A review of instruments of experimental psychological diagnostics of gender dysphoria and gender incongruence in the context of transition to ICD-11

Abstract

In 2024, Russia will change over to the 11th version of the International Classification of Diseases (ICD-11) where the diagnosis transsexualism will be replaced by gender incongruence. At present, clinical practice guidelines rooted in evidence-based medicine are being developed. This means that validated instruments of experimental psychological diagnostics should be used. In the present review, we identify ten instruments used in international practice. After discussing their strengths and weaknesses we can recommend four instruments for diagnosing gender dysphoria and gender incongruence: Transgender Congruence Scale, Trans Collaborations Clinical Check-In (TC3), Gender Congruence and Life Satisfaction Scale, and Utrecht Gender Dysphoria Scale Gender Spectrum (UDGS-GS). Six instruments are recommended for prescribing psychotherapy aimed to help the patients accept their gender identity and build resilience: Transgender Congruence Scale, Gender Identity Reflection and Rumination Scale, Gender Preoccupation and Stability Questionnaire, Trans Collaborations Clinical Check-In (TC3), Gender Congruence and Life Satisfaction Scale, and Transgender Identity Survey. At the same time, we do not recommend two widely used instruments Utrecht Gender Dysphoria Scale (classical version) and Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults due to their inapplicability to gender non-binary individuals and those in the process of gender transition. In the article we also discuss issues related to differential diagnostics in the context of ICD-11, as well as peculiarities of using diagnostic scales with gender non-binary individuals, intersex people and detransitioners.