Abstract
An unexpected complication of sex-reassignment surgery in a 23-year-old male-to-female transsexual is presented. Having been periodically depressed but never psychotic before surgery, the patient experienced an acute decompensation 3 days after operation. Symptoms of this time-limited illness included hallucinations and wish-fulfilling delusions, but most prominent was the demand to be in continuous contact with other people. Historical data revealed a symbiotic relationship with the grandmother ending precipitously with her death when the patient was 6. It is hypothesized that the unresolved grief reappeared after the surgery, owing to the unconscious linkage between becoming “female” and regaining the lost symbiotic object. Recompensation, possibly through the use of another person as a transitional object, was noted during the illness. This was felt to be a repetition of the pattern of reaction to previous losses.
Similar content being viewed by others
References
Benjamin, H. (1964). Nature and management of transsexualism.West. J. Surg. 72: 105–111.
Fraser, A. (1963). A relationship between transitional objects and preconscious mental process.Mod. Perspect. Child Dev., pp. 144–161.
Green, R., and Money, J. (1969).Transsexualism and Sex Reassignment Johns Hopkins Press, Baltimore, pp. 360–375.
Kubie, L. (1974). The drive to become both sexes.Psychoanal. Quart. June, 349–426.
Mahler, M. S. (1961). On sadness and grief in infancy and childhood.Psychoanal. Stud. Child 16: 332–351.
Money, J. (1971). Prefatory remarks on outcome of sex reassignment in 24 cases of transsexualism.Arch. Sex. Behav. 1: 163–165.
Ovesey, L., and Pearson, E. (1975). Presentation to AMA Convention, Atlantic City, N.J.
Rochlin, J. (1959). The loss complex.J. Am. Psychoanal. Assoc. 7: 300–315.
Stoller, R. J. (1968).Sex and Gender Science House, New York.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Childs, A. Acute symbiotic psychosis in a postoperative transsexual. Arch Sex Behav 6, 37–44 (1977). https://doi.org/10.1007/BF01579246
Issue Date:
DOI: https://doi.org/10.1007/BF01579246