Gender Dysphoria and Social Anxiety: An Exploratory Study in Spain

J Sex Med. 2016 Aug;13(8):1270-8. doi: 10.1016/j.jsxm.2016.05.009. Epub 2016 Jun 17.

Abstract

Introduction: Social anxiety in gender dysphoria is still under investigation.

Aim: To determine the prevalence and associated factors of social anxiety in a sample of individuals with gender dysphoria.

Methods: A cross-sectional design was used in a clinical sample attending a public gender identity unit in Spain. The sample consisted of 210 individuals (48% trans female and 52% trans male).

Main outcome measures: Mini-International Neuropsychiatric Interview (MINI) for diagnosis of social anxiety disorder, Structured Clinical Interview, Exposure to Violence Questionnaire (EVQ), Beck Depression Inventory (BDI-II), and Functional Social Support Questionnaire (Duke-UNC-11).

Results: Of the total sample, 31.4% had social anxiety disorder. Social anxiety disorder was highly correlated with age (r = -0.181; CI = 0.061-0.264; P = .009) and depression (r = 0.345; CI = 0.213-0.468; P < .001); it is strongly associated to current cannabis use (relative risk [RR] = 1.251; CI = 1.070-1.463; P = .001) and lifetime suicidal ideation (RR = 1.902; CI 1.286-2.814; P < .001). Moreover, it is significantly associated to lifetime nonsuicidal self-injury (RR = 1.188; CI 1.018-1.386; P = .011), nationality (RR = 7.792; CI 1.059-57.392; P = .013), perceived violence at school during childhood and adolescence (r = 0.169; CI = 0.036-0.303; P = .014), unemployment (RR = 1.333; CI 1.02-1.742; P = .021), and hospitalization of parents in childhood (RR = 1.146; CI = 1.003-4.419; P = .046). Using multivariable analysis, the highly significant variables within the model were depression score (odds ratio [OR] = 1.083; CI = 1.045-1.123; P < .001) and current cannabis use (OR = 3.873; CI = 1.534-9.779, P = .004), also age (OR = 0.948; CI = 0.909-0.989; P = .012), hospitalization of parents during childhood (OR = 2.618; CI = 1.107-6.189; P = .028), and nationality (OR = 9.427; CI = 1.065-83.457; P = .044) were associated with social anxiety disorder.

Conclusion: This study highlights the necessity of implementing actions to prevent and treat social anxiety in this high-risk population.

Keywords: Social Anxiety; Social Phobia; Transgender; Transsexuals; Victimization.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / psychology
  • Crime Victims / psychology
  • Cross-Sectional Studies
  • Depression / psychology
  • Depressive Disorder / psychology
  • Exposure to Violence / psychology
  • Fear / psychology
  • Female
  • Gender Dysphoria / psychology*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Phobia, Social / psychology*
  • Prevalence
  • Psychiatric Status Rating Scales
  • Retrospective Studies
  • Self-Injurious Behavior / psychology
  • Spain
  • Suicidal Ideation
  • Surveys and Questionnaires
  • Transsexualism / psychology*