Saldanha P H, Olazábal L C
Arq Neuropsiquiatr. 1976 Sep;34(3):251-7. doi: 10.1590/s0004-282x1976000300005.
By reviewing the syndromic manifestation, transsexualism in characterized as a psychiatric entity, apart from homossexualism and transvestism. The two main feasible etiologic causes of transsexualism are discussed: the psychoanalytical hypothesis based upon psycossexual regression with imprinting of maternal figure and the neuroendocrine model which assumes alterations of the gender role identity centers in the hypothalamus. On the grounds of the latter explanation and after the scheme that seems to occure in the Morris syndrome whose cells (XY) do not respond to the masculinizing effect of plasma testosterone, it is proposed that transsexuals should possess detectable or cryptic sex-chromosome mosaicism affecting hypothalamic centers of gender role identity which do not respond to the androgenic secretion produced by primitive gonad. This possibliity explains the excessive prevalence of the syndrome among men, its typical features in the male as well as its sporadic occurrence. Cytogenetic investigation reveals that the frequency (32%) of sex-chromosome mosaicism among 25 transsexuals and 40 normal control people, both groups presenting the proportion of the mosaicism practically null. The karyotypic criterion as a valuable aid in the syndrome diagnosis is considered.
通过回顾症状表现,易性癖被界定为一种精神疾病实体,有别于同性恋和异装癖。文中讨论了易性癖两个主要的可能病因:基于心理性性退化及对母亲形象印记的精神分析假说,以及假定下丘脑性别角色认同中枢发生改变的神经内分泌模型。基于后一种解释,并参照莫里斯综合征(其细胞为XY型,对血浆睾酮的男性化作用无反应)中似乎出现的情况,有人提出,易性癖者应具有可检测到的或隐匿的性染色体嵌合现象,影响下丘脑性别角色认同中枢,使其对原始性腺产生的雄激素分泌无反应。这种可能性解释了该综合征在男性中患病率过高的现象、其在男性中的典型特征以及其散发性。细胞遗传学研究表明,在25名易性癖者和40名正常对照人群中,性染色体嵌合现象的频率为32%,两组中嵌合现象的比例实际上都为零。核型标准被认为是该综合征诊断的一项有价值的辅助手段。