Transexualismo

[Scientific output on transsexuality in the Spanish biomedical literature: bibliometric and content analyses (1973-2011)]

OBJECTIVE

To explore the scientific output on transsexuality in the Spanish biomedical literature between 1973 and 2011, through bibliometric and content analyses.

METHODS

We carried out a descriptive, cross-sectional study of Spanish biomedical articles on transsexuality published between 1973 and 2011. The data sources consisted of Índice Médico Español and ISOC-Ciencias Sociales y Humanidades. Bibliometric and content analyses were performed.

RESULTS

A total of 65 papers were analyzed. Knowledge on transsexuality in Spain began to appear in medical journals between 1973 and 1984. A decade of intense productivity began in 1996 and the number of journals publishing articles on transsexuality multiplied in the following years. Until 2006, the year with the most biomedical productivity, biomedical discourses reproduced representations of transsexuality anchored in biological determinism. From 2008-2011, professionals writing on the topic incorporated feminist theories and social perspectives in their discourses.

CONCLUSIONS

In the last quarter of the twentieth century, the dominant medical discourse considered manifestations of transsexual people from a biologist perspective that conceives transsexuality as a configuration mismatch between sex and gender. The emergence of new identity categories and medical reflection from non-essentialist and non-normative gender perspectives has improved the clinical management of transsexuality.

Coordination of healthcare for transsexual persons: a multidisciplinary approach

PURPOSE OF REVIEW

To describe the experience in Spain concerning the public healthcare for transsexual persons using a multidisciplinary approach and to review the relevant literature. Treatment includes social and psychological support, cross-hormone treatment, and sex reassignment surgeries. Although the recommendations of The World Professional Association for Transgender Health are used as guidelines, the application of these standards of care varies considerably, probably because of specific clinical and country factors.

RECENT FINDINGS

The sex reassignment process is complex and requires not only coordination of multiple procedures, but also lifetime follow-up of transsexual individuals. Gender units must provide high-quality services, been essential the principle of accessibility to resources together with a protocolized follow-up and anticipation of secondary effects from the clinical surgical treatment. Two recent challenges are juvenile gender dysphoria and gender variants, which increasingly consult professionals.

SUMMARY

Transsexualism affects all adaptive physical and psychosocial aspects of a person. As diagnosis is based only on the history and personal perceptions, a broad social debate exists about the need for treatment financed by the public health systems. Some countries restrict the care to transsexuals with private medical policies. Thus, coordination of care also requires participation of the family and associations, with continuous information to the health authorities, the judiciary, and the media of each country.