Transexualidades de hombre a mujer / Transsexualité d’homme à femme / Male to female transsexualities

El propósito de este trabajo es intentar comprender más profundamente cómo se llega a la transexualidad de hombre a mujer. Presenta una discusión psicoanalítica sobre un estudio controlado de dos grupos: uno de 25 transexuales de hombre a mujer y el otro, de 25 controles, con sexo masculino e identidad de género masculina. Se estudian variables relacionadas con las representaciones de sus familias de la primera infancia. En la muestra de transexuales, la figura paterna se percibe como más negligente, las madres y los padres como más sobreprotectores e intrusivos, y los sujetos se ubican más cerca de sus madres y lejos de sus padres que en la muestra de los controles. Un tercio de la muestra de transexuales han recibido tamiento hormonal y cirugía completa de reasignación y aproximadamente un tercio presenta pechos femeninos, pero mantiene los genitales masculinos. Los resultados del estudio se discuten utilizando la teoría freudiana de las identificaciones: identificación primaria, narcisista e histérica. Dichos procesos de identificación se proponen como posibles vías para el establecimiento de una identidad de género divergente del sexo biológico. (AU)

The purpose of this work is to more deeply understand how male to female transsexualism occurs. It presents a psychoanalytic discussion on a controlled study of two sample groups, one of 25 adult male to female transsexuals and cohort control of 25 people of male sex and male gender identity. The variables related to these people’s representations of their early childhood families are studied. In the transsexual sample, the father figure is perceived as more negligent, the mothers and fathers as overprotective and intrusive, and the people remember being much closer to their mothers. One third of the transsexual sample has undergone total reassignment and approximately one third present female breasts but maintain male genitals. The results of the study are discussed using Freudian identification theory: primary, narcissistic, and hysterical identification. Said identification processes are proposed as channels of influence for the establishment of gender identity separate from biological factors. (AU)

Le propos de ce travail est d’essayer de comprendre plus profondément comment on arrive à la transsexualité d’homme à femme. Il présente une discussion psychanalytique sur une étude contrôlée de deux groupes : un de 15 transsexuels d’homme à femme et un autre, de 25 contrôles, de sexe masculin et identité de genre masculin. L’on étudie des variables aux représentations de leurs familles de la petite enfance. Dans l´échantillon des transsexuels, la figure paternelle est perçue comme plus négligente, les mères et les pères sont plus surprotecteurs et intrusifs, et les sujets se situent plus près de leurs mères et plus loin de leurs pères que dans l´échantillon de contrôle. Un tiers de l´échantillon de transsexuels a reçu un traitement hormonal et une chirurgie complète de réaffectation et environ un tiers présente des seins féminins, mais maintiennent les génitaux masculins. Les résultats de l’étude sont discutés en utilisant la théorie freudienne des identifications : identification primaire, narcissique et hystérique. Ces processus d’identification sont proposés comme des chemins possibles pour l’établissement d’une identité de genre divergeant du sexe biologique. (AU)

[Psychogenic non-epileptic seizures in an epilepsy surgery unit]. / Crisis no epilépticas de origen psicógeno en una unidad de cirugía de la epilepsia.

INTRODUCTION: The psychogenic non-epileptic seizures (PNES) represent a significant percentage of patients in different units of epilepsy surgery. AIMS. To analyze the characteristics of patients with PNES and compared with epileptic patients, to analyze the early response to the application of placebo and to discuss the multidisciplinary approach to these patients. PATIENTS AND METHODS: 408 patients, candidates for epilepsy surgery in the last nine years, were retrospectively evaluated. All patients were studied with scalp electroencephalography, magnetic resonance imaging, interictal single photon emission computed tomography and video-EEG. RESULTS: Patients were ascribed to the following diagnostic groups: epileptics (90.2%), patients with PNES and/or without seizures or signs of epilepsy (6.4%) and patients for whom no seizures were recorded, but showed signs of epilepsy (3.4%). There were no differences between patients with PNES and epileptic respect to age, average frequency, distribution of seizures or drug treatment, but the time of onset was earlier in PNES. Patients with PNES (n = 15) revealed the presence of epilepsy or irritative manifestations in 10 cases. Most (n = 13) were women and only five had a history of mild psychiatric disorders that were not present in the group of patients exclusively with PNES. In four cases was carried out an induction with placebo, which was positive. CONCLUSION: A multidisciplinary approach is required for the proper evaluation and treatment of patients with PNES.