Psychological Examination Prior to Gender-Affirming Surgery

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Yes, Anabel will need a psychological evaluation before the surgery. Gender dysphoria is a complex interplay between internal stressors associated with gender congruence and external stressors related to minority stress and social stigma that is rooted in cisnormative ideals of gender, which tend to affect the mental health of a person. From the case study, Anabel has internal stressors such as internal alienation, which affects her mental health. According to Frew et al. (2021), the core symptoms of dysphoria never occur in isolation, as psychosocial stressors and psychiatric conditions exacerbate them. This then creates the need for Anabel to go through a psychological evaluation and establish if she fully understands her decision to have the surgery or whether stress is driving her. The evaluation will also seek to understand whether her mental health status will affect her ability to cope with the transformation. Frew et al. (2021) state mental health comorbidities have a greater likelihood of persisting into the future if the surgery is conducted without an assessment. An evidence-based psychological assessment often involves the use multimodal approach consisting of clinician consultations, diagnostic conversations, as well as patient-reported (self-report) outcome measures (PROMs) (Wright et al., 2019).