Difficult Issues In Sexuality Development: A Mental Health Perspective

Abstract

Sexual development is a dynamic process that continues across the lifespan with multiple facets. There is a need to understand evolving perspectives of childhood and adolescent phase that shapes sexual attitudes, sexual identity and directly impacts sexual behavior. Gender dysphoria is one of the difficult issues encountered across developmental phase. Early identification of gender dysphoria and comprehensive assessment of physical as well as mental health by a multidisciplinary team is essential. Its diagnosis has complex social, medical, ethical and political ramifications. So, management should require a fine balancing between concerns of the family as well as myriad of emotions of patient. This article discusses possible biopsychosocial etiology behind this problem, prognosis of gender dysphoria across lifespan, different treatment strategies and associated ethical, legal and medical dilemmas. Barriers to treatment andlegal difficulties encountered in health seeking with regard to Indian health care system are elaborated. Reflections from the past concerning management guidelines across various countries, current scenario and implications for future management are also discussed.