Progressive Adult Gender Dysphoric Presentation during Intermittent Psychosis with Schizoaffective Disorder, Bipolar Type: A Case Report
Speaker Credentials
MD
Format
Poster
Start Date
6-11-2020 12:15 PM
End Date
6-11-2020 12:30 PM
Abstract
The patient is a 35 year old natal male identifying as a male to female upon admission, with a past psychiatric history of Schizoaffective Disorder, Bipolar Type, presenting involuntarily to the psychiatric inpatient unit for bizarre behavior and auditory hallucinations for the past three months. The patient has been refusing to eat, is easily agitated, and is exhibiting signs of mania, including decreased sleep and increased promiscuity. The patient reports medication noncompliance for an unknown duration. Upon admission, the patient held a male appearance, but identified as a female, with requests from the staff to refer to “him” as “her.” As per collateral, the patient has had multiple psychotic breaks since the age of 21, with identification as a female and immediate reversal to male identification upon stabilization. With each successive break, the patient’s presentation exhibits extreme progressive nature, commencing with laser body hair removal, then Hormonal Replacement Therapy, then obtaining one of two required letters for sexual reassignment surgery with intentions of both phallectomy and orchiectomy procedures. In this poster, we discuss a clear pattern of progressive gender identity alteration from male to female coinciding solely with psychotic breaks of Schizoaffective Disorder, Bipolar Type. Furthermore, we discuss the significance of a thorough history evaluation, with accurate diagnosis of true Gender Dysphoria vs. a psychosis-induced Gender Dysphoria in order to ensure proper care and management of such cases.
Progressive Adult Gender Dysphoric Presentation during Intermittent Psychosis with Schizoaffective Disorder, Bipolar Type: A Case Report
The patient is a 35 year old natal male identifying as a male to female upon admission, with a past psychiatric history of Schizoaffective Disorder, Bipolar Type, presenting involuntarily to the psychiatric inpatient unit for bizarre behavior and auditory hallucinations for the past three months. The patient has been refusing to eat, is easily agitated, and is exhibiting signs of mania, including decreased sleep and increased promiscuity. The patient reports medication noncompliance for an unknown duration. Upon admission, the patient held a male appearance, but identified as a female, with requests from the staff to refer to “him” as “her.” As per collateral, the patient has had multiple psychotic breaks since the age of 21, with identification as a female and immediate reversal to male identification upon stabilization. With each successive break, the patient’s presentation exhibits extreme progressive nature, commencing with laser body hair removal, then Hormonal Replacement Therapy, then obtaining one of two required letters for sexual reassignment surgery with intentions of both phallectomy and orchiectomy procedures. In this poster, we discuss a clear pattern of progressive gender identity alteration from male to female coinciding solely with psychotic breaks of Schizoaffective Disorder, Bipolar Type. Furthermore, we discuss the significance of a thorough history evaluation, with accurate diagnosis of true Gender Dysphoria vs. a psychosis-induced Gender Dysphoria in order to ensure proper care and management of such cases.