Features of gender identity disorders in schizophrenia spectrum disorders in comparison with transsexualism

Abstract

The original study presents the results of a comparative analysis of the clinical, psychopathological, and psychosexual characteristics of gender identity disorders in schizophrenia spectrum disorders and transsexualism. The sample consisted of 120 people with complaints about the inconsistency between gender self-perception and the biological sex, divided into 2 groups: with schizophrenia spectrum disorders and transsexualism. It was found that in the patients with transsexualism, compared to those with schizophrenia spectrum disorders, the age of gender incongruence awareness fell on an earlier age period, and they more often had elements of trans-role behavior in childhood. The respondents with transsexualism more often had experience of living in an associated gender and less often made attempts to adapt in accordance with the gender assigned at birth. The psychosexual development of the patients with transsexualism was generally normative, while the patients with schizophrenia often showed delays in the platonic-erotic stage of libido. It was concluded that in the differential diagnosis of transsexualism and gender identity disorders in schizophrenia spectrum disorders, attention should be paid to such parameters as the presence of signs of gender identity disorders in childhood, age of gender incongruence awareness, experience of life in the associated gender, the presence of dysmorphophobic symptoms not related to sexual characteristics, and the results of a psychological examination of gender identity.