Legal Gender Recognition in Portugal: A Path to Self-Determination
This paper presents research on the enforcement and impact of the first legal gender recognition legislation in Portugal (Law no.7/2011). The study describes how the administrative process created by the law functioned during its initial 5-year period, and identifies challenges and processes of resistance to this legal innovation. Simultaneously, it seeks to assess the impact of the law on the social and psychological well-being of trans people, including in their access to vital spheres of social life such as education and employment. The research employs a mixed-methods approach and a multi-informant methodology: an online questionnaire was completed by 68 trans and non-binary people, and semi-structured in-depth interviews were carried out with various selected stakeholders: representatives of trans and LGBTIQ+ organisations (n=5), health professionals identified as experts in the topic and as gatekeepers in legal gender recognition processes (n=12), and trans people (n=6). Results show, on the one hand, the significant positive impact that legal gender recognition has on the psychological well-being and social welfare of the participants. On the other hand, results also show several challenges and forms of resistance to the implementation of the law, in particular those challenges resulting from the fact that legal gender recognition depended on a clinical diagnosis and the provision of a clinical report.
Anders, S., Caverly, N. and Johns, M. (2014). Newborn bio/logics and US legal requirements for changing gender/sex designations on state identity documents. Feminism and Psychology, 24(2), 172-192.
Arístegui, I., Radusky, P. D., Zalazar, V., Romero, M., Schwartz, J. and Sued, O. (2017). Impact of the Gender Identity Law in Argentinean transgender women. International Journal of Transgenderism, 18(4),
Bauer, G.R., Scheim, A. I, Pyne, J., Travers, R. and Hammond, R. (2015). Intervenable factors associated with suicide risk in transgender persons: A respondent driven sampling study in Ontario, Canada. BMC Public Health, 15, 525.
Bess, J. A. and Stabb, S. D. (2009). The experiences of transgendered persons in psychotherapy: Voices and recommendations. Journal of Mental Health Counseling, 31, 265–282.
Bockting, W., Robinson, B., Benner, A. and Scheltema, K. (2004). Patient satisfaction with transgender health services. Journal of Sex and Marital Therapy, 30, 277–294.
Boletín Oficial de la República Argentina. (2012). Ley de Identidade de Género. Año CXX, Nro 32.404. Available at: http://www1.hcdn.gov.ar/BO/boletin12/2012-05/BO24-05-2012leg.pdf
Bränström; R. and Pachankis, J.E. (2019). Reduction in mental health treatment utilization among Transgender individuals after gender-affirming surgeries: A total population study. American Journal of Psychiatry, 0, 0-0.
Braun, V. and Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.
Budge, S. L., Adelson, J. L. and Howard, K. A. (2013). Anxiety and depression in transgender individuals: The roles of transition status, loss, social support, and coping. Journal of Consulting and Clinical Psychology, 81(3), 545-57.
Carroll, L. and Gilroy, P. J. (2002). Transgender issues in counselor preparation. Counselor Education and Supervision, 41, 233–242.
Castro, P. (2012). Legal Innovation for Social Change : Exploring Change and Resistance to Different Types of Sustainability Laws, 33(1), 105–121.
Castro, P. and Batel, S. (2008). Social representation, change and resistance: On the difficulties of generalizing new norms. Culture and Psychology, 14, 477–499.
Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., … Adler, R. K. (2011). Standards of care for the health of transsexual, transgender, and gender nonconforming people, 7th version. International Journal of Transgenderism, 13, 165-232.
Creswell, J. W. (2009). Chapter Ten: Mixed Methods Procedures. In Research Design: Qualitative, Quantitative and Mixed Methods Approaches (pp. 203-224). California: SAGE Publications.
Dean, L., Meyer, I. H., Robinson, K., Sell, R. L., Sember, R., Silenzio, V. M. B., et al (2000). Lesbian, gay, bissexual and transgender health: Findings and concerns. Journal of the Gay and Lesbian Medical Association, 4, 102-151.
