Abstract
The Gender and Sexualities Outpatient Clinic (AmbGen) at the Hospital das Clinicas of the State University of Campinas is one of the
few public devices that welcomes children and adolescents with gender variability. Psychiatry and psychology investigate mental disorders, triggers of psychological distress, dysphorias related to gender incongruity and, in the case of children and adolescents,
welcome families seeking understanding of family dynamics, clarification of doubts and stigmas. Hormonal intervention in adolescence is possible in two moments: at the beginning of puberty, through drug therapy aimed at pubertal block, and the second with cross-hormonization. Body adequacy to the trans person’s gender identity, through hormoneization, is desired by most adults. Art therapy performs services where it seeks to provide adequate standards to relevant issues, using expressive modalities and experiences of creative processes in a differentiated therapeutic way that provides a welcoming environment through an artistic bias. Gender and voice characteristics are very comprehensive, so speech therapy for trans people is not restricted to vocal production, but also relates to other aspects of communication and speech.
References
Newcomb ME, Hill R, Buehler K, Ryan DT, Whitton SW, Mustanski B. High burden of mental health problems, substance use, violence, and related psychosocial factors in transgender, non-binary, and gender diverse youth and young adults. Archives of Sexual Behavior [internet]. 2020; 49(2):645-659. doi:10.1007/s10508-019-01533-9.
Chumakov EM, Ashenbrenner YV, Petrova NN, Zastrozhin MS, Azarova LA, Limankin OV. Anxiety and depression among transgender people: findings from a cross-sectional online survey in Russia. LGBT Health [internet]. 2021; 8(6):412-419. Disponível em: http://doi.org/10.1089/Igbt.2020.0464.
Cooper K, Mandy W, Russell A, Butler C. Healthcare clinician perspectives on the intersection of autism and gender dysphoria. Autism. March [internet] 2022;1-12. Disponivel em: https://journals.sagepub.com/doi/pdf/10.1177/13623613221080315. doi:10.1177/13623613221080315.
Glidden D, Bouman WP, Jones BA, Arcelus J. Gender dysphoria and autism spectrum disorder: a systematic review of the literature. Sexual Medicine Reviews [internet]. 2016; 4(1):3-14.doi:10.1016/j.sxmr.2015.10.003.
Nowaskie DZ, Filipowicz AT, Choi Y, Fogel JM. Eating disorder symptomatology in transgender patients: Differences across gender identity and gender affirmation. International Journ. Eat Disord [internet]. 2021; 54(8):1493-1499. doi:10.1002/eat.23539.
Milano W, Ambrosio P, Carizzone F, De Biasio V, Foggia G, Capasso A. Gender dysphoria, eating disorders and body image: an overview. Endocr. Metab. Immune. Disord. Drug. Targets [internet]. 2020; 20(4):518-524. doi: 10.2174/18715303
Hafeez H, Zeshan M, Tahir MA, Jahan N, Naveed S. Health care disparities among lesbian, gay, bisexual, and transgender youth: a literature review. Cureus [internet]. 2017; 9(4):e1184. doi:10.7759/cureus.1184.
KlemmerCL, Arayasirikul S, Raymond HF. Transphobia-based violence, depression, and anxiety in transgender women: the role of body satisfaction. Journ. Interp. Violenc [internet]. 2021;36(5-6):2633-2655. doi: 10.1177/0886260518760015.
APA - American Psychiatric Association. DSM-5: manual diagnóstico e estatístico de transtornos mentais. Porto Alegre: Artmed Editora; 2014.
WHO - World Health Organization. ICD-11 - international classification of diseases 11th Revision [internet]. 2019 [acesso em 12 abr 2022]. Disponível em: https://icd.who.int/en.
Annelou LC, Vries MD, Peggy T, Cohen-Kettenis PT. Clinical management of gender dysphoria in children and adolescents. The Dutch Approach, Journ. Homosm [internet]. 2012;59(3):301-320. doi: 10.1080/00918369.2012.653300.
