Behavioral treatment of transsexualism: a case report.

Patients who believe themselves to be transsexual seek only confirmation of their diagnosis so that they may proceed with their pre-chosen course of management: hormones and surgery. Their syntonic emotional set generates resistance to any other therapeutic direction. Despite this attitude, it is the therapist's responsibility to assess each case individually and to decide, with the patient, on realistic goals even if they be different from the original one. This case emphasizes this need since a probing history revealed underlying conflict and anxiety related to severe homophobia. With revelation of the homophobia, various behavioral techniques could be used therapeutically. These resulted in acceptance of lesbianism as a life style. Careful assessment of patients with self-diagnoses of transsexualism can sometimes uncover a different etiology to which appropriate therapy can be applied.