Gender Dysphoria Publication Trends: A Bibliometric Analysis between 1900 and 2018

Abstract

Objective Research on gender dysphoria (GD) has been growing over the last decades with increasing interest in understanding and characterizing the causal relationships between psychological, genetics, hormonal, and sociocultural factors. Changes and acceptance of this condition as non-pathologic have led to significant changes in general perspective and its management over time. Our objective is to carry out a bibliometric analysis to know the publication trends and quality of evidence related to gender dysphoria.

Methods A systematic search and critical review of the literature was carried out between January 1900 and December 2018 to perform a bibliometric analysis. Research was done in the following databases: OVID, PubMed, EMBASE, Scopus, Web of Science and Google Scholar. The medical subject headings (MeSh) terms used were: gender dysphoria; and surgery and psychology. The results were plotted using the VOSviewer version 1.6.8. Statistical analyses were performed with the IBM SPSS, Version 25.0.

Results A total of 1,239 manuscripts were identified, out of which 1,041 were selected. The average number of cited times per year per manuscript is 1.84 (interquartile range [IQR] 0-2.33). The average impact index was 47.8 (IQR 20-111.6). The median of total citations per manuscript was 3 (IQR 0-33.1), and the highest number of citations per manuscript was 484. Most publications focus on the psychological aspects of GD, and there is a significant amount of manuscripts related to social and anthropological issues. Most articles have a low level of scientific evidence.

Conclusion There is a great amount of published literature on GD; however, there is a significant level of disagreement in many respects on this topic. Regarding surgical gender-affirmation, there is a lack of information supported by high level of evidence to uphold the emerging expansion of medical practices.

Resumen

Objetivo La investigación sobre la disforia de género (DG) ha crecido en las últimas décadas con un interés creciente por comprender y caracterizar las relaciones causales entre factores psicológicos, genéticos, hormonales y socioculturales. La aceptación de esta condición como no patológica ha llevado a cambios significativos en la perspectiva general y su manejo a lo largo del tiempo. Nuestro objetivo es realizar un análisis bibliométrico para evaluar las tendencias de publicación y la calidad de evidencias relacionadas con la disforia de género.

Métodos Se realizó una búsqueda sistemática y revisión crítica de la literatura entre enero de 1900 y diciembre de 2018 para hacer un análisis bibliométrico. Se utilizaron los criterios de los Ítems de Informe Preferido para Revisiones Sistemáticas y Metaanálisis (Preferred Reporting Items for Systematic Reviews and Meta-analysis, PRISMA, en inglés), y la investigación se realizó en las siguientes bases de datos: OVID, PubMed, EMBASE, Scopus, Web of Science y Google Scholar. Los términos de encabezados de temas médicos (medical subject headings, MeSh, en inglés) utilizados fueron: disforia de género; y cirugía y psicología. Los resultados se trazaron utilizando VOSviewer, versión 1.6.8. Los análisis estadísticos se realizaron con el IBM SPSS, versión 25.0.

Resultados Se identificaron un total de 1.239 manuscritos, y se seleccionaron 1.041. El número promedio de citas por año por manuscrito fue de 1,84 (rango intercuartil [RIC]: 0–2,33). El índice de impacto promedio fue de 47,8 (RIC: 20–111,6). La mediana del total de citas por manuscrito fue de 3 (RIC: 0–33.1), y el mayor número de citas por manuscrito fue de 484. La mayoría de las publicaciones se centran en los aspectos psicológicos de la DG, y hay una cantidad significativa de manuscritos relacionados con temas sociales y antropológicos. La mayoría de los artículos tienen un bajo nivel de evidencia científica.

Conclusión Existe una gran cantidad de literatura publicada sobre disforia de género; sin embargo, existe un nivel significativo de desacuerdo en muchos aspectos sobre este tema. Con respecto a la afirmación quirúrgica, hace falta información respaldada por un alto nivel de evidencia que argumente la expansión emergente de las prácticas médicas.

