{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:29:01Z","timestamp":1787023741277,"version":"build-2736575974"},"reference-count":67,"publisher":"Springer Publishing Company","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cogn Psychother"],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:p>Gender minorities experience unique minority stressors that increase risk for psychiatric disorders. Notably, gender minorities are four and six times more likely than their cisgender female and male peers, respectively, to be treated for or diagnosed with obsessive-compulsive disorder (OCD). Despite higher rates of OCD, more psychiatric comorbidities, and minority stressors, little is known about the clinical presentation and treatment outcomes of gender minorities with OCD. Using a sample of 974 patients in specialty treatment programs for OCD, the current study found that gender minorities reported more severe contamination symptoms and greater incidence of comorbid substance use\/addiction, trauma\/stressor-related, personality, and other\/miscellaneous disorders compared to cisgender male and female patients. Despite significantly longer lengths of stay, gender minorities reported less symptom improvement across treatment compared to cisgender male and female patients. Findings underscore the need for continued research to improve the effectiveness and individualization of treatment for gender minorities with OCD.<\/jats:p>","DOI":"10.1891\/jcpsy-d-20-00022","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T10:55:22Z","timestamp":1643972122000},"page":"42-59","source":"Crossref","is-referenced-by-count":26,"title":["Clinical Presentation and Treatment Trajectory of Gender Minority Patients With Obsessive-Compulsive Disorder"],"prefix":"10.1891","volume":"36","author":[{"given":"Caitlin M.","family":"Pinciotti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Nu\u00f1ez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley C.","family":"Riemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda E.","family":"Bailey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"793","published-online":{"date-parts":[[2022,2,4]]},"reference":[{"issue":"7","key":"2022022308000566000_36.1.42.1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1177\/070674370605100702","article-title":"The psychological treatment of obsessive\u2014compulsive disorder","volume":"51","year":"2006","journal-title":"The Canadian Journal of Psychiatry"},{"key":"2022022308000566000_36.1.42.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2005.09.011"},{"issue":"1","key":"2022022308000566000_36.1.42.3","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1016\/j.janxdis.2006.05.003","article-title":"The cognitive mediation of obsessive-compulsive symptoms: A longitudinal study","volume":"21","year":"2007","journal-title":"Journal of Anxiety Disorders"},{"key":"2022022308000566000_36.1.42.4","doi-asserted-by":"publisher","DOI":"10.1037\/a0018260"},{"key":"2022022308000566000_36.1.42.5","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) https:\/\/doi.org\/10.1176\/appi.books.9780890425596.","DOI":"10.1176\/appi.books.9780890425596"},{"issue":"5","key":"2022022308000566000_36.1.42.6","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.3390\/ijerph17051521","article-title":"Personality disorders and personality profiles in a sample of transgender individuals requesting gender-affirming treatments","volume":"17","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"2022022308000566000_36.1.42.7","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301241"},{"issue":"1","key":"2022022308000566000_36.1.42.8","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1080\/15532739.2016.1258352","article-title":"Transgender and anxiety: A comparative study between transgender people and the general population","volume":"18","year":"2017","journal-title":"International Journal of Transgenderism"},{"key":"2022022308000566000_36.1.42.