Within the framework of the study of gender-role deviations in mental illness, conducted by the authors, an analysis of differences in sexual behavior and gender identity in such forms of pathology as schizophrenia and intellectual disability (MR - mental retardation) is presented. The article presents the results of the study of gender identity disorders (GID) in men with schizophrenia and men with ID, presents pathopsychological examples of GID. The study is based on the assumption that both in schizophrenia and in mental retardation, the pathogenesis of transsexualism inherent in these mental disorders is due to the violation of semi-dymorphic brain structures, which qualitatively change the nature of sexual behavior and gender identity. However, the phenomenology of these disorders will depend on the nature and specifics of the pathology, which determines its pathopsychological picture. Based on the analysis of the current state of the problem and the data of our own research, it was found that the disorder of sexual behavior and gender identity in schizophrenia has the form of typical schizophrenic patterns that take the form of metaphysical interpretation, pretentiousness, delusional ideas, etc., that do not contain proper sexual erotic component and is not implemented by the behavior inherent in persons of the opposite sex. This does not allow us to speak about the true transsexual tendencies in schizophrenia and true GID. There are grounds to regard the features of GID in schizophrenia as a separate clinical and psychological phenomenon caused by the influence of the general schizophrenic process. With MR, the key factor of which is retardation, there is a psychologically expressed homosexuality and true transsexual tendencies, accompanied by corresponding inner experiences. The article is important for the pathopsychological differential diagnosis of transsexualism from other mental disorders occurring with EPI, and may contribute to expanding views on the origin of transsexualism.
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