE e TUD para Usuários de Cocaína/Crack / Adaptación y Validación Brasileña de las Escalas DASE y TUD para Usuarios de Cocaína/Crack

Abstract: Self-efficacy for abstinence and temptation to use illicit drugs are demonstrably key elements of changing addictive behaviors. This study's aim was to analyze the psychometric evidence for the Brazilian adaptation of the scales Drug Abstinence Self-efficacy Scale (DASE) and Temptation to Use Drugs Scale (TUD). The sample was composed of 300 men treated for cocaine and crack addiction. Análise Factorial Exploratory and internal consistency demonstrated the existence of four factors in the DASE that explained 54% of the total variation in the 24 items, and four factors in the TUD that explained 56% of the total change in the variation. The Cronbach's alpha coefficient was at DSE .920 and TUD .927. The Brazilian adaptation of the scales showed appropriate evidence of validity in the sample of hospitalized individuals addicted to cocaine and crack.

Resumo: Autoeficácia para abstinência e a tentação para uso de drogas são importantes elementos na mudança dos comportamentos aditivos. O objetivo do estudo foi analisar as evidências psicométricas da validação e adaptação brasileira das escalas Drug Abstinence Self-efficacy Scale (DASE) e Temptation to Use Drugs Scale (TUD). A amostra foi de 300 homens em tratamento pela dependência de cocaína e crack. A análise fatorial exploratória e de consistência interna demonstraram a existência de quatro fatores na DASE, explicando 54% da variação total dos 24 itens e quatro fatores na TUD explicando 56% da variação total. O coeficiente alpha de Cronbach na DASE foi 0,920 e na TUD 0,927. A adaptação brasileira das escalas mostrou evidências de validade adequadas na amostra de dependentes de cocaína e crack internados.

Resumen: Autoeficacia para abstinencia y la tentación para el consumo de drogas han sido elementos importantes en el cambio de las conductas adictivas. El objetivo del estudio fue analizar las evidencias psicométricas de la validación y adaptación brasileña de las escalas: Escala de Autoeficacia para Abstinencia de las Drogas (DASE) y Escala de Tentación de Utilizar Medicamentos (TUD). La muestra consistió en 300 hombres que reciben tratamiento para la adicción a la cocaína y el crack. El análisis factorial exploratorio y de consistencia interna mostraron la existencia de cuatro factores en la DASE, que explican el 54% de la variación total de los 24 artículos; y cuatro factores que explican el 56% de la variación total en la TUD. El coeficiente alfa de Cronbach fue 0,920 en la DASE y 0,927 en la TUD. La adaptación brasileña de las escalas muestra evidencias de validez adecuadas en la muestra de dependientes de la cocaína y el crack admitidos.

Laryngeal surgical treatment in transgender women: A systematic review and meta-analysis.

OBJECTIVE: To identify the effects of laryngeal surgical treatment in the voice of transgender women, especially on the fundamental frequency (f0). STUDY DESIGN: We performed a systematic review in PubMed and Scopus in July 2016, covering the period between 2005 and 2016. METHODS: Inclusion criteria were studies in English or Portuguese about the laryngeal surgical treatment in transgender women, featuring experimental design, title, year of publication, country of origin, journal of publication, participants, intervention, results. For the meta-analysis, only studies that had control group were selected. Exclusion criteria were articles that mentioned the use of surgical techniques but did not use the procedure in research, animal studies, studies of revision, and postmortem studies. RESULTS: Four hundred and twenty-three articles were identified in the initial search; 94 were selected for analysis by two referees, independently. After applying all the selection criteria, five studies remained in the meta-analysis. The surgical procedures that were identified included laryngoplasty with or without thyrohyoid approximation, Wendler glottoplasty, cricothyroid approximation, laser glottoplasty reduction and the vocal fold shortening and retrodisplacement of anterior commissure. There was no significant difference between the experimental group and the control group in relation to f0. CONCLUSION: No randomized clinical trials and prospective cohort studies are available, and a small number of retrospective cohort and case-control studies of surgical techniques reveal an increase in the f0. The evidence produced is not conclusive regarding which surgical technique would be better for vocal treatment of transgender women. LEVEL OF EVIDENCE: NA Laryngoscope, 127:2596-2603, 2017.

