Evaluation and Follow-Up of Gender İdentity and Sexual Orientation Problems in Adolescents: Four Female Cases

Gender Identity Disorder (GID) is defi ned as a continuous and severe discomfort of an individual’s biological sex and gender identity role, a strong desire to be a member of the other gender and the presence of a strong identifi cation with the opposite gender. A mutual interaction between biological factors, cultural characteristics and values occur during the construction of the sense of gender identity. The biological, psychological and social characteristics of adolescents with gender identity and sexual orientation problems should be evaluated on a multifaceted and multidisciplinary level. The treatment of psychological problems comorbid with gender identity disorders, maintaining school attendance in formal education system, the integrity of family and their supportive attitudes towards their children are signifi cant for the follow up process and preventive psychological health. In this paper, detailed psychological evaluation and follow-up processes of four female adolescents aged between 14 and 17 who were applied to Adolescent Unit of Child and Adolescent Psychiatry Department in Ege University, School of Medicine due to gender identity and sexual orientation problems were discussed in the light of relevant data from literature. While gender identity problems of two adolescents were regarded as a feature of developmental period, other two were observed to have intense and persistent feelings and distress about their gender identity role. A thorough assessment of various etiological and prognostic factors that should be carried out individually for every case is mandatory during differential diagnosis and follow up process. This paper might provide some contributions to multi-dimensional evaluation, therapeutic approach and prognostic factors during the follow-up process.