Diener, E., Emmons, R., Larsen, R. and Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 1105–1117.
European Commission (2012). Trans and intersex people: Discrimination on the grounds of sex, gender identity and gender expression. Luxembourg: European Commission. Available at: http://www.coe.int/t/dg4/lgbt/Source/trans_and_intersex_people_EC_EN.pdf
FRA – European Union Agency for Fundamental Rights (2014). Being Trans in the European Union: Comparative analysis of EU LGBT survey data. Luxembourg: European Union Agency for Fundamental Rights.
Gómez-Gil, E., Trilla, A., Salamero, M., Godás, T., and Valdés, M. (2009). Sociodemographic, clinical, and psychiatric characteristics of transsexuals from Spain. Archives of Sexual Behavior, 38(3), 378-92.
Hammarberg, T. (2009). Gender identity and human rights: Issue paper. Strasbourg: Council of Europe.
Hendricks, M. L., and Testa, R. J. (2012). A conceptual framework for clinical work with transgender and gender nonconforming clients: An adaptation of the minority stress model. Professional Psychology: Research and Practice, 43, 460–467. doi:10.1037/a0029597
Hepp, U., Kraemer, B., Schynder, U., Miller, N. and Delsignore, A. (2005). Psychiatric comorbidity in gender identity disorder. Journal of Psychosomatic Research, 58, 259-261.
Hill, C., Knox, S., Thompson, B. J., Williams, E. N., Hess, S. A. and Ladany, N. (2005). Consensual qualitative research: an update, Journal of Counseling Psychology, 52(2), 196-205.
Hines, S. (2007). Transforming gender: Transgender practices of identity, intimacy and care. Bristol: Policy Press.
Hines, S. and Santos, A. C. (2018). Trans* policy, politics and research: The UK and Portugal. Critical Social Policy, 38(1), 35-56.
Israel, T., Gorcheva, R., Walther, W. A., Sulzne, J. M. and Cohen, J. (2008). Therapists’ helpful and unhelpful situations with LGBT clients: An exploratory study. Professional Psychology: Research and Practice, 39, 361–368.
Israel, G. E. and Tarver, D. E. (1997). Transgender care: Recommended guidelines, practical information and personal accounts. Philadelphia, PA: Temple.
James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L. and Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.
Johnson, R., Onwuegbuzie, A. and Turner, L. (2007). Toward a definition of mixed methods research. Journal of Mixed Methods Research, 1(2), 112-133.
Kenagy, G. P. (2005). Transgender health: findings from two assessment studies in Philadelphia. Health Social Work, 30(1), 12-26.
Lawrence, A. A. (2008). Gender identity disorders in adults: Diagnosis and treatment. In D. L. Rowland and L. Incrocci (Eds.), Handbook of sexual and gender identity disorders (pp. 423-456). New York: Wiley.
Lo, S. and Horton, R. (2016). Transgender health: An opportunity for global health equity. Lancet, 388(10042), 316–318.
Lombardi, E. L.,Wilchins, R. A., Priesing, D. and Malouf, D. (2001). Gender violence: Transgender experiences with violence and discrimination. Journal of Homosexuality,42(1), 89-101.
Mason, J. (2006). Six strategies for mixing methods and linking data in social science research. National Centre for Research Methods. Working Paper Series, (04/06).
McNeil, J., Bailey, L., Ellis, S. and Regan, M. (2013). Speaking from the Margins: Trans Mental Health and Wellbeing in Ireland. Transgender Equality Network Ireland (TENI). Available at: https://lgbt.ie/wp-content/uploads/2018/06/attachment_5bdd0cd5-16b6-4ab6-9ee6-a693b37fdbcf.pdf
Mustanski, B. S., Garofalo, R. and Emerson, E. M. (2010). Mental Health Disorders, Psychological Distress, and Suicidality in a Diverse Sample of Lesbian, Gay, Bisexual, and Transgender Youths. American Journal of Public Health, 100(12), 2426-2432.
