The Right to Be Oneself: The International and Italian Situation Regarding Gender Incongruence, Focusing on Legislation, Rights, Access to Care, and Appropriateness

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This paper canvassed the various approaches to gender identity in different jurisdictions effectively and demonstrated similarities and differences to the Italian approach. This paper could be improved through better links between the first and second parts of the article, as well as the third part and the Conclusion. I was not sure what relevance the change in understanding of diverse gender identities as part of the DSM or as simply a variation in human experience linked to the approaches taken in various jurisdictions, particularly because the time at which various states changed their approach did not necessarily track with the changes in psychiatry. The author could also clarify the link between Part I and Part II. I was not necessarily sure about the link between Part III and the Conclusion as I was unclear what other jurisdictions could adopt or learn from the Italian approach and if ultimately the author was arguing for a supranational approach and if so, if this supranational approach should be based on some or any of the jurisdictional approaches canvassed. This aspect of the paper and argument could be clarified. Otherwise, it was a valuable and timely piece. 

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

I found the article interesting but I think there is room for improvement. Overall, it is a bit too descriptive. While this is helpful to orient the reader to the issue I think author(s) need to make their argument more clear. Where do they place themselves in this debate. This is particularly the case with the section on Italy. Is Italy in line with international norms or not?  

I think the work is in general a bit underreferenced. I think there needs to be more reference given to existing legal works in this area.

More specific comments and questions:

Line 21--How common is gender incongruence—not sure about common. Here a reference would help.

Line 56--Undoubtedly, around the world, TGD individuals commonly experience transphobia, stigmatization, and ignorance, leading to minority stress, which is  associated with higher rates of depression, suicide, and self-harm compared to the cisgender population—needs a reference.

Line 59--Furthermore, the issue of gender identity also has implications for TGD 59 individuals’ parenthood.—Give an example or two

 

 

Line 117 instead of conservative party should be Republican Party

A chart summarizing the international situation might be helpful. 

Line 150—reference to a German law but the discussion is of Italy?

Line 181--The result was the suspension of the treatment due to the absence of psychological or psychiatric support for young patients.  Was the suspension nation wide or only at the hospital under investigation?  Not clear.

Comments on the Quality of English Language

Line 43-44 'Transsexualism' first appeared in the DSM-III (American Psychiatric Association 1980). the 'psychosexual disorders' section, the DSM-III included three gender identity disorders: transsexualism, childhood gender identity disorder (GIDC), and atypical gender identity disorder.—combine these two sentences the first one is hanging.

 

Lien 56—U is missing from Undoubtedly

Author Response

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Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The authors appear to have adopted the feedback suggested. 

Author Response

Dear Reviewer,

Thank you for your valuable comments. We have made the requested changes.

Sincerely