Gender dysphoria and pregnancy 

Gender dysphoria (DSM V) designates a feeling of dissonance between gender identity and gender assigned at birth, ranging from transient distress to more stable forms that may eventually lead to the seeking of gender affirming... [ view full abstract ]

Gender dysphoria (DSM V) designates a feeling of dissonance between gender identity and gender assigned at birth, ranging from transient distress to more stable forms that may eventually lead to the seeking of gender affirming surgery. The intensity of gender dysphoria may vary as a function of life events. Among those, the project of childbearing (conception, pregnancy and, in term, birth giving) signifies a time of adjustment in perceived identity in general, as well as in gender roles. These events can also prove to be moments of vulnerability, exacerbating depressive or anxiety symptoms, body image issues or eating disorders, but also generate gender identity oscillation or distress. However, to our knowledge, the fluctuations in gender identity during conception, pregnancy and childbirth have not been sufficiently documented.

We present the case of a reactivation of gender dysphoria in a 37 year-old female-to- male patient fostering a project for a second child and having already presented acute gender dysphoria during a first pregnancy, three... [ view full abstract ]

We present the case of a reactivation of gender dysphoria in a 37 year-old female-to- male patient fostering a project for a second child and having already presented acute gender dysphoria during a first pregnancy, three years before. Painful gender identity concerns had appeared abruptly during that first pregnancy, accompanied by severe depression. Pregnancy came to term with gynaeco-obstetrical, psychiatric and family support. Gender dysphoria receded gradually in the months following childbirth, but was re- actualised in the context of a second parental project, leading to the formulation of a wish to undergo sex affirming surgery. At the time of consultation in our gender identity service, clinical features included acute anxiety and depression symptoms, as well as marked ambivalence towards the transition project, viewed by the patient as a very stressful option but also as an inevitable means of relieving gender distress. Moments of impression of physical transformation from female to male, as well as depersonalisation with a feeling of disappearance of gender identity altogether and non-recognition of the self in the mirror were reported in the patient’s history; however, those symptoms did not present with the same intensity in the current context.

Clinical case description, combining psychiatric consultations and psychological testing. [ view full abstract ]

Clinical case description, combining psychiatric consultations and psychological testing.

Clinical case description [ view full abstract ]

Clinical case description

Regular consultations in a setting specialising in gender identity and gender dysphoria issues, in synergy with the patient’s referring psychiatrist and psychotherapist, allowed for a stabilisation of the anxiety and... [ view full abstract ]

Regular consultations in a setting specialising in gender identity and gender dysphoria issues, in synergy with the patient’s referring psychiatrist and psychotherapist, allowed for a stabilisation of the anxiety and depression symptoms; the patient’s gender non- conformity persists to this day.

The diagnostic and therapeutic considerations raised by this observation allow us to discuss the relatively understudied aspect of gender identity fluctuation following a project to have a child and pregnancy. In a broader... [ view full abstract ]

The diagnostic and therapeutic considerations raised by this observation allow us to discuss the relatively understudied aspect of gender identity fluctuation following a project to have a child and pregnancy. In a broader perspective, these issues are discussed as they put forth a specific aspect of gender identity: parenthood, filiation, and transmission as a gendered parent.