DEPRESSION UNFOLDING GENDER DYSPHORIA: AN UNUSUAL CASE OF RURAL INDIA.

Abstract

BACKGROUND: Gender dysphoria is a rare condition, rarer in females and rarest in rural areas of India. From the surface case presented with depressive features, but inside the core diagnosis of gender dysphoria was met. The objective of index case is highlighting presentation of a female with stigmatizing condition and role of various available treatment options and utilization of services. Case presentation: A 20-year-old female from rural background demonstrating symptoms of low mood, easy fatiguability and ideas of selfharm from past few months with a long -standing history of distress and incongruence between experienced and assigned gender. According to DSM-5, diagnosis of gender dysphoria was made and further evaluated on Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA) and Hamilton depression rating scale. SSRI was started along with supportive psychotherapy sessions and various treatment options for gender dysphoria discussed. DISCUSSION: This case illustrates importance of history taking which becomes paramount in case of rare disorders like gender dysphoria. Multi-level interventions at the individual, interpersonal, and structural levels to reduce stigma toward transgenders, better acceptability would lead to further clarify hypothesis and early diagnosis of the disorder.