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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">psychiatry</journal-id><journal-title-group><journal-title xml:lang="ru">ПСИХИАТРИЯ</journal-title><trans-title-group xml:lang="en"><trans-title>Psychiatry (Moscow) (Psikhiatriya)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1683-8319</issn><issn pub-type="epub">2618-6667</issn><publisher><publisher-name>FSBSI “The Mental Health Research Centre”;   LLC «Publisher «MIA»</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.30629/2618-6667-2020-18-3-32-41</article-id><article-id custom-type="elpub" pub-id-type="custom">psychiatry-508</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПСИХОПАТОЛОГИЯ, КЛИНИЧЕСКАЯ И БИОЛОГИЧЕСКАЯ ПСИХИАТРИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PSYCHOPATHOLOGY, CLINICAL AND BIOLOGICAL PSYCHIATRY</subject></subj-group></article-categories><title-group><article-title>Кто обращается к психиатру с запросом на изменение пола: результаты 30-летнего исследования</article-title><trans-title-group xml:lang="en"><trans-title>Who Submits a Request to the Psychiatrist for a Gender Change: Results of a 30-Year Study</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6050-8215</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дьяченко</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Dyachenko</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дьяченко Антон Васильевич, врач-психиатр; аспирант</p><p>Ростов-на-Дону</p><p> </p></bio><bio xml:lang="en"><p>Anton V. Dyachenko, Psychiatrist; Post-Graduate Student</p><p>Rostov-on-Don</p></bio><email xlink:type="simple">avddoc@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бухановская</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Bukhanovskaya</surname><given-names>O. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бухановская Ольга Александровна, кандидат медицинских наук, главный врач</p><p>Ростов-на-Дону</p><p> </p></bio><bio xml:lang="en"><p>Olga A. Bukhanovskaya, MD, PhD, Cand. of Sci. (Med.), Chief Physician</p><p>Rostov-on-Don</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0222-3414</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Солдаткин</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Soldatkin</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Солдаткин Виктор Александрович, доктор медицинских наук, заведующий кафедрой</p><p>Ростов-на-Дону</p></bio><bio xml:lang="en"><p>Victor A. Soldatkin, MD, PhD, Dr. of Sci. (Med.), Head of the Department</p><p>Rostov-on-Don</p></bio><email xlink:type="simple">sva-rostov@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6629-7404</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Перехов</surname><given-names>А. Я.</given-names></name><name name-style="western" xml:lang="en"><surname>Perekhov</surname><given-names>A. Y.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Перехов Алексей Яковлевич, психиатр-сексолог, кандидат медицинских наук</p><p>Ростов-на-Дону</p></bio><bio xml:lang="en"><p>Alexey Y. Perekhov, Psychiatrist-Sexologist, MD, PhD, Cand. of Sci. (Med.)</p><p>Rostov-on-Don</p></bio><email xlink:type="simple">perekhov_a@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ООО «Лечебно-реабилитационный научный центр «ФЕНИКС»; Кафедра психиатрии, наркологии и медицинской психологии ФГБОУ ВО «Ростовский государственный медицинский университет» МЗ России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Medical and Rehabilitation Research Center “PHOENIX”; Department of Psychiatry, Narcology and Medical Psychology, Rostov State Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Кафедра психиатрии, наркологии и медицинской психологии ФГБОУ ВО «Ростовский государственный медицинский университет» МЗ России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Department of Psychiatry, Narcology and Medical Psychology, Rostov State Medical University, Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>17</day><month>09</month><year>2020</year></pub-date><volume>18</volume><issue>3</issue><fpage>32</fpage><lpage>41</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Дьяченко А.В., Бухановская О.А., Солдаткин В.А., Перехов А.Я., 2020</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="ru">Дьяченко А.В., Бухановская О.А., Солдаткин В.А., Перехов А.Я.</copyright-holder><copyright-holder xml:lang="en">Dyachenko A.V., Bukhanovskaya O.A., Soldatkin V.A., Perekhov A.