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Introduction Transsexualism is a gender identity disorder soon to be removed from the DSM criteria for mental disorders. The actual developmental/congenital origin of the disorder has yet to be established. One of the theories involves morphological and neuro-hormonal modification in the corpus callosum as a possible substrate. Objectives Diagnostic assessment of a 22 year old female - male transsexual patient with a history of agoraphobia and migraine, reporting intermittent symptoms of numbness of left side of body and cheek and headaches. Method Data on personal/family history was obtained and neurological examination was performed. MRI scan was acquired with a 1.5 T Siemens Magnetom system with a standard head coil. Sagittal three-dimensional 3D RAGE, contiguous 1.0 mm slices, 1 acquisition sequences were obtained. Results and discussion: Family history of anxiety disorder was confirmed. Symptoms appeared following reduction of anxiolytic medication and emotional crisis. Neurological status showed signs of left pyramid deficit. NMR scan findings showed bilateral arachnoid cysts in genu corpus callosum probably of congenital origin. Co-morbidity versus concomitant disorders of psychiatric, neurological and congenital origin were discussed.