“Same Same but Different”: Gender Dysphoria and Anorexia Nervosa in Adolescent Girls
„Same Same but Different“: Geschlechtsdysphorie und Anorexia nervosa in der weiblichen Adoleszenz
André Leonhardt, Martin Fuchs, Gabriele Kohlböck, Manuela Gander, Kathrin Sevecke - Février 2025
Contemporary discussions on the development of gender dysphoria in adolescent girls sometimes suggest that underlying psychodynamic factors may overlap with those contributing to anorexia nervosa. From a psychoanalytic perspective, it is emphasized that, particularly in adolescent girls, identity-related demands and threats often manifest in the confrontation with a sexually maturing body. In this context, gender dysphoria may be understood as a temporary developmental anxiety, accompanied by an attempt to resolve an internal conflict related to the body.
This article combines in-depth theoretical considerations with empirical research. In one study, 105 adolescent girls with gender dysphoria seen in a specialized outpatient clinic and 138 adolescent girls hospitalized for the treatment of anorexia nervosa completed standardized questionnaires assessing personality functioning (LoPF-Q 12–18), identity development (AIDA), childhood trauma (CTQ), as well as emotional and behavioral problems (YSR).
Both groups showed comparable impairments in personality functioning and identity development, as well as similar levels of internalizing symptoms. However, the girls with gender dysphoria reported significantly more traumatic experiences and externalizing problems. Psychodynamic parallels are analyzed theoretically based on these findings and placed in the context of differences in clinical care. Finally, the discussion addresses the implications for differential diagnosis and specific treatment approaches for gender dysphoria in adolescents.
Prax. Kinderpsychol. Kinderpsychiat. 74/2025, 173–192
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