Keywords

gender dysphoria - bibliometrics - publications - information sciences

Palabras clave

disforia de género - bibliometría - publicaciones - ciencias de la información

Publication History

Received: 31 August 2020

Accepted: 22 December 2020

Article published online:
21 June 2022

• References

• 1 Laub DR, Fisk N. A rehabilitation program for gender dysphoria syndrome by surgical sex change. Plast Reconstr Surg 1974; Apr; 53 (04) 388-403 DOI: 10.1097/00006534-197404000-00003.
• 2 Goldberg AETWPA for TH. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People The World Professional Association for Transgender. SAGE Encycl LGBTQ Stud; . Published online 2016 DOI: 10.4135/9781483371283.n464
• 3 Wylie K, Barrett J, Besser M. et al. Good Practice Guidelines for the Assessment and Treatment of Adults with Gender Dysphoria. Sex Relationship Ther 2014; 29 (02) 154-214 DOI: 10.1080/14681994.2014.883353.
• 4 Behavioral M, Factor R, Survey S, Variance G. American Psychological Association. Guidelines for psychological practice with transgender and gender nonconforming people. Am Psychol 2015; 70 (09) 832-864 DOI: 10.1037/a0039906.
• 5 Bowman C, Goldberg JM. Care of the patient undergoing sex reassignment surgery. Int J Transgenderism 2007; 9 (3–4): 135-165 DOI: 10.1300/J485v09n03_07.
• 6 Fernández R, Guillamon A, Cortés-Cortés J. et al. Molecular basis of Gender Dysphoria: androgen and estrogen receptor interaction. Psychoneuroendocrinology 2018; 98: 161-167
• 7 Smith ES, Junger J, Derntl B, Habel U. The transsexual brain--A review of findings on the neural basis of transsexualism. Neurosci Biobehav Rev 2015; 59: 251-266 DOI: 10.1016/j.neubiorev.2015.09.008.
• 8 Hengstschläger M, van Trotsenburg M, Repa C, Marton E, Huber JC, Bernaschek G. Sex chromosome aberrations and transsexualism. Fertil Steril 2003; 79 (03) 639-640 DOI: 10.1016/S0015-0282(02)04805-7.
• 9 Fisher AD, Ristori J, Morelli G, Maggi M. The molecular mechanisms of sexual orientation and gender identity. Mol Cell Endocrinol 2018; 467: 3-13 DOI: 10.1016/j.mce.2017.08.008.
• 10 Fernandez N, Puerto A, Azuero A. et al. Historical bibliometric analysis of the top cited articles on vesicoureteral reflux 1950-2016, and incorporation of a novel impact index. J Pediatr Urol 2018; 14 (05) 446.e1-446.e9 DOI: 10.1016/j.jpurol.2018.04.004.
• 11 Hughes IA, Houk C, Ahmed SF, Lee PA. LWPES Consensus Group, ESPE Consensus Group. Consensus statement on management of intersex disorders. Arch Dis Child 2006; 91 (07) 554-563 DOI: 10.1136/adc.2006.098319.
• 12 Benjamin H. The transsexual phenomenon. Trans N Y Acad Sci 1967; 29 (04) 428-430 DOI: 10.1111/j.2164-0947.1967.tb02273.x.
• 13 NHS. Gender dysphoria - NHS.UK. Overv. Published online 2016. https://www.nhs.uk/conditions/gender-dysphoria/
• 14 Arlington VAPA. Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association; 5th editio. 2013
• 15 Trujillo MA, Perrin PB, Sutter M, Tabaac A, Benotsch EG. The buffering role of social support on the associations among discrimination, mental health, and suicidality in a transgender sample. Int J Transgenderism 2017; 18 (01) 39-52 DOI: 10.1080/15532739.2016.1247405.
• 16 The World Professional Association for Transgender Health. Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People. J LGBT Health Res DOI: 10.1080/15574090802092879.
• 17 Dhejne C, Van Vlerken R, Heylens G, Arcelus J. Mental health and gender dysphoria: A review of the literature. Int Rev Psychiatry 2016; 28 (01) 44-57 DOI: 10.3109/09540261.2015.1115753.
• 18 Perez-Brumer A, Hatzenbuehler ML, Oldenburg CE, Bockting W. Individual- and Structural-Level Risk Factors for Suicide Attempts Among Transgender Adults. Behav Med 2015; 41 (03) 164-171 DOI: 10.1016/j.physbeh.2017.03.040.
• 19 Coelho JS, Suen J, Clark BA, Marshall SK, Geller J, Lam PY. Eating Disorder Diagnoses and Symptom Presentation in Transgender Youth: a Scoping Review. Curr Psychiatry Rep 2019; 21 (11) 107 DOI: 10.1007/s11920-019-1097-x.
• 20 Reisner SL, Katz-Wise SL, Gordon AR, Corliss HL, Austin SB. Social epidemiology of depression and anxiety by gender identity. J Adolesc Health 2016; 59 (02) 203-208 DOI: 10.1016/j.jadohealth.2016.04.006.Social.
• 21 Steele LS, Daley A, Curling D. et al. LGBT identity, untreated depression, and unmet need for mental health services by sexual minority women and trans-identified people. J Womens Health (Larchmt) 2017; 26 (02) 116-127 DOI: 10.1089/jwh.2015.5677.
• 22 Feder S, Isserlin L, Seale E, Hammond N, Norris ML. Exploring the association between eating disorders and gender dysphoria in youth. Eat Disord 2017; 25 (04) 310-317 DOI: 10.1080/10640266.2017.1297112.
• 23 Rabito-Alcón MF, Rodríguez-Molina JM, Frenzi M, Alcón R. Satisfaction with life and psychological well-being in people with gender dysphoria. Actas Esp Psiquiatr 2016; 44 (02) 47-54 http://www.actaspsiquiatria.es/repositorio//18/100/ENG/18-100-ENG-47-54-885183.pdf
• 24 Connolly MD, Zervos MJ, Barone II CJ, Johnson CC, Joseph CLM. The Mental Health of Transgender Youth: Advances in Understanding. J Adolesc Health 2016; 59 (05) 489-495 DOI: 10.1016/j.jadohealth.2016.06.012.
• 25 Peterson CM, Matthews A, Copps-Smith E, Conard LA. Suicidality, Self-Harm, and Body Dissatisfaction in Transgender Adolescents and Emerging Adults with Gender Dysphoria. Suicide Life Threat Behav 2017; 47 (04) 475-482 DOI: 10.1111/sltb.12289.
• 26 Schechter LS. Ed. Gender Confirmation Surgery. Principles and Techniques for an Emerging Field. 2020
• 27 Raigosa M, Avvedimento S, Yoon TS, Cruz-Gimeno J, Rodriguez G, Fontdevila J. Male-to-Female Genital Reassignment Surgery: A Retrospective Review of Surgical Technique and Complications in 60 Patients. J Sex Med 2015; 12 (08) 1837-1845 DOI: 10.1111/jsm.12936.
• 28 Gooren LJ. Management of female-to-male transgender persons: medical and surgical management, life expectancy. Curr Opin Endocrinol Diabetes Obes 2014; 21 (03) 233-238 DOI: 10.1097/MED.0000000000000064.
• 29 Serindere G, Serindere M. Bibliometric analysis of 50 most cited articles on odontomas. Pesqui Bras Odontopediatria Clin Integr 2020; 20: 1-10 DOI: 10.1590/pboci.2020.025.