I confess to being muddled on the issue relating to my experiences. Was psychosis in the way of delusional obsession a basis for my transsexual beliefs which lessened as i became less acutely ill, or was the lessening to do with a coping mechanism faced by the fact that transition was never going to happen due to my psychiatric diagnosis.
Even if i was truly transsexual(my thoughts on it started relatively late at 8-9) one problem for me was that of socially interacting with others. It could be seen that a difficulty with interacting with others in one’s birth sex would be a barrier to coping in one’s desired sex . This raises the question of aspergers or similar and GID.
There may indeed be some unfortunates who whilst transsexual are not equipped to cope with the issues of transitioning.
One of my first psychiatrists went on to head the gender identity clinic. http://pb.rcpsych.org/content/26/2/78.1
Someone asked me how i felt about my the diminished feelings. I think i’m grateful in that i’m not getting frustrated chasing an impossible dream. One other thing that crosses my mind is that it is both possible to be transsexual and yet have psychotic thoughts re gender and sex.
For example my thoughts on wanting to be female started at 8-9 and nothing delusional was going on. By 13 i was fantasising about having a baby but accepted it was just a fantasy. By the time i reached my late teens i had graduated to thinking i could have female orgasms if i tried hard enough and wondering whether i had internal female sexual parts. Another thing i used to do is look for body changes.
What really lessened these thoughts which popped up periodically, even after i obsessed less about changing sex, was consistently being on medication.
As the above shows more delusional thoughts came some time after thinking about wanting to change sex. Perhaps for a very small number of people there is a trajectory of transsexualism followed by psychosis resulting in comorbid psychosis and GID.
