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Psychiatr Clin North Am. 2017 Mar;40(1):51-64. doi: 10.1016/j.psc.2016.10.011. Epub 2016 Dec 24.

Affirmative Psychological Testing and Neurocognitive Assessment with Transgender Adults.

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Department of Psychology, University of Houston, Houston, TX 77204, USA; School of Medicine, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA; Lee and Joe Jamail Specialty Care Center, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030, USA. Electronic address:
Department of Psychology, Lemuel Shattuck Hospital, 170 Morton Street, Jamaica Plain, MA 02130, USA.


Neither consensus on best practice nor validated neuropsychological, intelligence, or personality testing batteries exist for assessment and psychological testing on the transgender population. Historically, assessment has been used in a gate-keeping fashion with transgender clients. There are no firm standards of care when considering the content and appropriateness of evaluations conducted presurgically. These evaluations are discussed in the setting of other presurgical evaluations, with a recommendation to move toward a competency to make a medical decisions model. Additional considerations are discussed, such as effects of transition on mood and how to interpret scores in a field where normative data are often gender stratified.


Affirmative; Assessment; LGBT; Neurocognitive; Neuropsychology; Testing; Transgender

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