Subjective Ideas of Sexual Change in Male Schizophrenics

Abstract

Ideas of changing sex, and the doubt about sexual identity which these ideas imply, are considered to be “invariable” and “pathognomonic” features of schizophrenia by Macalpine and Hunter (1955). The authors quote, in a footnote, a personal communication from Manfred Bleuler dated 1953 which states that Eugen Bleuler would have agreed that “schizophrenics are almost invariably, if not indeed invariably, in doubt about the sex to which they belong”. Planansky and Johnston (1962), in an uncontrolled study of 150 male schizophrenics, found that only 15 per cent. (22 cases) exhibited “direct expression of confusion of sex identity” and only 4·7 per cent. (7 cases) had clear delusions of having changed into a woman. Jackson (1960), Weckowicz and Sommer (1960), and Skottowe (1964) state merely that these ideas occur, or occur frequently. A check of the standard English language teaching texts reveals that Allen (1962), Bleuler (1911), Mayer-Gross et al. (1960), Noyes and Kolb (1963) and Sim (1963) make only oblique references to ideas of changing sex, whilst Anderson (1964), Arieti (1959), Bellak and Benedict (1958), Curran and Partridge (1963), Fish (1962 and 1964), Freeman et al. (1958), Henderson and Batchelor (1962), Merskey and Tonge (1965), and Stafford-Clark (1964) make no reference at all. In their study of schizophrenic delusions Lucas et al. (1962) similarly do not mention change of sex. They state simply that (in males) 30 per cent. had a sexual content.