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(01)00092-4"},{"issue":"6","key":"2022022308000566000_36.1.42.10","doi-asserted-by":"crossref","first-page":"346","DOI":"10.3928\/00485713-20160419-02","article-title":"Mental health and the transgender population","volume":"46","year":"2016","journal-title":"Psychiatric Annals"},{"key":"2022022308000566000_36.1.42.11","doi-asserted-by":"publisher","DOI":"10.5465\/amr.2011.0419"},{"key":"2022022308000566000_36.1.42.12","doi-asserted-by":"publisher","DOI":"10.1300\/J082v51n03_04"},{"key":"2022022308000566000_36.1.42.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.2011.02426.x"},{"key":"2022022308000566000_36.1.42.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2017.06.002"},{"key":"2022022308000566000_36.1.42.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(03)00108-6"},{"key":"2022022308000566000_36.1.42.16","unstructured":"Flores, A. R. , Brown, T. N. , & Herman, J. (2016). Race and ethnicity of adults who identify as transgender in the United States . Williams Institute, UCLA School of Law."},{"key":"2022022308000566000_36.1.42.17","unstructured":"Flores, A. R. , Herman, J. L. , Gates, G. J. , & Brown, T. N. T. (2016). How many adults identify as transgender in the United States? Williams Institute."},{"key":"2022022308000566000_36.1.42.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2006.10.004"},{"key":"2022022308000566000_36.1.42.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(02)00178-X"},{"issue":"3","key":"2022022308000566000_36.1.42.20","first-page":"201","article-title":"High rates of OCD symptom misidentification by mental health professionals","volume":"25","year":"2013","journal-title":"Annals of Clinical Psychiatry"},{"issue":"190","key":"2022022308000566000_36.1.42.21","first-page":"2167","article-title":"Non-contamination and non-symmetry OCD obsessions are commonly not recognized by clinical, counseling and school psychology doctoral students","volume":"4","year":"2015","journal-title":"Journal of Depression and Anxiety"},{"key":"2022022308000566000_36.1.42.22","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-016-1208-5"},{"key":"2022022308000566000_36.1.42.23","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v69n0404"},{"issue":"5","key":"2022022308000566000_36.1.42.24","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1111\/j.1521-0391.2011.00155.x","article-title":"Personality disorders in gay, lesbian, bisexual, and transgender chemically dependent patients","volume":"20","year":"2011","journal-title":"The American Journal on Addictions"},{"key":"2022022308000566000_36.1.42.25","doi-asserted-by":"publisher","DOI":"10.1177\/0022146512444289"},{"key":"2022022308000566000_36.1.42.26","doi-asserted-by":"publisher","DOI":"10.1037\/a0029597"},{"key":"2022022308000566000_36.1.42.27","unstructured":"Herman, J. (2016). LGB within the T: Sexual orientation in the National Transgender Discrimination Survey and implications for public policy. In Y. Martinez-San Miguel & S. Tobias (Eds.), Trans studies: The challenge to hetero\/homo normativities (pp. 141\u2013153). Rutgers University Press."},{"key":"2022022308000566000_36.1.42.28","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.112.121954"},{"key":"2022022308000566000_36.1.42.29","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jocrd.2017.08.005","article-title":"Mental contamination obsessions: An examination across the obsessive-compulsive symptom dimensions","volume":"17","year":"2018","journal-title":"Journal of Obsessive-Compulsive and Related Disorders"},{"key":"2022022308000566000_36.1.42.30","unstructured":"James, S. E. , Herman, J. L. , Rankin, S. , Keisling, M. , Mottet, L. , & Anafi, M. (2016). The report of the 2015 U.S. Transgender Survey . National Center for Transgender Equality."},{"key":"2022022308000566000_36.1.42.31","doi-asserted-by":"publisher","DOI":"10.1207\/s15327957pspr0204_3"},{"key":"2022022308000566000_36.1.42.