Accuracy of psychometric tools in the assessment of personality in adolescents and adults requesting gender-affirming treatments: A systematic review

Abstract

Background: The assessment and screening for personality disorders in individuals requesting gender affirming treatments may be an important aspect of predicting medical and surgical outcomes for this population, but there is no consensus on how best to do so.

Aims: To review the diagnostic accuracy of psychometric tools used for the assessment of personality disorders in those requesting gender affirming treatments.

Method: A systematic review: Prospero CRD42017078783 [1].

Results: Many studies have focussed on the assessment of personality disorders in this population, but since 1979, only two have used an index and reference test.

Conclusion: There are no agreed reference standards for this population and psychometric tools continue to be scored on reference data from the cisgender (not transgender) population. We need robust evidence on this issue, as individuals may be denied access to gender affirming treatments based on psychometric tools without established reliability in this population.

Keywords: Gender; Personality disorders; Psychometry and assessments in psychiatry; Sexual disorders; Social and cross cultural psychiatry.