Gender identity disorder and attachment theory: the influence of the patient's internal working models on psychotherapeutic engagement and objective. A study undertaken using the adult attachment interview

Until now, studies related to gender identity disorder (GID) in adult patients carried out within the framework of attachment theory have been scarce. The current research project aimed to explore the theme related to the specific nature of the current states of mind with respect to attachment in adult male patients suffering from GID, and to evaluate simultaneously the level of psychopathology associated with conditions of GID. The first 18 patients suffering from GID, who came to the Functional Area of Psychology of the Clinical Department of Neuroscience and Behaviour of the “Federico II” University Hospital between 2005 and 2007 to psychological assistance for problems connected to gender dysphoria, were registered in sequential order. The following tests were administered to all patients: (a) investigation of case histories and motivation, (b) Minnesota Multiphasic Personality Inventory (MMPI-2), and (c) Adult Attachment Interview. The results show an increase, among people with GID, of insecure conditions of the mind and of unresolved/disorganized conditions of the mind with respect to traumas or losses. Results obtained by MMPI-2 confirm the absence of other psychopathological conditions previously reported in the scientific literature. Based on the results of our exploratory research, we discuss how psychological intervention could have a dual objective of improving the possibility of access to a fuller and more satisfying emotional-relational life and of allowing an adequate working-through of complex traumatic events, which appear to affect the life experiences of individuals with GID and, often, seem not to have been adequately worked through.