Despite its brightness and demonstrativeness, manifestations of transsexualism are rather difficult to be diagnosed differentially with clinically similar conditions, such as:
● Transvestism – the desire to dress and wear the opposite sex. With transvestism, in contrast to transsexualism, there is no violation of sexual autoidentification;
● homosexuality – sexual attraction to people of your gender. In transsexualism, attraction to people with identical sexual self-consciousness, that is, aware of their belonging to the same sex, is considered homosexual. There are situations when homosexuals want to change the gender in order to strengthen communication with a partner. In these cases, careful differential diagnosis is necessary, since if an operation is performed, further disappointment occurs, since the operated homosexual ceases to interest his sexual partners;
● similar conditions associated with endogenous psychosis or organic brain damage;
● similar clinical manifestations that can be observed in schizophrenia.
To exclude transsexualism, first of all, there is no violation of sexual identity, the correct formation of a sexual role (preference in childhood games and peers of one’s own sex, normal sexual contact with the opposite sex).
The most unfavorable prognosis is when a transsexual with an active desire to change sex does not find such an opportunity, and the disharmony between the passport floor and sexual identity is not allowed. According to G. S. Vasilchenko (1983), protracted depressive states and suicidal thoughts in such cases occur in 60% of transgender males and 23% of transgender females, and suicidal attempts occur in 20 and 8% of cases, respectively.
After a surgical sex change, transsexuals quickly adapt to life. According to our data and a number of authors, many of them marry, and patients with male transsexualism often adopt children.
Further study of the etiology, pathogenesis and manifestations of transsexualism, as well as a deep understanding by doctors, especially endocrinologists, psychiatrists and therapists, of this disease will make it possible to make the diagnosis earlier and, therefore, quickly remove patients from chronic stress and prescribe hormonal treatment, side effects which increase with increasing age of treatment.