Descriptive Study of Gender Dysphoria and Sexual Behavior in a Disorder of Sex Development Group.

Disorder of Sex Development (DSD) refers to a heterogeneous group of congenital conditions in which chromosomal, gonadal, and anatomical sex are atypical. Typically, the diagnosis is made at birth or infancy and interventional actions are necessary in many cases. The repercussions in adult life, more specifically in the field of sexuality, have not been not widely studied yet. This study shows research data that seek to identify in a group of individuals with DSD (XX DSD, XY DSD, Chromosomal DSD), who are being monitored in the departments of pediatric surgery and urology of a hospital in the period from 2000 to 2019, and to verify the consequences on sex life after puberty. The sample has 16 participants (7 XY DSD, 4 XX DSD, and 5 Chromosomal DSD), aged between 16 and 50 years, single, with high school education, residents of the state capital and countryside of the state. The results depict the presence of a case of Gender Dysphoria; postponement of sexual debut for almost 3 years compared to the national average; a single sexual relationship for those who have already had a sexual experience with penetration; penis size below the general population average; presence of masturbatory activity in most participants. The presence of sexual attraction and masturbation indicate sexual desire. The group has a late onset of sexual life (almost 3 years after the national average). A recurrent feature in this group is that, even having already performed a penetrative sexual act, there is no continuation in their sexual life. The main noticeable aspect about Gender Dysphoria is the presence of only one case of incongruence in the Chromosomal DSD group. The limited sample prevents us from sufficient statements for generalization.

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.

As falhas do terapeuta: construções clínicas com pacientes de funcionamento mental regressivo / Therapist challenges: clinical constructions with regressive functioning patients

O presente artigo procura analisar o trabalho clínico com pacientes regressivos. A compreensão acerca de pacientes regressivos apoiada em uma revisão conceitual da teoria winnicottiana entrelaçada pela prática clínica em atendimentos de indivíduos com esse funcionamento. A construção clínica se deu a partir do manejo das falhas ambientais do terapeuta no processo analítico. Sendo assim, a ênfase sobre a perspectiva técnica encontrou-se nas características das relações terapeuta e paciente nesses casos. No presente artigo, destacou-se ainda contribuições quanto a manejo técnico e também algumas dificuldades no trabalho com esses pacientes.

As falhas do terapeuta: construções clínicas com pacientes de funcionamento mental regressivo / Therapist challenges: clinical constructions with regressive functioning patients

O presente artigo procura analisar o trabalho clínico com pacientes regressivos. A compreensão acerca de pacientes regressivos apoiada em uma revisão conceitual da teoria winnicottiana entrelaçada pela prática clínica em atendimentos de indivíduos com esse funcionamento. A construção clínica se deu a partir do manejo das falhas ambientais do terapeuta no processo analítico. Sendo assim, a ênfase sobre a perspectiva técnica encontrou-se nas características das relações terapeuta e paciente nesses casos. No presente artigo, destacou-se ainda contribuições quanto a manejo técnico e também algumas dificuldades no trabalho com esses pacientes. (AU)