Abstract

OLIVEIRA, Ana Gabriela; VILACA, Ana Filipa  and  GONCALVES, Daniel Torres. From transsexuality to gender dysphoria: how to approach and to guide in primary health care. Rev Port Med Geral Fam [online]. 2019, vol.35, n.3, pp.210-222. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i3.12105.

Objective: To elaborate a protocol of clinical guidance when facing a transsexual person, with or without gender dysphoria, to be applied in primary health care. Data sources and review methods: Research in the PubMed database of articles from 2010 to the present, with the keywords ‘Gender dysphoria’ and ‘Transsexualism’. Research of Portuguese law. Results: Every family doctor should know the regular sexual development of a person. Only then, he will be able to identify some deviations from female/male binarism and recognize a disturbance of gender identity. Through a detailed clinical history based on sexual history, and a targeted objective examination, it is possible to make the diagnosis, which is based essentially on the DSM-5 and ICD-10 criteria. Subsequently, the family doctor can guide the patient to the secondary health care, so that he is accompanied by a multidisciplinary team. In addition, family doctors should also require diagnostic complementary exams to monitor the side effects of therapeutics instituted therein. Conclusion: The differential diagnosis of transsexuality is complex and not always easy to solve. The family doctor is in a privileged position for diagnosing this disturbance of gender identity, given that he follows a person’s development from birth to adulthood. In this way, the family doctor has several opportunities to evaluate the individual's sexuality. The implementation of a pioneering protocol for approaching transsexuality with/without gender dysphoria that standardizes medical conduct aims to avoid delays in diagnosing and in the perpetuation of one’s suffering.

Keywords : Transsexuality; Gender dysphoria; Primary health care; Legislation.

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