Four-year remission of transsexualism after comorbid obsessive–compulsive disorder improved with self-exposure therapy

BackgroundThere has been no report of comorbid transsexualism and obsessive–compulsive disorder (OCD) or of their differential course over follow-up.MethodSuch comorbidity and follow-up are documented in a case report.ResultsA man who had been transsexual and homosexual since early adolescence developed severe OCD at age 40 as he became depressed when his mother, to whom he was very close, died. Two years later he was referred for his OCD. He refused treatment for his transsexualism. As his OCD and mood improved with self-exposure therapy, his transsexualism and homosexuality remitted also. Four years later depression and transsexualism recurred and remained to six-year follow-up despite full remission in OCD continuing throughout.ConclusionsThe sequence is like that in other cases in whom unusual sexual behaviour remitted for years after comorbid disorders improved with various treatments, or after circumstances changed.