Children and adolescents referred to an Italian network of specialised gender clinics: gender presentation and psychological features

Background A network of the Italian gender teams dealing with gender dysphoria in childhood and adolescence was established in 2012, within ONIG (Osservatorio Nazionale sull’Identità di Genere). In 2017 we presented the first data collected through a shared protocol of assessment and care: our results outlined a progressive increase in number of referrals, and the necessity of continuing in such systematic data collection. In addition, those results showed a difference between children with a cross-gender identification and children with a more fluid gender presentation, with the latters reporting higher rates of psychological suffering compared to the firsts. We will thus present the updated results of this multicentric study from to the Italian Network of Gender Clinics for Children and Adolescents, which involved the centers of Torino, Firenze, Torre Del Lago, Roma, Bologna, Napoli, Bari and Trieste. More specifically, we will outline: (1) the gender presentation and psychological features of these young people, and (2) the differences between cross-gender and non-cross gender identified referred children and adolescents in relation to psychological difficulties. Methods The shared assessment protocol includes a socio-demographic data sheet and a psychological case history form, filled out by the professionals working in each participating gender clinic, for children, adolescents and families of children consecutively referred to the centers. In addition to the demographic and social data, we analysed information about: preference for toys and activities in childhood, presence of gender-dysphoric feelings, age of onset and of coming out; feelings about pubertal development; education; perceived quality of family relations and of peer relations; bullying experiences; associated psychological difficulties; romantic experiences. Participants were divided in two subgroups: Cross-Gender Identified (CGI) and Non-Cross Gender Identified (non-CGI) children and adolescents. Such distinction has previously been proposed by Kuvalanka, Weiner, Munroe, Goldberg, and Gardner (2017). Demographic characteristics of the group of participants, differences and association between variables were tested through descriptive and multivariate statistics through the software SPSS.25. Results and Conclusions Up until now (data collection is ongoing) we collected data on a total sample of 285 children and adolescents aged 3 to 17. The mean age of the group is 14.37 (SD= 3.21), although 83.7% of the group is aged 13-17; participants’ assigned gender at birth was female for 52.3% of the group; 69.4% were assigned to the CGI group and 30.6% to the non-CGI group. The progressive increase of referrals across years we outlined in Belgrade, 2017 is confirmed, considering that, in two years, numbers have more than doubled. As regards differences between children and adolescents assigned to the CGI and non-CGI groups, our preliminary results show that, while rates of psychological suffering are higher in the non-CGI group, bullying experiences present a similar distribution in the two groups. Our result indicate the importance of (1) studying the factors underlying the higher rate of psychological suffering among children and adolescents assigned to the non-CGI group, (2) outlining the role of protective factors for psychological wellbeing including peer relations, family acceptance, and (3) of implementing a non-binary informed model of care.