Edwards-Leeper L, Leibowitz S, Sangganjanavanich VF. Affirmative practice with transgender and gender nonconforming
youth: expanding the model. Psychol. Sexual Orient. Gend. Divers [internet]. 2016; 3(2):165-172. Disponível em: https://
doi.org/10.1037/sgd0000167.
Conselho Federal de Psicologia (CFP). Resolucao nº 11 regulamenta os serviços psicológicos realizados por meios tecnológicos de comunicação a distancia, o atendimento psicoterapêutico em caráter experimental e revoga a Resolução CFP N.° 12/2005. Brasília (DF); 2012 [acesso em 12 abr 2022]. Disponível em: https://site.cfp.org.br/wp-content/uploads/2012/07/Resoluxo_CFP_nx_011-12.pdf.
CFP - Conselho Federal de Psicologia. Resolução nº 1 - estabelece normas de atuação para os psicólogos em relação a questão da Orientação Sexual. Brasília (DF); 1999 [acesso em 12 abr 2022]. Disponível em: https://site.cfp.org.br/wp-content/uploads/1999/03/resolucao1999_1.pdf.
CFP - Conselho Federal de Psicologia. Resolução nº 1 estabelece normas de atuação para as psicólogas e os psicólogos em relação as pessoas transexuais e travess. Brasília (DF); 2018 [acesso em 12 abr 2022]. Disponível em: https://site.cfp.org.br/wp content/uploads/2018/01/resolucao_cfp_01_2018.pdf.
Cunha EL. O que aprender com as transidentidades: psicanalise, género e politica. Porto Alegre: Criação Humana; 2021.
Vieira RG. Escutando transidentidades na psicanalise: potencialidades subversivas. Periódicus [internet]. 2016 [acesso em 28 abr 2022]; 1(5):171-184. Disponível em: http://portalseer.ufba.br/index.php/revistaperiodicus.
Coleman E, Adler R, Bockting W, Botzer M, Brown G, et al. Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism. 2012; 13(4):165-232.
Vries ALC, Cohen-Kettenis PT. Clinical management of gender dysphoria in children and adolescents: the Dutch approach. Journ. Homos. 2012; 59(3):301-320.
Mahfouda S, Moore JK, Siafarikas A, Zepf FD, Lin A. Puberty suppression in transgender children and adolescents. Lancet Diab. Endocr.. 2017; 5(10):816-826.
Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema S, Meyer WJ, & cols. Endocrine treatment of gender-dysphoric/gender-incongruent persons: an endocrine society clinical practice guideline: an Endocrine Society Clinical Practice Guideline. Journ. Clin. Endocr. Metabol. 2017;
(11):3869-3903.
Vries ALC, Steensma TD, Dpreleijers TAH, Cohen-Kettenis PT. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. Journ. Sex. Medic. 2011; 8(8):2276-2283.
Turban JL, King D, Carswell JM, Keuroghlian AS. Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics. 2020; 145(2):1-8.
, Schagem SE, Cohen-Kettenis PT, Waal HA, Delemarre-Van, Hannema SE. Efficacy and safety of gonadotropin-releasing hormone agonist treatment to suppress puberty in gender dysphoric adolescents. Journ. Sex. Medic. 2016;13(7):1125-1132.
Waal HAD, Cohen-Kettenis PT. Clinical management of gender identity disorder in adolescents: a protocol on psychological and pediatric endocrinology aspects.: a protocol on psychological and paediatric endocrinology aspects. Europ. Journ. Endocr. 2006; 155(1):131-137.
Mahfouda S, Moore JK, Siafarikas A, Hewitt T, Ganti U, et al. Gender-affirming hormones and surgery in transgender children and adolescents. Lancet Diabetes Endocrinol. 2019;7(6):484-498.
Hembree WC, Cohen-Kettenis PT, Gooren L, Hannema SE, Meyer WJ, & cols. Endocrine treatment of gender-dysphoric/ gender-incongruent persons: an endocrine Society Clinical Practice Guideline. J Clin. Endocrinol. Metab.2017;102(11):3869-3903.
