Gender Dysphoria and Co-Existing Psychosis: Review and Four Case Examples of Successful Gender Affirmative Treatment

anon79999497 · February 9, 2017, 12:45pm

CONCLUSION:

These case examples show that GA treatment is possible and safe in this vulnerable population.

ncbi.nlm.nih.gov

Gender Dysphoria and Co-Existing Psychosis: Review and Four Case Examples of Successful Gender Affirmative Treatment.

JH Meijer, GM Eeckhout, RH van Vlerken and AL de Vries, LGBT health, Apr 2017

Controversy exists as to if, and when, gender affirmative (GA) treatment should be offered to individuals with gender dysphoria (GD) and co-existing psychosis. Concerns exist regarding a high risk of misdiagnosis, regret afterward due to impulsive decision making, and deterioration of psychotic symptoms. This case series aims at extending the sparse literature on GA treatment in this population by identifying challenges in diagnosis and treatment and offering recommendations to overcome them.The authors present case descriptions of two transgender men and two transgender women in the age range of 29-57 years with a diagnosis of GD and a schizophrenia-related diagnosis. All had undergone GA treatment with a minimum follow-up of 3 years. The gender diagnosis was complicated by the fact that feelings of GD were only shared after the onset of psychosis, and GA treatment was hampered by the persistence of mild psychotic symptoms despite antipsychotic treatment. Close communication with the psychosis treating clinicians proved useful to address these problems. GA treatment was paralleled by a stabilization of psychotic symptoms, and adherence to and satisfaction with the therapy was high.These case examples show that GA treatment is possible and safe in this vulnerable population.

anon9798425 · February 9, 2017, 4:28pm

Very interesting. Thanks for sharing!

anon11056724 · February 9, 2017, 6:12pm

Again, I think that the meds cause this gender dysporia. They take away your emotions and your will to procreate making you essentially asexual.
No infer that people question or are unhappy with their gender.

anon79999497 · February 9, 2017, 10:06pm

That makes little sense as most people with gender dysphoria are not on psychiatric meds. Asexuality does not equate to gender dysphoria.

anon17132524 · February 9, 2017, 10:32pm

Sexual orientation and gender identity are distinct.

The suicide-attempt rate for the transgender community is 41% (much higher than any mental illness). How many people who are transgender have to die before society stops discriminating against them?

#StopTheHate

Sooner88 · February 9, 2017, 10:34pm

Very inappropriate that my post was deleted. That’s unnecessary. We can have a civil conversation about these things. All opinions are valid.

anon9798425 · February 9, 2017, 10:37pm

Your post was very inappropriate. We expect our members to treat others with respect here. If your opinion is disrespectful, you should keep it to yourself.

Rhubot · February 9, 2017, 10:37pm

Dude, your reply wasn’t civil.

anon11056724 · February 9, 2017, 10:42pm

Why is this news on our site?

Rhubot · February 9, 2017, 10:47pm

It’s about gender dysphoria as it interplays with psychosis. It’s on topic.

anon11056724 · February 9, 2017, 10:48pm

I had never heard of it until now. I have enough problems of my own.

Rhubot · February 9, 2017, 10:50pm

It’s surprisingly common on these boards. Count yourself lucky that this isn’t another source of distress for you.

anon11056724 · February 9, 2017, 10:51pm

I do. And it strengthens the argument that I don’t have schizophrenia.

Sooner88 · February 9, 2017, 10:59pm

And before you accuse me of being hateful or disrespectful, I happen to be gay and I know several trans people. I have no problem with them! My problem is with those “doctors” who manipulate them and lead them to destroying their bodies. Trans people are no different than anyone else and should be treated as equals in every way. We should show more compassion for them, not less.

anon9798425 · February 9, 2017, 11:14pm

This is research which shows that treatment of this kind is not psychologically destructive. I’m sure there is much more research out there with the same implications. I trust that the doctors who make these decisions know what they are doing more than any of us on this forum do, and I see very little use in laypersons questioning their expertise, and even less, their morality and commitment to their patients’ well-being, as you do now. Forgive me for finding it hard to believe that it is concern for others that makes you dismiss a condition which you have no personal experience with or expertise in. Being gay is a completely different matter and does not excuse you from behaving in a civil way towards people who identify as transgender.

Sooner88 · February 9, 2017, 11:17pm

I’m being civil. I was simply advocating for safer alternatives. Shock therapy used to be viewed as “not psychologically destructive” but boy have I seen some people who were ruined by that crap!

anon79999497 · February 9, 2017, 11:26pm

Having gender dysphoria is neither proof for or against having schizophrenia.

Rhubot · February 9, 2017, 11:42pm

This is a morally loaded, disrespectful descriptor.

Genbu · February 10, 2017, 12:00am

Well now ! That’s a very true statement! How perfectly that describes the relation between SZ and “doctors”?

If I have an expertise or complete knowledge of something, then I know it completely, and so, have no room for error in correcting any problem.

In short, you better believe I know damn well what I’m doing.

“Well that’s why they study and study, so that --”
“So that they can arrive at an answer?”
“Well you see it’s not that simple, it’s that --”
“Truth is at the root. It can’t be the bodies of knowledge which only grow and continue to grow and constantly escape their grasp due to a limited intellectual perspective.”

Also, my self-righteous radar is about to explode!

RowanAmethyst · February 10, 2017, 12:07am

Hi, transgender woman with schizophrenia checking in! All I know is that I was WAY worse off before starting treatments for transition. The added stress of dysphoria threw me into a downward spiral when my psychosis started ramping up, and I was pretty close to ending it by the time I got help. I still have trouble with my body image, I have a long way to go, but the changes that have been made have all greatly improved my ability to cope with everything else.

Oh, and none of this was impulsive or frivolous. I researched and debated and stalled for YEARS before getting treatment. The thought that it was the psychosis causing these feelings did cross my mind, but being on meds and having much fewer and less severe psychotic symptoms, my dysphoria hasn’t abated one bit, except for with transition.