Pseudotranssexualism: iatrogenic gender dysphoria

Individuals who wish sexual reassignment can be classified according to clinical entities. It is essential to recognize which clinical entities promote gender dysphoria. A complication arising in the intensive psychotherapy of a woman unhappy with her biologic sex is presented. A 32-year-old homosexual woman entered treatment with a female therapist for depression. Despite occasional fantasies of impregnating her therapist, the patient at first demonstrated no gender dysphoria. When her therapist actually did become pregnant, however, the patient began consciously to wish that she herself were male and stigmatized her homosexuality. During a two-week separation in treatment, the patient actively sought sexual reassignment. The role of eroticized transference is discussed to explain the emergency of gender dysphoria.