Personality and sexological characteristics of adolescent female-to-male gender-affi rming medical care applicants

Czech version

Authors: Schönauerová Dominika ¹; Weiss- Petr ^{1 3}
Authors‘ workplace: Katedra psychologie FF UK, Praha, Česko ¹; Katedra psychológie FiF UK, Bratislava, Slovensko ²; Sexuologický ústav 1. LF UK a VFN v Praze, Česko ³
Published in: Čes. a slov. Psychiat., 121, 2025, No. 2, pp. 77-85.
Category: Original Article
doi: https://doi.org/10.48095/cccsp202505

Overview

Objective: In light of the absence of research scrutinizing the steadily growing population of adolescent female-to-male (FtM) gender-affirming medical care applicants in the Czech Republic, this article focuses on a descriptive analysis of their anamnestic profile. Materials and methods: Records from the initial psychological assessment of assigned female at birth patients at the Institute of Sexology, General University Hospital in Prague (N = 78) diagnosed with F640 Transsexualism, aged between 15 and 19 years at the time of assessment (M = 16.3 years, SD = 1.00), were analyzed. Results: Late onset of gender incongruence (GI) at puberty or adolescence (M = 13.2 years, SD = 1.98) was present in the majority of adolescent FtM (93.6%), along with complete social transition at the time of the initial psychological assessment (70.5%). Acceptance of the offspring‘s gender identity by both parents was observed in only half of the cases (50.0%). Sexual orientation of the FtMs based on their gender identity was most often non-heterosexual (57.7%). The majority of patients (82.1%) wished to undergo a complete gender-affirming process, including surgical procedures, but different preferences – only hormonal treatment (14.1%) or uncertainty in the demands (3.8%) were also present. Almost half of the FtMs had experience of a romantic relationship (47.4%), but only one-third were sexually active (33.3%). There was a history of various psychiatric comorbidities; with particularly high frequencies of mixed anxiety-depressive disorder (33.3%), self-mutilation (51.3%), suicidal ideation (56.4%), and suicide attempts (25.6%), which were mostly repeated. In addition, a targeted psychological examination revealed a high prevalence of psychological instability (66.7%) and impaired personality development (28.6%). Previous contact with psychiatric care was frequent, with half of the patients (50.0%) having been under psychiatric care and a fifth (20.5%) having had a psychiatric hospitalization. Conclusion: Despite the reduced time interval between the onset of GI and entering medical care, adolescent FtM gender-affirming medical care applicants in the initial phase of the treatment process show an impaired mental health state. Their anamnestic characteristics suggest that both physical and social distress of high intensity are present, which plays a role.

Keywords:

comorbidity – adolescence – mental health – female-to-male – transsexualism

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