title: Neural Correlates of Psychosis and Gender Dysphoria in an Adult Male.
abstract: Gender dysphoria (GD) (DSM-5) or transsexualism (ICD-10) refers to the marked incongruity between the experience of one's gender and the sex at birth. In this case report, we describe the use of LSD as a triggering factor of confusion in the gender identity of a 39-year-old male patient, with symptoms of psychosis and 25 years of substance abuse, who sought psychiatric care with the desire to undergo sex reassignment surgery. The symptoms of GD/psychosis were resolved by two therapeutic measures: withdrawal of psychoactive substances and use of a low-dose antipsychotic. We discuss the hypothesis that the superior parietal cortical area may be an important locus for body image and that symptoms of GD may be related to variations underlying this brain region. Finally, this case report shows that some presentations of GD can be created by life experience in individuals who have underlying mental or, synonymously, neurophysiological abnormalities.
authors.affiliation: Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil. kschwarz@hcpa.edu.br.|Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil. kschwarz@hcpa.edu.br.
authors.forename: Karine
authors.identifier: http://orcid.org/0000-0002-9249-7901
authors.initials: K
authors.lastname: Schwarz
authors.affiliation: Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Anna Martha Vaitses
authors.initials: AM
authors.lastname: Fontanari
authors.affiliation: Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil.|Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Andressa
authors.initials: A
authors.lastname: Mueller
authors.affiliation: Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil.|Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Bianca
authors.initials: B
authors.lastname: Soll
authors.affiliation: Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Dhiordan Cardoso
authors.initials: DC
authors.lastname: da Silva
authors.affiliation: Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Jaqueline
authors.initials: J
authors.lastname: Salvador
authors.affiliation: Gender Identity Clinic, Child, Youth, and Family Services, Centre for Addiction and Mental Health, Toronto, ON, Canada.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Zucker
authors.affiliation: Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil.|Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Maiko Abel
authors.initials: MA
authors.lastname: Schneider
authors.affiliation: Graduate Program in Medical Sciences: Psychiatry, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2400, Porto Alegre, RS, 90035-003, Brazil.|Gender Identity Disorder Program, Hospital de Clinicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors.forename: Maria Inês Rodrigues
authors.initials: MI
authors.lastname: Lobato
mesh_terms: D000328:Adult; D001828:Body Image; D000068116:Gender Dysphoria / Q000150:complications / Q000523:psychology*; D005783:Gender Identity; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D057830:Gender-Affirming Surgery / Q000523:psychology; D014189:Transsexualism / Q000150:complications / Q000523:psychology*
keywords: DSM-5; Gender identity; Lysergic acid diethylamide; Parietal lobe; Psychotic disorders; Transsexualism