Archives of Sexual Behavior

, Volume 26, Issue 1, pp 13–26 | Cite as

Comorbidity of Gender Dysphoria and Other Major Psychiatric Diagnoses

  • Collier M. Cole
  • Michael O'Boyle
  • Lee E. Emory
  • Walter J. Meyer III

Abstract

Previous studies suggest that many transsexuals evidence an Axis I diagnosis according to the DSM-IV classification (e.g., psychoses, major affective disorder). The current study examined retrospectively the comorbidity between gender dysphoria and major psychopathology, evaluating the charts of 435 gender dysphoric individuals (318 male and 117 female). AH had undergone an extensive evaluation, addressing such areas as hormonal/surgical treatment, and histories of substance abuse, mental illness, genital mutilation, and suicide attempts. In addition, a subgroup of 137 individuals completed the MMPI. Findings revealed over two thirds were undergoing hormone reassignment, suggesting a commitment to the real-life cross-gender process. One quarter had had problems with substance abuse prior to entering treatment, but less than 10% evidenced problems associated with mental illness, genital mutilation, or suicide attempts. Those completing the MMPI (93 female and 44 male) demonstrated profiles that were notably free of psychopathology (e.g., Axis I or Axis II criteria). The one scale where significant differences were observed was the Mf scale, and this held true only for the male-to-female group. Psychological profiles as measured by the MMPI were more “normal” in the desired sex than the anatomic sex. Results support the view that transsexualism is usually an isolated diagnosis and not part of any general psychopathological disorder.

gender dysphoria transsexualism MMPI comorbidity of psychiatric disorders 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

REFERENCES

  1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed., American Psychiatric Association, Washington, DC.Google Scholar
  2. Benjamin, H. (1966). The Transsexual Phenomenon, Julian Press, New York.Google Scholar
  3. Buhrich, N., and McConaghy, N. (1978). Parental relationships during childhood in homosexuality, transvestism, and transsexualism. Aust. N. Z. J. Psychiat. 12: 103–108.Google Scholar
  4. Cauldwell, D. (1949). Psychopathia transsexualis. Sexology 16: 274–280.Google Scholar
  5. Cole, C. M., Emory, L. E., Huang, T., and Meyer, W. J. (1994). Treatment of gender dysphoria (transsexualism). Tex. Med. 90: 68–72.Google Scholar
  6. Finney, J., Brandsma, J., Tondow, M., and Lemaistre, G. (1975). A study of transsexuals seeking gender reassignment. Am. J. Psychiat. 132: 962–964.Google Scholar
  7. Fleming, M., Cohen, D., Salt, P., Jones, D., and Jenkins, S. (1981). A study of pre-and post-surgical transsexuals' MMPI characteristics. Arch. Sex. Behav. 10: 161–170.Google Scholar
  8. Green, R., and Money, J. (1969). Transsexualism and Sex Reassignment, Johns Hopkins Press, Baltimore, MD.Google Scholar
  9. Halle, E., Schmidt, C., and Meyer, J. (1980). The role of grandmothers in transsexualism. Am. J. Psychiat. 137: 497–498.Google Scholar
  10. Hirschfeld, M. (1945). Sexual Pathology, Emerson Books, New York.Google Scholar
  11. Krafft-Ebing, R. von. (1894). Psychopathia Sexualis (Trans. by F. Graz in 1939), Pioneer Publications, New York.Google Scholar
  12. Lloyd, C., Overball, J., Kimsey, L., and Click, M. (1983). A comparison of the MMPI-168 profiles of borderline and non-borderline patients. J. Nerv. Ment. Dis. 171: 207–215.Google Scholar
  13. Lothstein, L. (1979a). Psychodynamics and sociodynamics of gender dysphoric states. Am. J. Psychother. 33: 214–238.Google Scholar
  14. Lothstein, L. (1979b). The aging gender dysphoria (transsexual) patient. Arch. Sex. Behav. 8: 431–434.Google Scholar
  15. Lothstein, L. (1983). Female-to-Male Transsexualism: Historical, Clinical and Theoretical Issues. Routledge and Kegan Paul, Boston.Google Scholar
  16. Lundstrom, B., Pauly, I., and Walinder, J. (1984). Outcome of sex reassignment surgery. Acta Psychiat. Scand. 70: 289–294.Google Scholar
  17. Meyers, J. K., and Bean, L. L. (1964). A Decade Later: A Follow-Up of Social Class and Mental Illness, Wiley, New York.Google Scholar
  18. Morgan, A. (1978). Psychotherapy for transsexual candidates screened out of surgery, Arch. Sex. Behav. 7: 273–283.Google Scholar
  19. Ovesey, L., and Person, E. (1973). Gender identity and sexual psychopathology in men: A psychodynamic analysis of homosexuality, transsexualism, and transvestism. J. Am. Acad. Psychoanal. 1: 54–59.Google Scholar
  20. Pauly, I. (1990). Gender identity disorders: Evaluation and treatment. J. Sex Educ. Ther. 16: 2–24.Google Scholar
  21. Roback, N., McKee, E., Webb, W., Abramowitz, C., and Abramowitz, S. (1976). Psychopathology in female sex-change applicants and two help-seeking controls. J. Abn. Psychol. 85: 430–432.Google Scholar
  22. Robins, L. N., Helzer, J. E., Weissman, M. M., Orvaschel, H., Gruenberg, E., Burke, Jr., J. D., and Regier, D. A. (1984). Lifetime prevalence of specific psychiatric disorders in three sites. Arch. Gen. Psychiat, 41: 949–958.Google Scholar
  23. Rosen, A. (1974). Brief report of MMPI characteristics of sexual deviation. Psychol. Rep. 35: 73–74.Google Scholar
  24. Stoller, R. (1968). Sex and Gender: On the Development of Masculinity and Femininity, Science House, New York.Google Scholar
  25. Stoller, R. (1975). The Transsexual Experiment, Hogarth, London.Google Scholar
  26. Walker, P., Berger, J., Green, R., Laub, D., Reynolds, C., and Wollman, L. (1985). Standards of Care: The hormonal and surgical sex reassignment of gender dysphoric persons. Arch. Sex. Behav. 14: 79–90.Google Scholar
  27. Weissman, M. M., Bruce, M. L., Leaf, P. J., Florio, L. P., and Holzer III, C. (1991). Affective Disorders. In Robins, L. N., and Regier, D. A. (eds.), Psychiatric Disorders in America: The Epidemiologic Catchment Area Study, Free Press, New York, pp. 53–80.Google Scholar
  28. Weissman, M. M., and Myers, P. S. (1978). Psychiatric disorders in U.S. urban populations. Am. J. Psychiat. 135: 459–465.Google Scholar

Copyright information

© Plenum Publishing Corporation 1997

Authors and Affiliations

  • Collier M. Cole
    • 1
    • 2
  • Michael O'Boyle
    • 1
  • Lee E. Emory
    • 1
    • 2
  • Walter J. Meyer III
    • 1
  1. 1.Department of Psychiatry and Behavioral SciencesUniversity of Texas Medical BranchGalveston
  2. 2.Rosenberg ClinicGalveston

Personalised recommendations