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Body Image in Young Gender Dysphoric Adults: A European Multi-Center Study

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Abstract

The alteration of sex-specific body features and the establishment of a satisfactory body image are known to be particularly relevant for individuals with Gender Dysphoria (GD). The aim of the study was to first develop new scales and examine the psychometric properties of the Hamburg Body Drawing Scale (Appelt & Strauß 1988). For the second part of this study, the satisfaction with different body features in young GD adults before cross-sex treatment were compared to female and male controls. Data collection took place within the context of the European Network for the Investigation of Gender Incongruence (ENIGI) including 135 female-to-male (FtMs) and 115 male-to-female (MtFs) young GD adults and 235 female and 379 male age-adjusted controls. The five female and six male body feature subscales revealed good internal consistency. The ENIGI sample reported less satisfaction with overall appearance (d = 0.30) and with all of their body features than controls, but no subgroup differences for sexual orientation (FtM and MtF) and Age of Onset (FtM) were found. Body dissatisfaction was higher with regard to sex-specific body features (largest effect sizes of d = 3.21 for Genitalia in FtMs and d = 2.85 for Androgen-responsive features and genitalia in MtFs) than with those that appeared less related to the natal sex (d = 0.64 for Facial features in FtMs and d = 0.59 for Body shape in MtFs). Not only medical body modifying interventions, but also psychosocial guidance with regard to body image might be helpful for GD individuals before transitioning.

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Acknowledgments

We would like to thank all the participants who contributed to this study within the European Network for the Investigation of Gender Incongruence (ENIGI) as well as the clinicians who participated in this project by gathering diagnostic data in Amsterdam, Ghent, Hamburg and Oslo. We would also explicitly like to thank the collaborating psychosocial staff and colleagues from the Hamburg team, particularly Franziska Brunner, Maike Fliegner, Verena Klein, and Kerstin Krupp, for the helpful discussions as well as Christina Handford for improving English grammar and expression. We also thank Katinka Schweizer for her input at the beginning of the ENIGI protocol in Hamburg.

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Authors and Affiliations

  1. Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany

    Inga Becker, Timo O. Nieder, Susanne Cerwenka, Peer Briken & Hertha Richter-Appelt

  2. Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Inga Becker

  3. Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands

    Baudewijntje P. C. Kreukels & Peggy T. Cohen-Kettenis

  4. Department of Sexology and Gender Problems, Ghent University Hospital, Ghent, Belgium

    GrietDe Cuypere

  5. Division of Clinical Neuroscience, Department of Neuropsychiatry and Psychosomatic Medicine, Rikshospitalet, Oslo, Norway

    Ira R. Hebold Haraldsen

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  1. Inga Becker
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  2. Timo O. Nieder
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Correspondence to Hertha Richter-Appelt.

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Becker, I., Nieder, T.O., Cerwenka, S. et al. Body Image in Young Gender Dysphoric Adults: A European Multi-Center Study. Arch Sex Behav 45, 559–574 (2016). https://doi.org/10.1007/s10508-015-0527-z

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