{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:35:57Z","timestamp":1782477357616,"version":"3.54.5"},"reference-count":23,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T00:00:00Z","timestamp":1642723200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns4:p>Trans\u00a0women (TW)\u00a0have\u00a0a\u00a0high prevalence of poor mental health. Gender-affirming treatments\u00a0could reduce distress regarding their gender incongruity. However, psychiatric comorbidities might\u00a0complicate\u00a0the\u00a0management\u00a0or even\u00a0confirmation\u00a0of\u00a0being\u00a0transgender.\u00a0We reported three TW with complex\u00a0mental illnesses,\u00a0including anxiety disorder with cultural explanation, neurodevelopmental disorders with\u00a0cross-dressing, and severe personality disorder accompanied by major depression.\u00a0All cases received both psychiatric and gender-affirming treatments,\u00a0which demonstrated promising outcomes.\u00a0Along with gender dysphoria\u00a0(GD), psychiatric comorbidities also altered\u00a0these\u00a0TW\u2019s identity and manifestations.\u00a0Recognition\u00a0of such conditions\u00a0would be beneficial in providing care for all TW, both with and without\u00a0GD.<\/ns4:p>","DOI":"10.12688\/f1000research.75144.1","type":"journal-article","created":{"date-parts":[[2022,1,21]],"date-time":"2022-01-21T09:30:28Z","timestamp":1642757428000},"page":"74","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Complex\u00a0psychiatric\u00a0comorbidities\u00a0in Thai\u00a0trans\u00a0women: A\u00a0case\u00a0series"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6306-0930","authenticated-orcid":false,"given":"Sorawit","family":"Wainipitapong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soravit","family":"Burakitpachai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3311-8040","authenticated-orcid":false,"given":"Thanapob","family":"Bumphenkiatikul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2022,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"127-144","DOI":"10.1111\/1468-5914.00210","article-title":"Guilt and Shame in Chinese Culture: A Cross-Cultural Framework from the Perspective of Morality and Identity.","volume":"33","author":"O Bedford","year":"2003","journal-title":"J. Theory Soc. Behav."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"211-231","DOI":"10.1300\/J082v40n03_11","article-title":"Asian values, family values: Film, video, and lesbian and gay identities.","volume":"40","author":"C Berry","year":"2001","journal-title":"J. Homosex."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"384-401","DOI":"10.1080\/15299732.2013.863262","article-title":"The impact of self-reported childhood trauma on emotion regulation in borderline personality disorder and major depression.","volume":"15","author":"S Carvalho Fernando","year":"2014","journal-title":"Journal of Trauma & Dissociation: The Official Journal of the International Society for the Study of Dissociation (ISSD)."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2533-2550","DOI":"10.1080\/00918369.2020.1809892","article-title":"\u201cBeing Born like This, I Have No Right to Make Anybody Listen to Me\u201d: Understanding Different Forms of Stigma among Thai Transgender Women Living with HIV in Thailand.","volume":"68","author":"J Lind van Wijngaarden","year":"2020","journal-title":"J. Homosex."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"216-231","DOI":"10.1002\/pmh.1330","article-title":"Sexuality-related issues in borderline personality disorder: A comprehensive review.","volume":"10","author":"A Fr\u00edas","year":"2016","journal-title":"Personal. Ment. Health."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"379-388","DOI":"10.1080\/15532739.2018.1500966","article-title":"Family support and discrimination and their relationship to psychological distress and resilience amongst transgender people.","volume":"19","author":"K Fuller","year":"2018","journal-title":"Int. J. Transgenderism"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3-14","DOI":"10.1016\/j.sxmr.2015.10.003","article-title":"Gender Dysphoria and Autism Spectrum Disorder: A Systematic Review of the Literature.","volume":"4","author":"D Glidden","year":"2016","journal-title":"Sex. Med. Rev."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"317-325","DOI":"10.1097\/HRP.0000000000000234","article-title":"Distinguishing and Addressing Gender Minority Stress and Borderline Personality Symptoms.","volume":"27","author":"H Goldhammer","year":"2019","journal-title":"Harv. Rev. Psychiatry."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2217-2223","DOI":"10.1007\/s10803-018-3480-6","article-title":"The Co-occurrence of Gender Dysphoria and Autism Spectrum Disorder in Adults: An Analysis of Cross-Sectional and Clinical Chart Data.","volume":"48","author":"G Heylens","year":"2018","journal-title":"J. Autism Dev. Disord."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"52-64","DOI":"10.1177\/1074840719895264","article-title":"Shame, Suffering, and Believing in the Family: The Experiences of Grandmothers of a Grandchild With a Developmental Delay or Disability in the Context of Chinese Culture.","volume":"26","author":"Y Huang","year":"2020","journal-title":"J. Fam. Nurs."