@2024 Afarand., IRAN

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ISSN: 1027-1457    Scientific Journal of Forensic Medicine 2019;25(3):131-138

Background
Sexual identity as a psychological characteristic represents a person's sense of being male or female and corresponds to the anatomical gender of the individual [1]. [2].
Previous Studies
... [3, 4]. A study of 18 men transgendered to women and one woman transgendered to men to investigate the impact of surgery showed that none of the patients regretted surgery [5]. Also, a study examining the role of gender and gender identity of 12 transsexuals after surgery, revealed their satisfaction with their surgery and improvement of their social and psychological status [6]. … [7]. ... [8-13]. According to a study conducted by Hep et al. on the comorbidity of gender dysphoria with other mental disorders, the highest comorbidity was reported with depression [9] .. [15-19]. A study on a group of transsexuals aged 16-24 years showed that 47% of transsexuals had suicidal thoughts and 19% had attempted suicide in the past year [20]. Also, according to a study by Jvaherian & Kuchakian on 40 transsexuals, 65% of them had suicidal thoughts and 6 subjects of them had attempted suicide once, 11 of them 2 to 5 times and 6 of them more than 5 times [21]. ... [22]. According to the results of Radkin & Indericus research, social support is important for maintaining mental health and low levels of this factor put transsexuals at risk for depression, anxiety, and psychosis [23]. ... [24-30].
Aim(s)
The purpose of this study was to compare depression, suicidal thoughts, and social support in transsexuals with and without gender reassignment.
Research type
This descriptive research was a causal-comparative study.
Research society, place and time
This study was conducted on 249 transsexuals with and without gender reassignment covered by the Gender Identity Organization of Iran in 2018.
Sampling method and number
Sampling was done by referring to the Gender Identity Organization and obtaining the permission from its head and 60 transsexuals (30 transsexuals with gender reassignment and 30 transsexuals without gender reassignment) were selected by convenience sampling.
Used devices&materials
Research tools included Beck Depression Inventory (BDI-II) [31-33], Beck Suicidal Thought Inventory (BSSI) [34, 35] and Sherbourne & Stewart Social Support Questionnaire (MOS-SSS) [36, 37]. Researchers first obtained permission from the Azad University, Bookan branch and referred to the Gender Identity Organization in Tehran and selected the sample size based on the research objectives. The consent was obtained from the subjects and they were informed about the research process and the questionnaires were distributed among the participants. While answering, the researcher was actively present to prevent inaccurate responses (quick response and without focus and answering before the end of considered time) and answer possible questions. After one hour, the questionnaires were collected. Data were analyzed by SPSS 24 software. The Kolmogorov-Smirnov test was used to check the normality of the data distribution. The results were analyzed using the Box's M test for the variance-covariance matrix and the Levin test for homogeneity of variances. Multivariate analysis of variance was used for data analysis.
Findings by Text
The mean age in the transsexual group with gender reassignment was 29.46 ± 4.27 years and in the without gender reassignment group was 22.93 ±3.12 years. Among transsexuals with gender reassignment, 16.7% were male to female and 83.3% were female to male. Of the transsexuals with gender reassignment 93.3% also had hormone therapy plus sex change surgery and no transsexuals without gender reassignment had hormone therapy, but 50.0% of them had sex change surgery. Mean scores of depression and suicidal thoughts were higher in the transsexual group without gender reassignment than in the transsexual group with gender reassignment; however, regarding social support, the transsexual group with gender reassignment had a higher mean score. There was a significant difference between two groups regarding suicidal thoughts and social support, but there was no significant difference between two groups in depression (Table 1).
Main comparison to the similar studies
The results showed that there was a significant difference between transsexuals with and without gender reassignment in terms of suicidal thoughts and social support at a level of 0.01. The results of this research regarding depression are in contrast to the results of Rahimi Ahmad Abadi et al. [], Oswalt & Welderer [17], and Budg et al. [18], and Rakis et al. [18]. In these studies, the mean level of depression decreased after sex change in transsexuals, but there was no difference in the rate of depression in the two groups. ... [38]. In Cohen & Goren's study on 163 transsexuals with an average of 2.5 years after surgery, the sense of inadequacy between the anatomical gender and the sexual identity of the patients disappeared, and up to 64% of them were very satisfied and most of their complaints were about social encounters [39]. Concerning suicidal thoughts, the results were consistent with those of Budg et al. [18], Liu & Mustanski [22], and Javaherian and Kochakian [21], and the mean of suicidal thoughts in transsexual without gender reassignment was more. Concerning social support, the results of the present study are consistent with the findings of the Fallah et al. [26], Qara'at & Mohammadi [27], Radkin & Indricus [23], Nath Thorn et al. [28], Fivens et al. [29], and Davy et al. [30]. ... [40]. Factor & Rothblum comparing transsexual men and women with non-transsexual brothers and sisters found that transsexuals received weaker social support from the family [41].
Suggestions
It is suggested that strategies to increase social support for transsexuals before and after surgery be assessed in future studies.
Limitations
The sample was limited to one location, difficulty to access the subjects and a small sample size were some of the limitations of this study.
Conclusions
In both transsexual groups with and without gender reassignment, depression and suicidal thoughts were moderately present, but transsexual without gender reassignment had more suicidal thoughts and transsexual with gender reassignment sought more social support.
Acknowledgments
The authors would like to acknowledge the officials of the Azad University, Bookan branch and also the Gender Identity Organization of Iran for their cooperation.
Conflict of interest
None declared.
Ethical Permissions
This study was approved by the Graduate Research Council of the Azad University, Bookan branch (Ethics Code: 4744).
Funding Sources
None declared.

TABLES and CHARTS

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