Psychosis After Fsh and Lh Stimulation for Ovocytes Preservation in Gender Dysphoria – a Case Report

Introduction Gender dysphoria is a new diagnostic class in DSM-5 that reflects a new conceptualization of the disorder emphasizing the phenomenon of 'gender incongruence”. It refers to the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender. Hormone and/or surgery are treatment options available. There is some clinical evidence that patients under gonadotropin-releasing hormone (GnRH) agonists may develop symptoms consistent with various psychiatric disorders with and without psychotic features. Objectives and Aims To review new DSM-5 conceptualization of gender dysphoria and psychiatric side-effects of ovocyte stimulation drugs. Also to report one selected clinical case of psychosis after FSH and LH stimulation in a patient under female to male sex reassignment process. Methods The authors have conducted an online search on PubMed on psychosis after ovocytes stimulation and gender dysphoria and systematically reviewed a case report. Results There is little evidence of psychiatric side-effects of GnRH agonist. Case report: 22 years old male with diagnosis of gender dysphoria under female to male sex reassignment process with FSH and LH stimulation to ovocyte preservation that acutely developed psychiatry symptoms of bizarre behaviour, irritability, flight of ideas, soliloquies and erotomaniac delusions that remit on antipsychotic drugs. Conclusions Gender dysphoria is a new diagnostic class in DSM-5. There are multiple hormone and/or surgery treatments options. There is little evidence hormone treatments are associated with psychiatric side-effects, namely psychosis. To conduct a well-designed clinical trial on psychiatric symptoms related with hormone treatment in gender dysphoria patients is needed.