Sintomas psiquiátricos e características sociodemográficas associados à tentativa de suicídio de usuários de cocaína e crack em tratamento / Psychiatric symptoms and sociodemographic characteristics associated with the attempted suicide of cocaine and crack users under treatment

RESUMO Objetivo O objetivo do estudo foi analisar as características sintomatológicas e sociodemográficas associadas ao histórico de tentativa de suicídio (TS) de usuários de cocaína e crack internados para tratamento. Métodos Trata-se de um estudo transversal envolvendo 160 participantes que responderam a uma entrevista clínica semiestruturada e ao instrumento Adult Self-Report (ASR). O modelo de Regressão Logística foi utilizado para testar os sintomas psicológicos associados à TS dessa amostra. Resultados As diferenças entre o grupo com TS e sem TS foram significativas (p < 0,001), e, do total da amostra, 30,6% (n = 49; p = 0,428) possuíam histórico de TS e 30,5% (n = 20) relataram ideação suicida no atual tratamento. A etnia, os sintomas de depressão e os problemas de pensamento estiveram associados à TS, enquanto comportamentos intrusivos, de quebra de regras e problemas internalizantes serviram de proteção à TS. Conclusões Os achados reforçam a necessidade da avaliação psiquiátrica dos estados emocionais, de comorbidades e do risco de suicídio no ingresso e durante o tratamento para dependência química.

ABSTRACT Objective The objective of this study was to analyze the symptoms and sociodemographic characteristics associated with the history of attempted suicide (TS) of cocaine and crack users hospitalized for treatment. Methods This is a cross-sectional study involving 160 participants who completed a semi-structured clinical interview and the Adult Self-Report (ASR) instrument. The Logistic Regression model was used to test the psychological symptoms associated with TS of this sample. Results The differences between the TS and non-TS groups were significant (p < 0.001). Of the total sample, 30.6% (n = 49; p = 0.428) had a history of TS and 30.5% (N = 20) reported suicidal ideation in the current treatment. Ethnicity, symptoms of depression and problems of thinking were associated with TS, whereas intrusive, rule-breaking and internalizing problems served as protection for TS. Conclusions The findings reinforce the need for psychiatric evaluation of emotional states, comorbidities and risk of suicide at admission and during treatment for chemical dependence.

Transsexual Voice Questionnaire for Male-to-female Brazilian Transsexual People.

OBJECTIVES: The aim of the study was to verify the answers to the transsexual voice questionnaire for male-to-female transsexual (TVQMtF) people given to individuals who participated in the Gender Identity Program (PROTIG) at the Hospital de Clínicas de Porto Alegre, Brazil, in relation to some of their demographic characteristics, visual-perceptual evaluations of the face, laryngeal prominence, and auditoryperceptual judgments of voice. METHODS: In this cross-sectional study, 47 transsexual women aged between 18 and 50 responded to the (TVQMtF). The demographic data and perceptual ratings were selected from the PROTIG database. RESULTS: Among all participants, 55.32% had completed secondary education, and 72.34% had not undergone a sex reassignment surgery; 4.2% of subjects did not use hormones, 23.40% had undergone speech therapy, the average number of years of experience in the female role was 13.98 years, and the participants had been definitively cross-dressing for 5-34 years. Most of the participants had low scores on the (TVQMtF), and significant differences in the total score were observed in accordance with age (higher scores were observed among those <30 years and ≥40 years old) and visual-perceptual evaluations of the face (higher scores were observed in the individual evaluated with masculine face). There were no significant correlations between the total score obtained by the participants and the other demographic variables. CONCLUSIONS: Although most of the participants had low scores on the (TVQMtF), some individuals were still experiencing distress due to being perceived as being of the opposite sex or were dissatisfied with their voices.

BIRTH ORDER AND ANDROPHILIC MALE-TO-FEMALE TRANSSEXUALISM IN BRAZIL.

