Male who
maintains a collection of female clothing that he intermittently
utilizes for cross-dressing describes the condition of Transvestic
Fetishism (TF). This occurs in heterosexual males and is not
part of Gender Identity Disorder. These heterosexual males may
have very few sexual partners and have occasional homosexual
relationships. When not cross-dressing, they may behave in stereotypic
male fashion but this behavior may be quite feminine when wearing
women's clothing. The actual wearing of an article, which may
not be visible to the casual onlooker, It may be a means of
reducing anxiety or depression. In in some cases, it may also
give rise to gender dysphoria (discontent with one's own gender).
Thus, the motivation for cross dressing may change over time.
Clinically significant problems in social and occupational roles
are most often the result.
Repeatedly for at
least 6 months, a heterosexual male has intense sexual desires,
fantasies or behavior concerning cross-dressing.
This causes clinically
important distress or impairs work, social or personal functioning.
Specify
if With Gender
Dysphoria. The patient is persistently uncomfortable with
gender identity or role.
Generally
there is a moderate to severe coexisting personality disturbance.
Frequently the person experiences considerable anxiety and
depression, which he or she may attribute to the inability
to live in the role of the desired sex.
Differential Diagnosis
Some disorders
have similar or even the same symptoms. The clinician, therefore,
in his/her diagnostic attempt has to differentiate against the
following disorders which need to be ruled out to establish
a precise diagnosis.
Gender
Identity Disorder Not Otherwise Specified - Those who wish
to belong to the other sex and to be rid of their own genitals.
Transsexualism.
Schizophrenia
Cause:
There
is little understanding of the cause of TF, some therapists have
theorized that, for some reason, a particular item or object,
a pair of gloves, shoes, becomes associated with sexual gratification.
This, for the person forms a permanent mental connection that
may persist for years. Some therapist consider that one of the
causes of this disorder is an avoidance response; or fleeing from
the demands of human intimacy and find it less anxiety-provoking
to engage in their paraphilia.
Treatment:
The
major form of treatment revolves around psychotherapy although
drugs are used in some cases.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Cognitive, behavior, and psychoanalytic therapies are used to
treat individuals with paraphilia's.
Some
prescription medicines have been used to help decrease the compulsive
thinking associated with the paraphilia's. Hormones may be prescribed
occasionally for individuals who experience intrusive sexual thoughts,
urges, or abnormally frequent sexual behaviors. Almost always
the treatment must be long-term if it is to be effective.
