Gender Dysphoria & Dissociative Identity Disorder in Autism Spectrum Disorder

This patient is a 17 year old Caucasian transgender male (FTM) with autism spectrum disorder (ASD level 1), gender dysphoria (GD), and dissociative identity disorder (DID). The patient has multiple psychiatric comorbidities including obsessive-compulsive disorder (OCD), generalized anxiety disorder (GAD), attention-deficit hyperactivity disorder (ADHD), emotional dysregulation, trauma and stressor disorder, and insomnia. Medical comorbidities include 16p13.3 and 16p24.3 microdeletions, hypotonia, bilateral cataracts (surgically corrected), and minimal change disease. To our knowledge, this is the first case report in which the patient is suffering from ASD, GD, and DID as comorbid diagnoses. Our review of this patient serves to highlight the complexity of providing care to patients with a comorbidity of ASD, GD, and DID, as well as the complexity in distinguishing these conditions from one another.