Approccio psicologico al paziente transessuale donna-uomo (D-U) prima e dopo la riassegnazione chirurgica del sesso

Between January 1989 and June 1996 we have performed 17 female-to-male surgical gender re-attributions in transsexual patients aged 28 to 40 yrs. Another five are currently in our waiting list. The patients are followed by a multispecialistic team; they all have pre-operative psychological support and are followed-up for 5 years after surgery. Aims of this study: 1) study of the female-to-male transsexuals' personality; 2) study of their specific traits and of their familial background; 3) evaluation of patients' happiness after surgical gender re-attribution. To obtain their personality profile, we subjected the patients to: a) partially structured interview; b) MMPI; c) Rorschach test; d) Zullinger test. Results: The family history revealed an absent or weak father figure who is often angry and alcoholic; an overwhelming mother figure, who often refuses, belittles and has no empathy for her daughter. While the MMPI does not reveal a personality disorder, both the Rorscahch and Zullinger tests reveal a deeply disturbed self in a borderline personality, markedly narcissistic, with a paucity of objective relationships and a preference for symbiotic relationships. These results lead us to reconsider the choice of the tests to be used in psychometric evaluation. In fact the discordance of results between MMPI, Zullinger and Rorschach tests could mean that the MMPI is not adequate. After surgical gender re-attribution patients are generally happy with results and both their social and sentimental life seem to improve. All patients would choose again to undergo surgery.