I am trapped in a wrong body

• Published in: European psychiatry Vol. 33; no. S1; p. S590
• Main Authors: Hernandez Anton, R, Noval Canga, C, Rybak Koite, E, De La Red Gallego, H, Gallardo Borge, L, Alonso Sanchez, A, Sevillano Benito, I, Garcia Cantalapiedra, M.J, Marques Cabezas, P, Uribe Ladron De Cegama, F, Espina Barrio, J.A, Isidro Garcia, G
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.03.2016
• Subjects: Internal Medicine; Psychiatry
• ISSN: 0924-9338; 1778-3585
• DOI: 10.1016/j.eurpsy.2016.01.2199

Introduction Gender dysphoria is incoherence between the sex a person feels or expresses and the biological. Objective Revise the inclusion criteria for hormone therapy and sex reassignment surgery in gender dysphoria. Expose the multidisciplinary approach. Make differential diagnosis with other psychological disorders. Methodology A 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. Results It 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. Conclusions Is 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).