Need for a Multidisciplinary Approach in Transsexuality

ABSTRACT

Objective: Literature review of the relationship between testosterone and suicidal behavior, emphasizing the relevance of a multidisciplinary approach in transsexuality. 

Clinical case: 33-year-old male (biological woman), with a psychiatric history of admission in 2010 diagnosed with Depressive Disorder NOS and Personality disorder NOS. Subsequently, irregular follow-up in psychiatric consultations until voluntary discontinuation. In 2019, new consultation for assessment of gender dysphoria. He refers not to feel identified with his body and to feel rejection towards his sexual characteristics. After diagnostic confirmation, an Endocrinology consultation was requested, prescribing testosterone. Four days after starting crossover hormonal treatment, the patient commited a suicide attempt. There were no previous suicide attempts or suicidal ideation.

Conclusions and discussion: The literature describes the effect of testosterone on aggressiveness, dominance, impulsivity and libido, as well as, it suggests an association between testosterone and suicidal behavior. This fact supports the need for a multidisciplinary follow-up of the transsexual process, being the approach by Mental Health professionals essential.