1. PSYCHOLOGICAL, MEDICAL AND SURGICAL MANAGEMENT IN GENDER IDENTITY DISORDERS: A PICTURE OF EUROPEAN CENTERS Mariateresa MOLO*, Chiara CRESPI*, Valentina MINECCIA* * Fondazione Carlo Molo Onlus, Turin – Italy* Gender Team C.I.D.I.Ge.M., Turin – Italy AIM IN THE OCCASION OF THE FIRST EUROPEAN MEETING ON TRANSSEXUALISM HELD IN TURIN ON MAY 2012, A QUESTIONNAIRE WAS SENT TO SOME EUROPEAN CENTERS DEALING WITH TRANS PEOPLE. THE AIM OF THIS QUESTIONNAIRE WAS TO GET A PICTURE OF THE EUROPEAN SITUATION ABOUT CARE AND TREATMENTS OFFERED TO TRANSSEXUAL, TRANSGENDER AND GENDER NON CONFORMING PEOPLE (WPATH 7TH VERSION OF STANDARDS OF CARE, SEPTEMBER 2011). CONCLUSIONS ALL CENTERS SHARE THE GENERAL INTERNATIONAL STANDARDS OF CARE, EVEN IF THERE ARE SPECIFIC DIFFERENCES IN EACH COUNTRY RELATED TO CULTURAL ASPECTS IT IS IMPORTANT UNDERLINE THAT ALL THESE EUROPEAN GENDER TEAMS DO NOT ACCEPT THE SELF DIAGNOSIS PRINCIPLE BUT THEY HIGHLIGHT THE NEED OF PSYCHOLOGICAL OR PSYCHIATRIC EVALUATION BEFORE BOTH THE HORMONAL TREATMENT AND THE SURGERY MOST OF EUROPEAN GENDER TEAMS ARE PUBLIC IN ITALY THE PSYCHOTERAPY DURING R.L.E. IS STILL A MATTER OF DEBATE AMONG DIFFERENT CENTERS  SELF DIAGNOSIS No center accepts self diagnosis except T1 DIAGNOSIS QUESTIONNAIRE THE QUESTIONNAIRE USED IS COMPOSED OF 36 ITEMS TO INVESTIGATE CRITERIA OF TAKING IN CHARGE, DIAGNOSIS, REAL LIFE EXPERIENCE, MEDICAL AND SURGICAL TREATMENTS, NUMBER AND QUALIFICATION OF PROFESSIONALS. COUNTRYYEARS of ACTIVITYN of PATIENTS FOLLOWED STRUCTUREPROFESSIONALS SWEDEN13450General Hospital14 HOLLAND38375General Hospital14 SPAIN12730General Hospital7 SWITZERLAND450Private Practice20 UNITED KINGDOM15160General Hospital11 ITALY (MEAN of 5 CENTRES O.N.I.G. )10227General Hospital9 T3 REAL LIFE EXPERIENCE  IN EVERY CENTER THE LENGTH IS ALMOST 12 MONTHS  PSYCHOTERAPY BEFORE S.R.S. IS RACCOMANDED BY EVERY CENTER EXCEPT  KIND OF PSYCHOTERAPY: INDIVIDUAL OR GROUP  PSYCHOLOGICAL OR PSYCHIATRIC EVALUATION, BEFORE S.R.S., IS MANDATORY FOR ALL CENTERS T1 T2 T3 T4 T5 DIAGNOSIS HORMONAL TREATMENT RELA LIFE EXPERIENCE Sex Reassignment Surgery FOLLOW UP  World Profesisonal Association for Transgender Health ( WPATH) Standards of Care followed by: YES NO YES, but only some criteria  ITALY follows National Standards of Care by O.N.I.G.(Gender Identity National Observatory) T2 HORMONAL TREATMENT PSYCHOLOGICAL EVALUATION FOR HORMONAL TREATMENT IS MANDATORY FOR ALL THE EUROPEAN CENTERS  DIAGNOSTIC TOOLS CLINICAL INTERVIEW TESTS PENILE PROSTHESIS IS FREE OF CHARGE EXCEPT FOR T4 SURGERY  HORMONAL TREATMENT IS FREE OF CHARGE IN EUROPEAN CENTERS WITH SOME DIFFERENCES IN ITALIAN GENDER TEAMS  S.R.S. IS UNDER N.H.S. FOR EACH COUNTRY FtM MtF MOST OF CENTERS OFFER FREE OF CHARGE MAMMOPLASTY UNDER SPECIFIC CONDITIONS (IN ITALY IT IS FREE OF CHARGE IN SOME CENTRES) LASER IS FREE OF CHARGE ONLY IN NO CENTERS OFFER FREE OF CHARGE VOCAL CORD SURGERY EXCEPT AND, IN SOME CASES, DSMIV-TR ICD 10 T5 FOLLOW UP After S.R.S. follow up is done by not by TRANSFORMATION PROGRAMME SERVICES DIRECTED TO CHILDREN AND ADOLESCENTS WITH ATYPICAL GENDER IDENTITY ORGANIZATION (A.G.I.O.)