RIYADH — Gender dysphoria (GD), previously gender identity disorder, is a mental illness and not a hormonal or organic disorder, according to a competent Saudi scientific body. "Gender dysphoria is a psychological illness, and those affected by it do not have any hormonal, organic, or genetic defect, knowing that they have the complete external and internal organs of masculinity and femininity on the basis of the gender with which they were born," the Committee for Professional and Ethical Practices in Mental Health, affiliated with the National Center for Mental Health Promotion, said in a statement issued on Wednesday. Gender dysphoria is the distress a person experiences due to a mismatch between their gender identity — their personal sense of their own gender and their sex assigned at birth. The causes of gender incongruence are unknown but a gender identity likely reflects genetic, biological, environmental, and cultural factors. The committee noted that the gender is determined by examining chromosomes, with the male having 46 XY chromosomes and the female having 46 XX chromosomes and is not determined by abstract self-desire. "Those who suffer from GD do not accept the gender identity with which they were born, and they have a strong desire to make external and internal physical changes to conform to the form of the psychologically desired gender. It was found in follow-up of such cases that there is a percentage of infected people who want to return to their primary sex and accept it after specialized medical assistance," the statement pointed out. The committee stressed that medical interventions through hormones and gender affirmation surgeries for these patients not only lack effectiveness, but also lead to serious psychological and medical complications in the short and long term, including the need for long-term hospitalization in psychiatric departments, high suicide rates, increased incidence of cancer, and the possibility of early death, in addition to many social challenges faced by those who undergo these procedures. "Based on the above factors, and in line with professional practices and medical ethics applied in Saudi Arabia, the Committee for Professional and Ethical Practices in Mental Health considered that since the disorder is basically a psychological one, the therapeutic intervention shall also be basically a psychological one. Therefore what is expected of the doctor is to diagnose the condition and explain its nature to the affected person, with making available of the options for psychological intervention, and providing available psychological treatments so as to alleviate their suffering and improve their adaptive skills, and explain this scenario to their families as well," the statement said. The committee also considered that recommending gender affirmation surgeries, or prescribing different-sex hormones before or after surgeries, is deceitful for patients suffering from GD, and that no scientific support for it has been conclusively proven to improve the psychological satisfaction associated with the disorder. Therefore it is an unacceptable intervention, with negative consequences much more than its gains. The committee stressed the need for doctors to adhere to professional practice and medical ethics, by not recommending through medical reports or approving gender change for patients with gender dysphoria, but rather writing the report is sufficient to describe the patient's condition, diagnosis, and the necessary psychological recommendations. The committee stressed the need to take stringent measures and hold accountable those who mislead people suffering from the disorder, through false hormonal or surgical interventions, either for convictions that have not been scientifically proven or for personal motives and gains. It called on all health sectors in Saudi Arabia to establish specialized psychological treatment programs based on solid scientific research for such psychological disorders, and support its psychological services to do their part in dealing with cases of GD or other psychological disorders, which require the combined efforts of several specialties at the same time such as mental health, social service, religious guidance, and occupational therapy. The committee also underlined the need for an accredited national guide to deal with these cases, and the commitment to work on it by all practitioners and all relevant specialties. It also called on everyone to communicate with the committee via e-mail [email protected] in the event of any comments, suggestions or inquiries
