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Neural Correlates of Psychosis and Gender Dysphoria in an Adult Male

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Abstract

Gender dysphoria (GD) (DSM-5) or transsexualism (ICD-10) refers to the marked incongruity between the experience of one’s gender and the sex at birth. In this case report, we describe the use of LSD as a triggering factor of confusion in the gender identity of a 39-year-old male patient, with symptoms of psychosis and 25 years of substance abuse, who sought psychiatric care with the desire to undergo sex reassignment surgery. The symptoms of GD/psychosis were resolved by two therapeutic measures: withdrawal of psychoactive substances and use of a low-dose antipsychotic. We discuss the hypothesis that the superior parietal cortical area may be an important locus for body image and that symptoms of GD may be related to variations underlying this brain region. Finally, this case report shows that some presentations of GD can be created by life experience in individuals who have underlying mental or, synonymously, neurophysiological abnormalities.

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Authors and Affiliations

  1. Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil

    Karine Schwarz, Andressa Mueller, Bianca Soll, Maiko Abel Schneider & Maria Inês Rodrigues Lobato

  2. Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Karine Schwarz, Anna Martha Vaitses Fontanari, Andressa Mueller, Bianca Soll, Dhiordan Cardoso da Silva, Jaqueline Salvador, Maiko Abel Schneider & Maria Inês Rodrigues Lobato

  3. Gender Identity Clinic, Child, Youth, and Family Services, Centre for Addiction and Mental Health, Toronto, ON, Canada

    Kenneth J. Zucker

Authors
  1. Karine Schwarz
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  2. Anna Martha Vaitses Fontanari
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  3. Andressa Mueller
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  4. Bianca Soll
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  5. Dhiordan Cardoso da Silva
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  6. Jaqueline Salvador
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  7. Kenneth J. Zucker
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  8. Maiko Abel Schneider
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  9. Maria Inês Rodrigues Lobato
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Corresponding author

Correspondence to Karine Schwarz.

Additional information

Dr. Stephen B. Levine served as the Action Editor for this article.

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Schwarz, K., Fontanari, A.M.V., Mueller, A. et al. Neural Correlates of Psychosis and Gender Dysphoria in an Adult Male. Arch Sex Behav 45, 761–765 (2016). https://doi.org/10.1007/s10508-015-0660-8

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  • DOI: https://doi.org/10.1007/s10508-015-0660-8

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