State of Mind of Attachment and Reflective Function in an Italian transsexual sample

Abstract Introduction According to the DSM-5 (APA, 2013), gender dysphoria is a form of incongruence between the subjective experience of belonging to a specific gender and the gender one has been assigned at birth. Objective The purpose of this paper is to explore attachment state of mind in a transsexual adult population in order to identify the most appropriate ways and forms of interventions, since improving attachment state of mind might boost the subject's quality of life. Method The sample consisted of 52 transsexual patients, of whom 51.9% were biologically male (MtF; n = 27) and 48.1% female (FtM; n = 25). Results The data obtained through the Adult Attachment Interview (AAI, George et al., 1985) show that the majority of the participants (92.3%) were found to have an insecure attachment state of mind. When classifying participants with GD on the basis of one of three attachment state of mind, 71.2% (n = 37) of the sample showed a dismissing state of mind with respect to attachment and 21.2% (n = 11) an entangled state of mind. The data obtained through the AAI also show that almost half of the sample reported one or more traumatic life events, with no differences found between the MtF and FtM groups. Using the Unresolved/disorganized (U/d) condition to classify the AAI data, we found frequent signs of unresolved experiences of trauma among those with an insecure attachment state of mind. No traumatic experiences with respect to attachment were reported by participants who were classified as secure. Conclusion Our findings suggest that interventions with transgender patients should impact on their current state of mind relating to attachment and traumatic experiences by promoting a secure state of mind with respect to attachment.