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Introduction: Gender identity disorder (GID) is a mental disorder in which gender identity is incongruent with the anatomical sex, in the absence of any clear and defined genetic or biological alteration. The diagnosis of GID as well as the assessment of patient eligibility for sex reassignment surgery (SRS) are prerequisite to the legal recognition procedure. The aim of this study was to evaluate the usefulness of the Rorschach test in differential diagnosis determination and primarily in providing information on patient eligibility for SRS, in the framework of the clinical, therapeutic and forensic psychometric and psychodiagnostic assessment, and according to the World Professional Association for Transgender Health (WPATH) criteria., Materials and Methods: For this purpose we analysed the Rorschach test of 47 patients (33 GID and 14 GID NAS)., Results: Results show that GID NAS patients have greater difficulties in stress control and less adaptability, which could lead to disorganisation, impulsiveness, behavioural disorders, as well as higher levels of situational and chronic stress, with altered thought patterns and uncontrolled ideation, a higher frequency of thought disorders and disturbed relations, with lower quality and less adaptive interpersonal relationships, which are characterized by dependency and aggressive behaviours., Conclusions: This research shows that the Rorschach test cannot be used alone in the determination of the differential diagnosis between GID and GID NAS in the diagnosis and evaluation of patient eligibility for SRS, especially when comparing groups which do not shows significant differences in the prevalence of the main psychopathological disorders.

Polygraphic recordings of nocturnal sleep and hormonal behavior were studied in three male and two female transexual subjects, aged 17 to 26 years, who had required a surgical sex reassignment. The transexual state was assayed by psychological investigations according to the law. All subjects appeared healthy at physical examination and no abnormalities were revealed by basal laboratory data. Chromosomal picture was in accordance with sexual characteristics. Pituitary sella enlargements were excluded by radiographic examination. In each patient two adjustment days were followed by polygraphic recording (EEG,EOG,EMG of chin muscles) of nocturnal sleep and blood drawing for cortisol assay. Blood samples were drawn at 30 minutes intervals for 24 hours, starting from the bedding-time. Hormonal blood concentration were determined by radioimmunoassay. Cosinor method was employed in the analysis of circadian rhythm. In transexual subjects the percentage of sleep intermediate phase, or ambiguous sleep, with reference to total sleep time, was significantly higher than in matched controls.(ABSTRACT TRUNCATED AT 250 WORDS)