Please respond to two peers. At least one peer reviewed reference is required
Sandra Monica Delgado
Good morning:
After reviewing this case with patient Fatima Durrani and her family. I can say that according to the DSW-5 criteria describes that people that live with Dysphoria have marked incongruence between their experienced or expressed gender and the one they assigned at birth (Epperson, K. A, 2012) This patient is having a criterion for dysphoria because she has been experiencing a significant distress related to having a strong desire with an opposite gender. This patient will need a lot of help. First, psychotherapy will be beneficial for this patient, so a referral needs to be done. This will help her reveal the underlying cause of dysphoria. Also, gender dysphoria can be approached in supported with hormonal therapy such as masculinizing hormone therapy and surgery which will benefit Fatima and that can be achieved by referring the patient to a gynecologist. Resources in the community will be to provide her with different organizations Telethon kid’s institute which supports these group of children until the age of 21 with gender dysphoria. A recommendation to seek material about dysphoria will be provided to patient and family members. Books like: Understanding Gender Dysphoria by Mark A. Yarhouse and The End of Gender between others. Also, movies about dysphoria like The Danish Girl and 52 Tuesdays so she can be more knowledgeable of her symptoms, and they can all be very well educated on her diagnosis and why does she feel like that. Cultural backgrounds are very influential in cases like this. People from Pakistan still have the belief that their child is not normal because of symptoms of Dystonia like in this case and may be ashamed as this is not expected for them to happen. Gender dysphoric and transgender patients in Pakistan has been socially discriminated and that is why this is very sensitive topic for this family and patient. To be culturally sensitive in my practice with this family and patient I must be able to first listen to them and provide information so they can understand the grounds of why a patient suffers dysphoria and how they can help them better by understanding these symptoms are nor controlled by the person experiencing it nor can they be changed. This family needs to understand through this process that Fatima needs them and needs their comprehension and support.
Bernadine Clarke
Discussion 16.1: Case Study: Fatima Durrani
- What is the DSM-5 criteria for gender dysphoria? Would Fatima meet the criteria for this? Explain your rationale.
According to the DSM-5 criteria, the following must be present to diagnosed persons with gender dysphoria. The initial condition for the identification of gender dysphoria in both adults and teenagers is a noticeable incongruence between the gender the patient believes they are, and what society perceives them to be. This disparity should be ongoing for at least 6 months and should consist of 2 or more of the subsequent criteria (American Psychiatric Association, 2013):
(a) Noticeable incongruence between the gender that the patient sees themselves are, and what their classified gender assignment
(b)An intense need to do away with his or her primary or secondary sex features (or, in the case of young teenagers, to avert the maturity of the likely secondary features)
© An intense desire to have the primary or secondary sex features of the other gender
(d) A deep desire to transform into another gender
(e) A profound need for society to treat them as another gender
(f) A powerful assurance of having the characteristic feelings and responses of the other gender
(g)The second necessity is that the condition should relate to clinically important distress, or affects the individual significantly socially, at work, and in other import areas of life.
Explain your rationale.
Based on the DSM5 criteria, which states that the disparity should be ongoing for at least 6 months and should consist of 2 or more of the subsequent criteria (American Psychiatric Association, 2013). In her case she is 20 years-old, she reports that since she was a teen, she felt that she should have been a boy. She acknowledged that she preferred to dress like the opposite sex and enjoyed playing sports which were more align for the opposite sex. She reports that she repeatedly fell in love with females and was comfortable kissing and caressing their breast. She exhibits assurance of having the characteristic feelings and responses of the other gender and She has no attraction for the opposite sex
In my opinion, she has met three of the needed criteria to be diagnosed as having gender dysphoria. she does have noticeable incongruence between the gender that she identifies herself as, and what her classified gender assignment is.
2.What resources are in your community for Fatima and her family?
Transgender Therapists in Wellington, FL – Psychology Today
https://www.psychologytoday.com
Transgender Therapist in Wellington, FL – Inspire Recovery, MSW; Karen A Peters, PsyD, LMHC; Sheridan Lynn Koplow, EdD; Melissa Schwartz
Transgender Support Groups in Palm Beach County, FL
https://www.psychologytoday.com › groups › palm-beach county.
Transgender Support Groups in Palm Beach County, FL; Boca Raton Monthly Transgender Support Group. Clinical Social Work/Therapist, PhD, LSCW, CST.
2.What referrals would you make for Fatima?
Family and societal rejection of gender identity are some of the strongest predictors of mental health difficulties among people who are transgender.1 Family and couples’ therapy can be important for creating a supportive environment that will allow a person’s mental health to thrive. Parents of children and adolescents who are transgender may benefit from support groups. Peer support groups for transgender people themselves are often helpful for validating and sharing experiences.
- Recommend a movie, TV show, or book about or by a transgender person.
Ma Vie en Rose (1997)
This French film is one of those, telling the story of a little boy named Ludovic who’s certain he’s really a girl. It’s a sweet portrayal of a young person transitioning, despite disapproval from his family and community.
- Are you familiar with this or similar cultures? What would you need to do in your practice to be culturally sensitive?
I am familiar with this culture, in my current practice, we are trained in culture sensitivity and awareness. It is a yearly mandatory train within our company for all staff members.
I would expand on the current available training, by adding training specifically geared for clinicians through the world of working with the lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) community with the goal of promoting greater understanding of the needs and issues affecting the LGBTQIA community to create more welcoming and inclusive clinical atmosphere