A Case of Bipolar Psychosis and Transsexualism

Abstract

A case of bipolar disorder and transsexualism is reported and discussed. The case report shows the problematic nature of the distinction between transsexualism and psychosis-induced transsexual desires. If there is a true comorbidity of these disorders, a subtly differentiated process to guide medical expert opinion and therapy is necessary.

Psychiatric Axis I Comorbidities among Patients with Gender Dysphoria

“…However, Haraldsen and Dahl (2000) [11] reported two cases (2.3%) of bipolar mood disorder among 84 patients. Habermeyer et al (2003) [26] also reported a case of a GID patient in manic episode with psychotic features. Among the 31 patients studied by Hepp et al (2005), two cases of psychotic disorder NOS (Not Otherwise Specified) existed [13].…”

Autocastration and Autopenectomy as Surgical Self-Treatment in Incarcerated Persons with Gender Identity Disorder

“…Of these cases, at least 62 persons completed autocastration in association with (a) schizophrenia (Agoub, 2000;Agoub & Battas, 2000;Cooper & Swamy, 1994), (b) gender identity disorder or transsexualism (Haberman & Michael, 1979;Springer, 1981), (c) obsessive-compulsive disorder (single case report; Yang, Chen, & Chen, 2006), (d) bipolar disorder (Habermeyer, Kamps, & Kawohl, 2003), (e) paraphilia, or (f) personality disorder with or without comorbid substance abuse at the time of the genital self-injury. In the largest case series published on autocastration, Springer reported that he was able to document 37 cases in the English-and German-language literature between 1901 and 1981 (Springer, 1981), one of which was evaluated by him.…”

Recommended Revisions to the World Professional Association for Transgender Health'sStandards of CareSection on Medical Care for Incarcerated Persons with Gender Identity Disorder

“…Persons with GID need to be evaluated for the presence of other major psychiatric disorders (Cole, O'Boyle, Emory, & Meyer, 1997), as case reports indicate that the concurrence of psychosis and GID, or gender dysphoric symptoms, may be associated with genital self-harm (Agoub, 2000;Duggal, Jagadheesan, & Nizamie, 2002;Gossler, Vesely, & Friedrich, 2002;Habermeyer, Kamps, & Kawohl, 2003;Martin & Gattaz, 1991;Myers & Nguyen, 2001;Mellon, Barlow, Cook, & Clark, 1989;Nakaya, 1996;Novak-Grubic & Tavcar, 2002;O'Gorman, 1980;Springer, 1981). It is also clear that, in the absence of psychiatric comorbidities, that autocastration in the form of surgical selftreatment for GID occurs in institutionalized persons who do not have, or are denied, access to appropriate transgender health care (Brown, 2007).…”