Transvestic Disorder

Desires

Step 1: View clinicals

A 16 year old boy complains of experiencing recurrent desires to wear his mother's clothing, for the last 2 years. These desires were accompanied by sexual feelings, which would not subside until he wore her clothes and masturbated. He finds this behavior disturbing, and says that it has significantly interfered with his studies and social functioning. He denies wanting to become female, or to be treated as a woman. His medical and family histories are unremarkable. He does not use recreational drugs.


Step 2: Order all relevant investigations

CT Brain

The CT scan of the brain is completely normal.

EEG

The EEG appears completely normal.

Hormonal Profile

Total Testosterone, free Testosterone, T3, T4, TSH, FSH, LH, and Prolactin are all within normal parameters.

Urine Drug Screen

The urine drug screen is negative.


Step 3: Select appropriate management

Fluoxetine
Psychosurgery
Cognitive Behavioral Therapy
LHRH agonists


Score: ★★☆