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0191-3085(01)23002-0"},{"issue":"1","key":"2022022308000566000_36.1.42.33","first-page":"25","article-title":"Path analysis","volume":"3","year":"2005","journal-title":"Encyclopedia of Social Measurement"},{"issue":"1","key":"2022022308000566000_36.1.42.34","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s13011-015-0015-4","article-title":"A qualitative study of transgender individuals\u2019 experiences in residential addiction treatment settings: Stigma and inclusivity","volume":"10","year":"2015","journal-title":"Substance Abuse Treatment, Prevention, and Policy"},{"key":"2022022308000566000_36.1.42.35","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.65.2.339"},{"key":"2022022308000566000_36.1.42.36","unstructured":"McNeil, J. , Bailey, L. , Ellis, S. , Morton, J. , & Regan, M. (2012). Trans mental health and emotional wellbeing study . Scottish Transgender Alliance."},{"key":"2022022308000566000_36.1.42.37","doi-asserted-by":"crossref","unstructured":"Meade, A. W. (2005, April). Sample size and tests of measurement invariance . Annual Conference of the Society for Industrial and Organizational Psychology.","DOI":"10.1037\/e518612013-693"},{"key":"2022022308000566000_36.1.42.38","doi-asserted-by":"crossref","unstructured":"Meyer, I. H. , & Frost, D. M. (2013). Minority stress and the health of sexual minorities. In C. J. Patterson & A. R. D\u2019Augelli (Eds.), Handbook of psychology and sexual orientation (pp. 252\u2013266). Oxford University Press.","DOI":"10.1093\/acprof:oso\/9780199765218.003.0018"},{"issue":"3","key":"2022022308000566000_36.1.42.39","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1037\/sgd0000132","article-title":"Resilience in the study of minority stress and health of sexual and gender minorities.","volume":"2","year":"2015","journal-title":"Psychology of Sexual Orientation and Gender Diversity"},{"key":"2022022308000566000_36.1.42.40","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1037\/sgd0000132","DOI":"10.1037\/sgd0000132"},{"key":"2022022308000566000_36.1.42.41","doi-asserted-by":"publisher","DOI":"10.1007\/s11135-007-9143-x"},{"issue":"1","key":"2022022308000566000_36.1.42.42","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/15532739.2016.1258353","article-title":"Prevalence of anxiety symptoms and disorders in the transgender population: A systematic review of the literature","volume":"18","year":"2017","journal-title":"International Journal of Transgenderism"},{"issue":"1","key":"2022022308000566000_36.1.42.43","doi-asserted-by":"crossref","first-page":"20","DOI":"10.3390\/socsci6010020","article-title":"Beyond depression and suicide: The mental health of transgender college students","volume":"6","year":"2017","journal-title":"Social Sciences"},{"key":"2022022308000566000_36.1.42.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2007.07.001"},{"key":"2022022308000566000_36.1.42.45","doi-asserted-by":"crossref","unstructured":"Pinciotti, C. M. , & Orcutt, H. K. (2020). Obsessive-compulsive symptoms in sexual minorities. Psychology of Sexual Orientation and Gender Diversity. Advance online publication. https:\/\/doi.org\/10.1037\/sgd0000437","DOI":"10.1037\/sgd0000437"},{"issue":"1","key":"2022022308000566000_36.1.42.46","first-page":"1142","article-title":"Differences in intolerance of uncertainty in OCD and comorbid PTSD underlying attenuated treatment response","volume":"8","year":"2020","journal-title":"Annals of Psychiatry and Mental Health"},{"key":"2022022308000566000_36.1.42.47","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v67n0503"},{"key":"2022022308000566000_36.1.42.48","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2003.10.009"},{"key":"2022022308000566000_36.1.42.49","doi-asserted-by":"crossref","unstructured":"Rachman, S. J. (2006). The fear of contamination: Assessment and treatment . Oxford University Press.","DOI":"10.1093\/med:psych\/9780199296934.001.0001"},{"key":"2022022308000566000_36.1.42.50","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.jadohealth.2016.04.006","article-title":"Social epidemiology of depression and anxiety by gender identity","volume":"59","year":"2016","journal-title":"Journal of Adolescent Health"},{"key":"2022022308000566000_36.1.42.51","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2014.10.264"},{"issue":"4","key":"2022022308000566000_36.1.42.52","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1037\/h0101733","article-title":"OCD