Intérêt des tests de personnalité dans le diagnostic différentiel du transsexualisme M-F et du transvestisme bivalent

Abstract

Background – An increasing number of patients are seeking a sex-reassignment that is only approved in cases of primary transsexualism. The main difficulty is to differentiate primary M-F transsexualism (M-Fs) from some forms of transvestic fetishism. From a theoretical point of view, transvestic fetishism occurs in bisexual or heterosexual men who cross-dress for the purpose of sexual excitement, whereas M-Fs refers to an early and persistent cross-gender identification. A history of transient transvestic fetishism is often reported in the childhood of M-Fs and the percentage of transsexually inclined transvestites asking for hormonal and surgical reassignement is increasing. Objective – To improve the therapeutic decisions by evaluating the gender identification with two psychometric variables: Masculinity/Feminity (M/F) score on the MMPI and card III of the Rorschach. Methods – M-Fs ( n = 28) and transvestites ( n = 15) were individually administered the MMPI and the Rorschach test and were compared to each other and to a male control group ( n = 10). Results – Regarding frequency of cross-gender responses on card III, M-Fs and transvestites were indistinguishable and differed from the male controls. When the M/F score was calculated by genetic sex, M-Fs and transvestites scored higher than the mean and differed from the male controls. When calculated by desired sex, M-Fs scored within the norms, like female controls, whereas transvestites scores remained pathological. Discussion – When using Rorschach card III, the gender identification of transvestites was virtually indistinguishable from that of M-Fs. However, the M/F score on the MMPI could be a more useful indication to discriminate between these two groups.