In the Netherlands it has recently become
possible for transsexual patients to receive hormonal treatment from the onset
of puberty. Until the age of 16, pubertal development can be prevented with
luteinizing hormone-releasing hormone (LHRH) agonists. From 16 years of age
onwards, gender adjustment can be initiated by administration of hormones of
the opposite sex. Surgical treatment can be offered once the patient reaches
18 years of age.
Although such treatment will only be
initiated with reticence and after a long phase of intense diagnostic
screening, the question arises whether a clear differentiation can be made
between pure gender identity disorders and secondary transsexual feelings that
are part of an ongoing psychopathological development, such as schizophrenia.
The potential diagnostic confusion is
illustrated by a case history of a male schizophrenic patient. This patient
had been treated hormonally for transsexualism for years before acute
psychotic decompensation occurred. Neuroleptic treatment of the psychosis
rapidly reduced the psychotic symptoms.
In retrospect, the patient regards his
transsexual period as a 'mistake'. Delusions about one's physical appearance
and the urge to drastically change the way one looks appear to be relatively
common in patients suffering from schizophrenia.
Citation:
Ned Tijdschr Geneeskd 2001 Sep 29;145(39):1876-80 an
article published on the Internet by PubMed <http://www.ncbi.nlm.nih.gov/>
