The Contribution of Forensic Psycodiagnostic in Legal Medical Evaluations Regarding the Amendment of Sex Assignment: The Rorschach Test

Abstract

Aim: In previous studies, other authors have proposed the Gender Identity Disorder as a subtype of Borderline Personality Disorder. Our research hypothesis expected that the Primary transsexuals (TSS) group would show statistically significant differences in psychological scoring as compared to the TSP group, especially in the areas of object relations and reality testing. The aim of this study is to evaluate if the clinically observed differences between the TSPs and the TSSs are psychometrically measureable using the Exner CS Rorschach. Materials and methods: 47 subjects with the diagnosis of Gender Identity Disorder were classified as either primary (TSP) or secondary (TSS) transsexuals according to the criteria put forth by H. Benjamin. Results: The results have demonstrated that TSSs appear to be more vulnerable in the area of stress control and showed greater difficulty in adaptation, along with a higher tendency toward disorganization, impulsivity, and behavioral disorders with respect to TSPs. TSSs suffered much more from states of situational and chronic stress with alterations in the stream of voluntary thought. Analysis of the ideational section of the test reveals a higher frequency of thought disorders in the TSS group, in particular, cognitive mismanagement, ideational disorganization, pessimistic thought, and a higher tendency toward aggression. The quality of interpersonal relationships of TSSs is qualitatively lower and less adaptive, and a greater tendency toward establishing relationships connoted by dependence is more evident. Conclusions: It would therefore seem that classification, according to Benjamin’s criteria, could prove useful both in clinical and research settings. Moreover, the Rorschach Test appears to be a valid psychometric instrument in assisting the clinician in the differential diagnosis and evaluation of the suitability of patients for sex reassignment surgery (SRS).