title: Psychopathological profiles in transsexuals and the challenge of their special status among the sexes.
abstract: OBJECTIVE
  Investigating psychopathological profiles of transsexuals raises a very basic methodological question: are control groups, which represent the biological or the phenotypic sex, most suited for an optimal evaluation of psychopathology of transsexuals?
  
  
  METHODS
  Male-to-female (MtF) (n=52) and female-to-male transsexuals (FtM) (n=32), receiving cross-sex hormone treatment, were compared with age matched healthy subjects of the same genetic sex (n=178) and with the same phenotypic sex (n=178) by means of the Symptom Check List-90-Revisited instrument (SCL-90-R). We performed analyses of covariance (ANCOVA) to test for group and sex effects. Furthermore, we used a profile analysis to determine if psychopathological symptom profiles of transsexuals more closely resemble genotypic sex or phenotypic sex controls.
  
  
  RESULTS
  Transsexual patients reported more symptoms of psychopathological distress than did healthy control subjects in all subscales of the SCL-90-R (all p<0.001), regardless of whether they were compared with phenotype or genotype matched controls. Depressive symptoms were more pronounced in MtF than in FtM (SCL-90-R score 0.85 vs. 0.45, p = 0.001). We could demonstrate that FtM primarily reflect the psychopathological profile of biological males rather than that of biological females (r = 0.945), while MtF showed a slightly higher profile similarity with biological females than with biological males (r = 0.698 vs. r = 0.685).
  
  
  CONCLUSIONS
  Our findings suggest that phenotypic sex matched controls are potentially more appropriate for comparison with the psychopathology of transsexual patients than are genetic sex matched controls.
authors.affiliation: Department of Internal Medicine, Endocrinology and Clinical Chemistry, Max Planck Institute of Psychiatry, Munich, Germany.
authors.forename: Matthias K
authors.initials: MK
authors.lastname: Auer
authors.forename: Nina
authors.initials: N
authors.lastname: Höhne
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: Bazarra-Castro
authors.forename: Hildegard
authors.initials: H
authors.lastname: Pfister
authors.forename: Johannes
authors.initials: J
authors.lastname: Fuss
authors.forename: Günter K
authors.initials: GK
authors.lastname: Stalla
authors.forename: Caroline
authors.initials: C
authors.lastname: Sievers
authors.forename: Marcus
authors.initials: M
authors.lastname: Ising
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011599:Psychopathology / Q000379:methods*; D012723:Sex; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*