I am trapped in a wrong body

IntroductionGender dysphoria is incoherence between the sex a person feels or expresses and the biological.ObjectiveRevise the inclusion criteria for hormone therapy and sex reassignment surgery in gender dysphoria. Expose the multidisciplinary approach. Make differential diagnosis with other psychological disorders.MethodologyA 45 years old male patient (biological female), who was sent from Endocrinology Unit for a psychiatric evaluation before restart a hormonal treatment. Since his childhood, he has presented dissatisfaction with his sexual characteristics; he has had fantasies and dreams, in which he belonged to the other sex. He has always chosen male activities and male stereotypes companies. He has presented preference for cross-dressing from 9 years. Always felt the sexual attraction for women. He first consulted for this reason in 1995.ResultsIt reported favorably to start hormone treatment after completing the eligibility criteria: > 18 years old; knowledge of the effects of hormones; and more 3 months documented real-life experience. The hormone therapy caused the growth of microprolactinoma, which was treated with dopamine agonists until it disappeared and the cessation of galactorrhea. Testosterone treatment is restarted. Laboratory tests are done every 3 months during the first year and then, every 6 months.ConclusionsIs the gender disphoria a pathology? The EU recommends a reclassification as no pathological disorders in ICD-11. The treatment of gender dysphoria is necessary, and there is no reason to postpone it. The main difficulty is the differential diagnosis; there may be comorbidity with others mental disorders which are not exclusive (psychotic disorder, OCD, personality disorders and other disorders of gender identity).Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Gender dysphoria: recognition and assessment

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.109.007211 ◽

2012 ◽

Vol 18 (1) ◽

pp. 2-11 ◽

Cited By ~ 4

Author(s):

Kate Eden ◽

Kevan Wylie ◽

Emily Watson

Keyword(s):

Mental Health ◽

Health Professional ◽

Mental Health Professional ◽

Gender Dysphoria ◽

Gender Identity Disorder ◽

Life Experience ◽

Real Life ◽

Healthcare Settings ◽

And Gender

SummaryThe role of the mental health professional, and of the psychiatrist in particular, is evolving and changing. As the recognition of transsexualism and gender identity disorder expands across the transgender spectrum, it has been recommended that gender dysphoria should replace existing diagnostic terminology. Patient-focused care is evolving and this article considers the limitations of current healthcare settings and how the mental health professional can support patients undergoing the real-life experience. Differentiation from other mental health conditions that may present as gender dysphoria is outlined, as well as specific clinical situations.

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TORNAR-SE HOMEM, TORNAR-SE MULHER - RELATO DE CASO

Revista Psicologia Diversidade e Saúde ◽

10.17267/2317-3394rpds.v6i4.1612 ◽

2017 ◽

Vol 6 (4) ◽

pp. 229

Author(s):

Vera Lucia Soares Chvatal ◽

Amilton Dos Santos Junior ◽

Marcelo Modesto Fagundes de Araujo ◽

Egberto Ribeiro Turato

Keyword(s):

Gender Dysphoria ◽

The Body ◽

Treatment Recommendation ◽

Sex Reassignment Surgery ◽

Eligibility Criteria ◽

Humanitarian Organizations ◽

Gender Reassignment ◽

Management Recommendations ◽

Psychological Defenses

Introdução: Visando promover o bem estar da população transexual, mundialmente há alterações nas recomendações de condutas clínicas. Os critérios para os tratamentos visam minimizar os efeitos da Disforia de Gênero desta população resguardando-lhes o direito à dignidade humana, e devem ser adotados pelas condições de elegibilidade e de presteza; dentre eles, a complexa Cirurgia de transgenitalização. Objetivo: Discutir a atípica situação de sujeito transexual que não deseja passar pelo procedimento cirúrgico. Método: Emprego de entrevista qualitativa que visou estudar as relações dos significados atribuídos pelo sujeito da pesquisa. Resultados: Relato de Caso descritivo de sujeito que se contrapõe a um dos elementos do diagnóstico psiquiátrico de transexualismo: atendendo aos critérios de elegibilidade à transgenitalização prefere conservar suas características físicas, mas mantém uma atitude positiva em relação ao seu corpo devido a eficiência de suas defesas psicológicas. Conclusão: Este caso nos convida a refletir que a mudança de sexo, apesar de aliviar a disforia de gênero, pode não ser suficiente como tratamento para o transexual. A recomendação do tratamento deve ir além da elegibilidade e deve avaliar o préstimo ofertado à qualidade de vida do sujeito dentro de novas perspectivas despatologizadas promovidas por entidades de cuidado humanitário na área da saúde. Introduction: Intending to promote the welfare of the transsexual population there are worldwide changes in clinical management recommendations. The criteria for treatments aim at minimizing the effects of Gender Dysphoria of this population safeguarding their right to human dignity and shall be adopted by the conditions of eligibility and readiness; the complex sex reassignment surgery is among these treatments. Objective: To discuss the atypical situation of a transsexual subject who does not want to go through the surgical procedure. Method: Use of qualitative interview aimed at studying the relationships of meanings attributed by the research subject. Results: Descriptive Case Report of atypical subject opposed to one of the elements of the psychiatric diagnosis of transsexualism: meeting the eligibility criteria for gender reassignment, prefers to keep its physical characteristics but maintains a positive attitude to the body due to its efficient psychological defenses. Conclusion: This case invites us to reflect that sex change, although alleviating gender dysphoria, may not be sufficient as a treatment for the transsexual. The treatment recommendation must go beyond the eligibility and must assess the benefit offered to the quality of life of the subject within unpathologized new perspectives promoted by humanitarian organizations in health care.

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