Brown G R
Department of Psychiatry, University of Texas Health Science Center, San Antonio.
J Clin Psychiatry. 1990 Feb;51(2):57-64.
Gender dysphoric patients are not infrequently encountered in the clinical practice of psychiatry. A comprehensive review of the world literature reveals that the systematic study of severe gender disorders--as exemplified by transsexualism--is relatively new, consisting of just over 25 years of collective experience. While the formal diagnosis of transsexualism is rare, this disorder represents the most severe form of the gender dysphoric conditions. Many nontranssexual patients with a variety of other psychiatric disorders present to psychiatrists desperately requesting somatic treatments (cross-gender hormones, sex reassignment surgery, and other cosmetic surgical procedures). A lengthy differential diagnosis needs to be considered, and a specialized approach to interviewing gender dysphoric patients is highly recommended. Available treatments and their efficacy are discussed. Large prospective controlled studies of treatments for gender dysphoria, such as sex reassignment surgery and psychotherapy, are lacking. Countertransference issues are noted to be particularly relevant in the care of gender dysphoric individuals.
在精神病学临床实践中，经常会遇到性别焦虑症患者。对世界文献的全面回顾表明，对严重性别障碍（如易性癖）的系统研究相对较新，仅有25年多的集体经验。虽然易性癖的正式诊断很少见，但这种障碍代表了性别焦虑症最严重的形式。许多患有各种其他精神疾病的非易性癖患者会向精神科医生绝望地寻求躯体治疗（跨性别激素、性别重置手术和其他整容手术）。需要考虑进行冗长的鉴别诊断，强烈建议采用专门的方法来访谈性别焦虑症患者。文中讨论了现有的治疗方法及其疗效。缺乏对性别焦虑症治疗（如性别重置手术和心理治疗）的大型前瞻性对照研究。反移情问题在性别焦虑症患者的护理中被认为尤为重要。