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.journalpsychiatry.com/jour/article/view/508">https://www.journalpsychiatry.com/jour/article/view/508</self-uri><abstract><sec><title>Обоснование</title><p>Обоснование: несмотря на существенное повышение спроса на проведение мероприятий по изменению пола, наблюдаемое в течение последних нескольких лет, механизмы увеличения числа трансгендеров довольно редко подвергаются изучению.</p></sec><sec><title>Цель</title><p>Цель: анализ частоты и структуры обращаемости пациентов с запросом на выдачу справки об изменении пола.</p></sec><sec><title>Материал</title><p>Материал: исследовано 179 медицинских карт пациентов, обратившихся с запросом на выдачу справки об изменении пола в лечебно-реабилитационный научный центр «ФЕНИКС» в период с 1991 по 2020 г.</p></sec><sec><title>Методы</title><p>Методы: клинический, математический, статистический.</p></sec><sec><title>Результаты</title><p>Результаты: в течение последнего десятилетия выявлено повышение случаев обращения пациентов, стремящихся к изменению пола, по сравнению с 2000–2009 гг. В основном это происходит за счет значительного увеличения числа больных с расстройствами шизофренического спектра и нарушениями половой идентификации по сравнению с предшествующими двумя десятилетиями. Выявлена связь между повышением частоты встречаемости нарушений половой идентификации при эндогенных заболеваниях и современной информационной средой.</p></sec><sec><title>Выводы</title><p>Выводы: есть основания полагать, что выявленное изменение частоты и клинической структуры обращаемости с запросом на изменение пола обусловлено социальным патоморфозом расстройств шизофренического спектра. Высказана основанная на установленных закономерностях точка зрения о необходимых мерах по совершенствованию помощи лицам, страдающим расстройствами половой идентификации. Эти меры, учитывая медико-социальный дуализм проблемы, должны базироваться в равной степени на естественно-научной реальности, клинической доказательности, идеях гуманизма и правовых нормах демократического светского общества.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Background</title><p>Background: despite the significant increase in demand for gender change interventions observed over the past few years, the mechanisms for increasing the number of transgender people are rarely studied.</p></sec><sec><title>The Aim</title><p>The Aim: to analyze the frequency and structure of patients’ requests for a certificate of gender change. Material: 179 medical records of patients who applied for a certificate of gender change in the Medical and Rehabilitation Research center “PHOENIX” during the period from 1991 to 2020.</p></sec><sec><title>Materials and Methods</title><p>Materials and Methods: clinical, mathematical, statistical.</p></sec><sec><title>Results</title><p>Results: over the past decade, there has been an increase in cases of patients seeking to change their gender compared to the period from 2000 to 2009. Basically, this increase is due to a marked increase of the number of patients with schizophrenic spectrum disorders with sexual identification disorders compared to the previous two decades. The connection between the increased frequency of sexual identification disorders in endogenous diseases and the modern information environment is revealed.</p></sec><sec><title>Conclusions</title><p>Conclusions: it seems that the revealed change in the frequency and clinical structure of requests for sex change is due to the social pathomorphosis of schizophrenic spectrum disorders. A point of view based on established regularities is expressed by the necessary measures to improve assistance to persons suffering from sexual identification disorders. These measures, taking into account the medical and social dualism of the problem, should be based equally on natural-scientific reality, clinical evidence, ideas of humanism and legal norms of a democratic secular society.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>расстройства шизофренического спектра</kwd><kwd>шизофрения</kwd><kwd>смена пола</kwd><kwd>транссексуализм</kwd><kwd>трансгендерность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>schizophrenic spectrum disorders</kwd><kwd>schizophrenia</kwd><kwd>sex change</kwd><kwd>transsexualism</kwd><kwd>transgenderism</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Ляная ГА. Становление понимания феномена расстройства половой идентификации. Психиатрия. 2019;17(3):51–61</mixed-citation><mixed-citation xml:lang="en">Lyanaya GA. Formation of understanding of the phenomenon of sexual identification disorder. 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