Gender identity assessment with trans individuals – findings of a systematic literature review of assessment instruments and ethical considerations

Abstract

Purpose
In several Western legislations, trans individuals must frequently undergo some form of gender identity assessment, for example, to receive legal recognition of their gender or to access therapeutic interventions. Thus, a standardised and empirically supported assessment approach becomes necessary. The purpose of this paper is to critically reflect on the current international guidelines for assessments by the World Professional Association for Transgender Health, which will be compared to standards in secure forensic settings, illustrated by British prison policies.

Design/methodology/approach
Findings of a systematic literature review following preferred reporting items for systematic reviews and meta-analysis standards are presented, summarising the current state of research pertaining to gender identity assessment instruments. Studies were included, when they presented empirical details pertaining to assessment approaches and passed the quality appraisal, but were excluded when they did not use a trans sample or presented clinical assessments not linked to gender identity.

Findings
A total of 21 included English articles, which mostly have been published in the USA in the past 20 years, propose ten different assessment approaches. Most of the studies support the use of the Minnesota Multiphasic Personality Inventory-2, the Bem Sex-Role Inventory, Body Image Scale for Transsexuals and the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults. The instruments are briefly summarised.

Practical implications
It becomes apparent that this field is severely understudied and that there is no consensus regarding the best assessment approach. Hence, any recommendations are only preliminary and are contextualised with further ethical considerations and suggestions for future research.

Originality/value
To the best of the author’s knowledge, this is the first systematic literature review pertaining to the (semi-)structured assessment of gender identity.