subtypes: Which, if any, are valid?","volume":"22","year":"2015","journal-title":"Clinical Psychology Science and Practice"},{"key":"2022022308000566000_36.1.42.53","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.drugalcdep.2014.11.023","article-title":"Prevalence and correlates of substance use among trans* female youth ages 16\u201324 years in the San Francisco Bay Area","volume":"147","year":"2015","journal-title":"Drug and Alcohol Dependence"},{"key":"2022022308000566000_36.1.42.54","doi-asserted-by":"publisher","DOI":"10.1108\/S1474-7979(2011)0000022012"},{"key":"2022022308000566000_36.1.42.55","doi-asserted-by":"publisher","DOI":"10.1177\/1534765610395614"},{"key":"2022022308000566000_36.1.42.56","doi-asserted-by":"crossref","unstructured":"Sookman, D. , & Pinard, G. (2002). Overestimation of threat and intolerance of uncertainty in obsessive compulsive disorder. In Cognitive approaches to obsessions and compulsions , (pp. 63\u201389). Pergamon. https:\/\/doi.org\/10.1016\/B978-008043410-0\/50006-4","DOI":"10.1016\/B978-008043410-0\/50006-4"},{"key":"2022022308000566000_36.1.42.57","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(96)00036-8"},{"key":"2022022308000566000_36.1.42.58","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2003.00200.x"},{"key":"2022022308000566000_36.1.42.59","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jvb.2017.07.009","article-title":"What lies beneath: How paranoid cognition explains the relations between transgender employees\u2019 perceptions of discrimination at work and their job attitudes and wellbeing","volume":"103","year":"2017","journal-title":"Journal of Vocational Behavior"},{"key":"2022022308000566000_36.1.42.60","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-6185(02)00182-2"},{"key":"2022022308000566000_36.1.42.61","unstructured":"von Ende, C. N. (2001). Repeated-measures analysis. In S. M., Scheiner. & J., Gurevitch (Eds.), Design and analysis of ecological experiments , (pp. 134\u2013157). Oxford University Press: New York, NY."},{"key":"2022022308000566000_36.1.42.62","doi-asserted-by":"publisher","DOI":"10.1037\/0022-0167.55.3.419"},{"issue":"Suppl. A","key":"2022022308000566000_36.1.42.63","first-page":"12","article-title":"The effects of depression on the treatment of OCD in a residential sample","volume":"84","year":"2020","journal-title":"Bulletin of the Menninger Clinic"},{"key":"2022022308000566000_36.1.42.64","first-page":"352","article-title":"High rates of psychiatric diagnoses are found in young transgender women","volume":"2016","year":"2016","journal-title":"BMJ"},{"key":"2022022308000566000_36.1.42.65","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbtep.2011.09.003"},{"issue":"12","key":"2022022308000566000_36.1.42.66","doi-asserted-by":"crossref","first-page":"3041","DOI":"10.1016\/j.brat.2007.08.013","article-title":"Identification and explanation of racial differences on contamination measures","volume":"45","year":"2007","journal-title":"Behaviour Research and Therapy"},{"key":"2022022308000566000_36.1.42.67","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.jocrd.2016.04.008","article-title":"Examination of racial differences in assessment of OCD symptoms and obsessive beliefs","volume":"10","year":"2016","journal-title":"Journal of Obsessive-Compulsive and Related Disorders"}],"container-title":["Journal of Cognitive Psychotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1891\/JCPSY-D-20-00022","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T11:02:13Z","timestamp":1645614133000},"score":1,"resource":{"primary":{"URL":"http:\/\/connect.springerpub.com\/lookup\/doi\/10.1891\/JCPSY-D-20-00022"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,1]]},"references-count":67,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,2,4]]},"published-print":{"date-parts":[[2022,2,1]]}},"alternative-id":["10.1891\/JCPSY-D-20-00022"],"URL":"https:\/\/doi.org\/10.1891\/jcpsy-d-20-00022","relation":{},"ISSN":["0889-8391","1938-887X"],"issn-type":[{"value":"0889-8391","type":"print"},{"value":"1938-887X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,1]]}}}