Nemoto, T., Bodeker, B. and Iwamoto, M. (2011). Social support, exposure to violence, and transphobia: Correlates of depression among male-to-female transgender women with a history of sex work. American Journal of Public Health, 10, 1980-1988.
Newfield, E., Hart, S. Dibble, S. and Kohler, L. (2006). Female-to-male transgender quality of life. Quality of Life Research, 15, 1447-1457.
Nuttbrock, L., Hwahng, S., Bockting, W., Rosenblum, A., Mason, M., Macri, M. and Becker, J. (2010). Psychiatric impact of gender-related abuse across the life course of male-to-female transgender persons. Journal of Sex Research, 47(1), 12-23.
Open Society Foundations (2014). License to be yourself: Laws and advocacy for legal gender recognition of trans people. New York: Open Society Foundation. Available at: http://www.opensocietyfoundations.org/reports/license-be-yourself
Pinto, N. and Moleiro, C. (2012). Experiences of Health Care by Transexual People in Portugal: The perspectives of health professionals and health care users. PSICOLOGIA, 26(1), 129-151.
Pinto, N. and Moleiro, C. (2015). Gender trajectories: Transsexual people coming to terms with their gender identities. Professional Psychology: Research and Practice, 46(1), 12-20.
Pitts, M. K., Couch, M., Mulcare, H., Croy, S. and Mitchell, A. (2009). Transgender People in Australia and New Zealand: Health, Well-being and Access to Health Services. Feminism and Psychology 19(4), 475-495.
Raj, R. (2002). Towards a transpositive therapeutic model: Developing clinical sensitivity and cultural competence in the effective support of transsexual and transgendered clients. The International Journal of Transgenderism, 6. Available at: http://www.symposion.com/ijt/ijtvo06no02_04.htm
Reardon, S. (2019). The largest study involving transgender people is providing long-sought insights about their health. Nature, 568(7753), 446-449.
Rotondi, N. K., Bauer, G. R., Scanlon, K., Kaay, M., Travers, R. and Travers, A. (2011). Prevalence of and Risk and Protective Factors for Depression in Female-to-Male Transgender Ontarians: Trans PULSE Project. Canadian Journal of Community Mental Health, 30(2), 135-155.
Sánchez, F. J., and Vilain, E. (2009) Collective self-esteem as a coping resource for male-to-female transsexuals. Journal of Counseling Psychology, 56(1), 202--209.
Simões, A. (1992). Ulterior validação de uma escala de satisfação com a vida (SWLS). Revista Portuguesa de Pedagogia, XXVI, 3, 503-515.
United Nations Development Programme. (2013). Discussion paper: Transgender health and human rights. New York, NY: UNDP.
Vocks, S., Stahn, C., Loenser, L. and Tegenbauer, U. (2009). Eating and body image disturbances in male-to-female and female-to-male transsexuals. Archives of Sexual Behavior, 38(3), 364-377.
Winter, S., Diamond, M., Green, J., Karasic, D., Reed, T., Whittle, S. and Wylie, K. (2016). Transgender people: Health at the margins of society. The Lancet, 388(10042), 390–400.
World Medical Association (2015). WMA Statement on Transgender People. Russia, Moscow: World Medical Association. Available at: www.wma.net/policies-post/wma-statement-on-transgender-people/
World Professional Association for Transgender Health (2017). WPATH Identity Recognition Statement. Available at: www.wpath.org/media/cms/Documents/Web%20Transfer/Policies/WPATH%20Identity%20Recognition%20Statement%2011.15.17.pdf
Zeluf, G., Dhejne, C. and Orre, C. (2018). Targeted Victimization and Suicidality Among Trans People: A Web-Based Survey. LGBT Health, 5(3), 180-190.
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