Previous research has indicated that biological older brothers increase the odds of androphilia in males. This finding has been termed the fraternal birth order effect. The maternal immune hypothesis suggests that this effect reflects the progressive immunization of some mothers to male-specific antigens involved in fetal male brain masculinization. Exposure to these antigens, as a result of carrying earlier-born sons, is hypothesized to produce maternal immune responses towards later-born sons, thus leading to female-typical neural development of brain regions underlying sexual orientation. Because this hypothesis posits mechanisms that have the potential to be active in any situation where a mother gestates repeated male fetuses, a key prediction is that the fraternal birth order effect should be observable in diverse populations. The present study assessed the association between sexual orientation and birth order in androphilic male-to-female transsexuals in Brazil, a previously unexamined population. Male-to-female transsexuals who reported attraction to males were recruited from a specialty gender identity service in southern Brazil (n=118) and a comparison group of gynephilic non-transsexual men (n=143) was recruited at the same hospital. Logistic regression showed that the transsexual group had significantly more older brothers and other siblings. These effects were independent of one another and consistent with previous studies of birth order and male sexual orientation. The presence of the fraternal birth order effect in the present sample provides further evidence of the ubiquity of this effect and, therefore, lends support to the maternal immune hypothesis as an explanation of androphilic sexual orientation in some male-to-female transsexuals.

Sintomas internalizantes, externalizantes e relações interpessoais de adolescentes em tratamento para dependência química / Symptons internalizing, externalizing and interpersonal relations teenagers in treatment for addictions / Síntomas internalizantes, externalizantes y relaciones interpersonales de adolescentes en tratamiento de adicciones

O uso de drogas na adolescência produz importantes impactos psicológicos, comportamentais e nos estilos interpessoais do individuo. Este estudo visou examinar e descrever tais aspectos através do instrumento Young Self Report (YSR), uma entrevista clínica semi-estruturada e uma sessão de grupo focal com cinco adolescentes internados pela a dependência de drogas. O discurso dos participantes foi analisado através da Análise de Conteúdo de Bardin, modalidade temática e as sintomatologias clínicas examinadas pelo YSR. O conteúdo do grupo obteve seis categorias finais: habilidades interpessoais, dificuldades interpessoais, aspectos emocionais, aspectos físicos, ambiente escolar e ambiente familiar. Os resultados mostraram características importantes no funcionamento adaptativo, que facilita as relações e problemas clínicos que podem estar associados a estilos menos adaptativos. Este estudo destaca a importância de avaliar os elementos individuais envolvidos na dependência das drogas e no plano terapêutico, bem como, sugerir modelos de intervenções que atendem a essas demandas. (AU)

Drug use in adolescence produces significant psychological impact, behavioral and interpersonal styles of the individual. This study aimed to examine and describe these aspects through the instrument Young Self Report (YSR), a semi-structured clinical interview and a focus group session with five teenagers hospitalized for drug addiction. The speech of the participants was analyzed by the Bardin Content Analysis, thematic modality and clinical symptomatology examined by YSR. The content of the group obtained final six categories: interpersonal skills, interpersonal difficulties, emotional, physical, school environment and family atmosphere. The results showed important characteristics in the adaptive operation which facilitates relations and medical problems which may be associated with less adaptive styles. This study highlights the importance of assessing the individual elements involved in drug addiction and therapeutic, as well as suggest intervention models that meet these demands. (AU)

El consumo de drogas en la adolescencia produce impacto psicológico significativo, estilos de comportamiento e interpersonales del individuo. El objetivo este estudio fue examinar y describir los aspectos através del instrumento Young Self Report (YSR), una entrevista clínica semiestructurada y una sesión de grupo focal con cinco adolescentes hospitalizados por adicción a las drogas. El discurso de los participantes fue analizado por el análisis de contenido de Bardin, modalidad temática y la sintomatología clínica examinadas por YSR. El contenido del grupo contenida seis categorías: habilidades interpersonales, dificultades interpersonales, ambiente emocional, físico, la escuela y ambiente familiar. Los resultados mostraron características importantes en el funcionamiento adaptativo que facilita las relaciones y problemas clínicos que pueden estar asociados con los estilos de menos de adaptación. Este estudio menciones la importancia de evaluar los elementos individuales implicados en la adicción de drogas y terapéutica, así como proponer modelos de intervención que cumplen estas exigencias. (AU)