Travestismo de duplo papel ou bivalente: considerações gerais / Dual role transvestism or bivalent: general considerations

A Classificação Internacional de Doenças, 10a edição (CID-10), inclui, na seção Transtornos de Identidade Sexual, o transexualismo, o travestismo de duplo papel ou bivalente e o transtorno de identidade sexual na infância. Este artigo se pauta na apresentação daqueles que se percebem ambivalentes quanto ao gênero (masculino ou feminino), os quais podem ou não vestir e utilizar adornos do sexo oposto e/ou fazer uso de próteses e hormônios, mas não têm desejo de se submeter à cirurgia de redesignação sexual. Essa condição se aproxima do travestismo de duplo papel ou bivalente pela CID-10. Não há excitação sexual nessa experiência.A origem dos transtornos de identidade sexual bivalente permanece pouco esclarecida.Consumo abusivo de álcool e drogas e maior exposição a situações de risco para doenças sexualmente transmissíveis (DST) são mais elevados na população com transtorno de identidade sexual (entre eles os bivalentes), quando comparada à população geral. A frequência de comorbidades psiquiátricas e, entre elas, a ideação suicida, é alta nessa população.Um número expressivo de artigos se volta para a questão das políticas públicas para a população de transgêneros. Embora partam de investigações sobre aspectos clínicos, o maior interesse parece ser a vulnerabilidade psicossocial desses indivíduos e a importância da implementação de intervenções voltadas para as reais necessidades deles. Apontam, tais artigos, para a fragilidade e a escassez dessas políticas e para o compromisso ético com a diversidade sexual.

Treatment of a transvestic fetishist with cognitive-behavioral therapy and supportive psychotherapy: case report.

Transvestic fetishism is a paraphilia marked by recurrent, intense sexually arousing fantasies, sexual urges, or behavior involving cross-dressing, in a heterosexual male. There are many explanations of the pathogenesis, but none are conclusive. Different treatments have been applied, but they generally remain obscure and disappointing. Transvestic fetishists rarely seek psychotherapy, because of their dynamic balance between perversion and intrapsychic disintegration. There are few studies, either qualitative or quantitative, associated with transvestic fetishism in Taiwan. This case report describes an adolescent transvestic fetishist who underwent a brief course of psychotherapy in the outpatient department of a psychiatric center in Taipei. After consultation for one year, he still maintained his deviant sexual behavior but also developed more severe moral anxiety. He was then referred for psychotherapy. Cognitive-behavioral and psychodynamic theories associated with transvestic fetishism were reviewed and applied in both understanding and treating this client. Some temporal effectiveness was achieved with combined cognitive-behavioral and dynamic-oriented supportive psychotherapy. After 18 sessions of psychotherapy over more than 4 months, the client was able to stop his perverse behavior and have fewer sexually arousing fantasies. The prognosis of transvestic fetishism is generally supposed to be pessimistic and have a high rate of recurrence. Some propose that adolescents have a better outcome after treatment. This case report reveals the possibility of change for a transvestic fetishist. However, the long-term effects of the brief course of psychotherapy require further evaluation in the future.

The childhood and family dynamics of transvestites.

This article reports a survey of childhood experiences and family dynamics reported by a sample of 85 cross-dressing males drawn from the readership of a magazine for transvestites. The sample had a higher percentage of only children and eldest children compared to a national sample and also a much closer relationship with their mothers than with their fathers. Their identification as nuclear or marginal transvestites or transsexuals is related to the quality of the reported relationship with the mother, to the factors they identify as associated with their cross-dressing, and to their sexual orientation. Covert cross-dressers account for over three fourths of the subjects, but those who were overt (their cross-dressing openly encouraged by female family members) show significantly different patterns and distributions on several variables. A constellation of family and parental relationships is proposed--drawn in part from the insights of object relations and family systems theory--which may contribute to the development of transvestism.

Clinical observations and systematic studies of autogynephilia.

The term autogynephilia denotes a male's paraphilic tendency to be sexually aroused by the thought or image of himself as a woman. This term subsumes transvestism as well as erotic ideas or situations in which women's garments per se play a small role or none at all. This review article presents clinical examples of the lesser known types of autogynephilia (i.e., those in which the element of cross-dressing is secondary or entirely absent), sketches earlier attempts to label and conceptualize these phenomena, summarizes recent quantitative studies exploring the relationships between autogynephilia and other psychosexual variables (e.g., heterosexual attraction), and speculates on the etiology of autogynephilia and its relationship to transsexualism. It is concluded that the concept of autogynephilia is needed to fill a gap in our current battery of concepts and categories for thinking about gender identity disorders.

The role of perceived relative parent personality in the development of heterosexuals, homosexuals, and transvestites.

This study examines the hypothesis that non-normative parent sex-role qualities contribute to homosexual and transvestite development. Using the Parent Characteristics Questionnaire (PCQ), this hypothesis was tested among samples of male and female heterosexuals, male and female homosexuals, and male transvestites. The PCQ assesses the relative distribution of five personality traits between mother and father: R-F (relative father) intellectuality, R-F dependence, R-F affiliation, R-F endurance, and R-F aggressive-dominance. No significant differences were noted for the male homosexuals, while the hypothesized effects were evident for lesbian women and male transvestites, even when statiscally controlling for age and education differences. Theoretical interpretations of the results are offered in the context of a nonpathological explanation of sexual orientation and preference.

[Cerebral dysfunction and disorders of sexual behaviour (author's transl)]. / Atteinte des fonctions cérébrales et troubles du comportement sexuel.

The effects of epilepsy and focal brain lesions on sexual behaviour are described. Fits may be provoked by hypervenilation in epileptics during sexual activity, but also by orgasm and other sexual stimuli. Epileptic auras consisting of tactile genital sensations and sexual feelings, including orgasm, also occur. Post-ictal sexual automatisms consist of masturbation or other poorly structured activity, imitating the gestures of sexual intercourse. Focal brain lesions most commonly produce a reduction in sexual activity. However, frontal lobe lesions may produce disinhibition with inappropriate sexual behaviour and temporal lobe lesions may be associated with true hypersexuality, transvestite and transsexual behaviour. Eleven cases, which illustrate the various associations, are described.

Transvestism: previous findings and new areas for inquiry.

The transvestite is a heterosexual fetishistic cross-dresser. The phenomenology of the disorder reveals individuals to be heterosexual males who have usually married and fathered children. The course of the disorder is unknown. Many transvestites note genital arousal from cross-dressing abates, yet continue episodically to wear women's clothes. A small segment of these individuals become gender dysphoric and seek sexual reassignment. Etiologic explanations include pregenital psychopathology in the genesis of the condition. The treatment for transvestism remains disappointing although behavior modification may offer individuals who wish to change their transvestitic behavior some hope. This review suggests new areas for inquiry and possible research strategies.