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1-10","DOI":"10.1155\/2018\/8684625","article-title":"Quality of Life in Transitioned Trans Persons: A Retrospective Cross-Sectional Cohort Study.","volume":"2018","author":"L Jellestad","year":"2018","journal-title":"Biomed. Res. Int."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"575-582","DOI":"10.1016\/j.psc.2018.07.001","article-title":"Differential Diagnosis of Borderline Personality Disorder.","volume":"41","author":"J Paris","year":"2018","journal-title":"Psychiatr. Clin. North Am."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"723-733","DOI":"10.1016\/j.mcna.2019.02.005","article-title":"Mental Health in Sexual Minority and Transgender Women.","volume":"103","author":"J Schulman","year":"2019","journal-title":"Med. Clin. North Am."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1871-1875","DOI":"10.1007\/s10508-016-0750-2","article-title":"Gender Dysphoria in a 62-Year-Old Genetic Female With Congenital Adrenal Hyperplasia.","volume":"45","author":"M Silveira","year":"2016","journal-title":"Arch. Sex. Behav."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"65-67","DOI":"10.1176\/appi.ps.201800232","article-title":"Affirming Gender Identity of Patients With Serious Mental Illness.","volume":"70","author":"W Smith","year":"2019","journal-title":"Psychiatric Services (Washington, D.C.)."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"288-297","DOI":"10.1016\/j.yhbeh.2013.02.020","article-title":"Gender identity development in adolescence.","volume":"64","author":"T Steensma","year":"2013","journal-title":"Horm. Behav."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"105-115","DOI":"10.1080\/15374416.2016.1228462","article-title":"Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents.","volume":"47","author":"J Strang","year":"2018","journal-title":"Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"360-367","DOI":"10.1016\/j.jpsychires.2021.03.005","article-title":"Mental health difficulties among trans and gender diverse young people with an autism spectrum disorder (ASD): Findings from Trans Pathways.","volume":"137","author":"P Strauss","year":"2021","journal-title":"J. Psychiatr. Res."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"220-233","DOI":"10.1080\/26895269.2020.1750529","article-title":"Experiences with stigmatization among transgender individuals after transition: A qualitative study in the Netherlands.","volume":"21","author":"M Verbeek","year":"2020","journal-title":"Int. J. Transgender Health."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1758-1787","DOI":"10.1080\/00918369.2017.1386025","article-title":"Attitudes Toward Homosexuality in China: Exploring the Effects of Religion, Modernizing Factors, and Traditional Culture.","volume":"65","author":"Y Xie","year":"2018","journal-title":"J. Homosex."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"e201236","DOI":"10.1001\/jamanetworkopen.2020.1236","article-title":"Age at First Experience of Gender Dysphoria Among Transgender Adults Seeking Gender-Affirming Surgery.","volume":"3","author":"M Zaliznyak","year":"2020","journal-title":"JAMA Netw. Open."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"86-93","DOI":"10.1016\/j.esxm.2018.11.005","article-title":"Age-Related Differences for Male-to-Female Transgender Patients Undergoing Gender-Affirming Surgery.","volume":"7","author":"D Zavlin","year":"2019","journal-title":"Sex. Med."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"217-247","DOI":"10.1146\/annurev-clinpsy-021815-093034","article-title":"Gender Dysphoria in Adults.","volume":"12","author":"K Zucker","year":"2016","journal-title":"Annu. Rev. Clin. Psychol."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/11-74\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-74\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-74\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T11:35:12Z","timestamp":1674646512000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/11-74\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,21]]},"references-count":23,"URL":"https:\/\/doi.org\/10.12688\/f1000research.75144.1","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.78971.r123259","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.78971.r160175","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.78971.r160175","asserted-by":"object"},{"id-type":"doi","id":"10.5256\/f1000research.78971.r123259","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,21]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/11-74\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.78971.r123259, Awirut Oon-Arom, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, 28 Mar 2022, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/11-74\/v1#referee-response-123259","order":0,"name":"referee-response-123259","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.78971.r160175, Gonzalo R Quintana, Quintana Zunino, Departamento de Psicolog\u00eda y Filosof\u00eda, Facultad de Ciencias Sociales y Jur\u00eddicas, Universidad de Tarapac\u00e1, Arica, Chile, 25 Jan 2023, version 1, indexed","URL":"https:\/\/f1000research.com\/articles\/11-74\/v1#referee-response-160175","order":1,"name":"referee-response-160175","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}