Impact of transition to identified gender on transgender adults’ quality of life, autistic traits and experiences of interpersonal interactions

Nobili, Anna (2019) Impact of transition to identified gender on transgender adults’ quality of life, autistic traits and experiences of interpersonal interactions. PhD thesis, University of Nottingham.

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Transgender people often experience poor mental health and there is a strong clinical impression that this population reports high rates of autistic traits. These issues potentially have a negative impact upon their Quality of Life (QoL) and interpersonal issues. Transgender people generally wish to undergo Gender-Affirming Treatments (GAT), which consist of medical interventions such as Cross-Sex Hormone Treatment (CHT) and gender-affirming surgeries. These procedures help align transgender people’s physical characteristics with the gender they identify with and help improve their physical quality of life. However, there is need to understand the impact of undergoing GAT upon mental health-related QoL and social interactions. Thus, Study 1, a systematic review and meta-analysis, was conducted to explore the evidence related to different dimensions of quality of life as well as to gain understanding of the effect of CHT upon mental health-related QoL. Results of this study suggest that transgender people have poorer mental health-related quality of life than the general population. Additionally, some evidence suggests that post-treatment their disadvantage becomes less apparent.

There is paucity of studies trying to understand if this population truly displays enhanced rates of autistic traits as well as the impact of medically transitioning and undergoing CHT on these traits in order to provide transgender people with the needed support. Therefore, Study 2 was carried out to determine if a large sample of transgender people (n= 656) report higher rates of autistic traits compared to a matched sample of cisgender people and Study 3 longitudinally explored the impact of undergoing CHT upon levels of autistic traits in a sample of 91 transgender participants. Findings from the cross-sectional study suggest that transgender adults assigned female at birth display higher levels of autistic traits compared to cisgender females. Transgender adults assigned male at birth had lower levels of autistic traits compared to matched cisgender males. Results of the longitudinal study of transgender adults show that undergoing CHT widens the gender gap, with autistic traits slightly worsening for birth assigned females whilst remaining stable for birth assigned males. This provides some evidence for the stability of autistic traits and for the impact of testosterone treatment upon autistic traits.

In spite of evidence of poorer mental health-related QoL and high rates of autistic traits in transgender adults assigned female at birth research that tries to understand the actual experiences of interpersonal interactions in this population and the factors that influence them is lacking. Thus, Study 4 was carried out to fill this gap in the literature by interviewing a sample of young transgender people. From the interviews it surfaced that transitioning is perceived as having a positive impact upon transgender people’s perceptions of interpersonal interactions and social skills. People also suggested individual differences and personal traits to play a significant role in social interactions and that sharing common interests fosters socialisation.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Glazebrook, Cris
Arcelus, Jon
Keywords: Transgender people; Quality of life; Mental health; Autistic traits; Interpersonal relations
Subjects: W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 59243
Depositing User: Nobili, Anna
Date Deposited: 30 Apr 2020 12:30
Last Modified: 25 Aug 2020 14:22

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