Drescher J, Byne W. Gender dysphoric/gender variantn (GD/GV) children and adolescents: Summarizing what we know and what we have yet to learn. Journal of Homosexuality. 2012; 59(3):501-510.
Entidades de Fiscalização do Exercício das Profissões Liberais; Conselho Federal de Medicina. Resolução nº 2.265
de 20 de setembro de 2019. Diario Oficial da União; 9 jan. 2020;Seção 1:96
Schlúter K, Sabino MRA. Hormonização em adultos. In: ÁNS Ciasca SV, Hercovitz A, Lopes Jr A. Saúde LGBTQIA+ práticas de cuidado transdisciplinar. Barueri: Manole; 2021. p.451-59.
Schnebelt BA. Art therapy considerations with transgender individuals [dissertação] [internet]. Los Angeles: Loyola Mary Mount University; 2015 [acesso em 12 abr 2022]. Disponível em: https://digitalcommons. Imu.edu/etd/154.
Davis B. Fighting isolation and celebrating gender diversity art therapy with transgender and gender expansive youth. New York: Imprint Routledge; 2019.
Norgren MBP. Arteterapia, promoção de saúde e aprendizagem socioemocional. Rio de Janeiro: Ed. Wak; 2017.
Silva AL, Oliveira AAS. Transexualidade/travestilidade na literatura brasileira: sentidos e significados. Arq Bras Psicol. 2013; 65(2):274-87.
Drumond LB. Fonoaudiologia e transgenitalização: a voz no processo de reelaboração da identidade social do
transexual. In: Anais do XV Encontro Nacional da Associação Brasileira de Psicologia Social. Maceió; 2009.
Mastronikolis NS, Remacle M, Biagini M, Kiagiadaki D, Lawson G. Wendler glottoplasty: an effective raising surgery in male-to-female transexuals. J Voice. 2013; 27(4):516-22.
Sandmann K, Zehnhoff-Dinnesen A, Schmidt CM, Rosslau K, Lang-Roth R, & col. Differences between self-assessment and external rating of voice with regard to sex characteristics, age, and attractiveness. J Voice [internet]. 2014 [acesso em 29 abr 2022]; 28(1):128-e11-28.e18. Disponivel em: https://pubmed.ncbi.nim.nih.gov/24216271/.
Azul D. Transmasculine people’s vocal situations: a critical review of gender-related discourses and empirical data. Intern Journ Lang. Commun. Dis. 2015; 50:31-47.
Gelfer MP, Schofield KJ. Comparison of acoustic and perceptual measures of voice in MtF transsexuals perceived as female vesus those perceived as males. Voice. 2000; 14(1):22-33.
Davies S, Goldberg JM. Clinical aspects of transgender speech feminization and masculinization. Int. J. Transgenderism.
; 9(3-4):167-196.
Schimidt JG, Goulart BND, Dorfman MEKY, Kuhl G, Paniagua LM. Percepcao vocal em mulheres transgénero. Rev. CEFAC. 2018; 20(1):79-86.
, Barros AD, Cavadinha ET, Mendonca AVM. A percepcao de homens trans sobre a relação entre voz e expressão
de género em suas interações sociais. Tempus, Act. Saúd. Colet. 2018;11(4):9-24.
Guedes ZCF. A linguagem por meio dos gestos. In: Kyrillos LR. Expressividade da teoria à prática. Rio de Janeiro: Revinter; 2005:76-86.
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Copyright (c) 2023 Rafael Gobbo, Mayra de Souza El Beck, Kamila Baruque Bignotto, Daniel Nigro Lopes, Nathália Ajudarte Lopes, Karine Schlúter, Octavio de O. Santos Neto, Ana Helena Elias Alvim, Flávia Flávia Cavaletti, Eduardo Belanga, Katerine Baruque Bignotto, Mariana Manfrinatti de Seixas Queiroz, Patricia Gatti, Milena Martins Umeda Souza, Ligia Evora Constantino , Amilton dos Santos Junior, Paulo Dalgalarrondo