Gender Identity Disorders and Bipolar Disorder Associated With the Ring Y Chromosome – Faycal Mouaffak, M.D., Thierry Gallarda, M.D., Nicolas Baup, M.D., Jean-Pierre Olie, M.D. and Marie-Odile Krebs, M.D., P.h.D.

To The Editor: Gender identity disorder is a rare condition of atypical gender development in which there is a subjective perception of self in opposition to an individual?s gender. The lifetime prevalence of mood disorders comorbidity with gender identity disorder is approximately 45% (1). We report the case of a patient carrying a Y chromosomal abnormality associated with gender identity disorder and comorbid bipolar II disorder.

“Mr. G” was a 31-year-old, single, bank manager who was first referred in May 2000 for depressive symptoms and suicidal thoughts precipitated by the accidental death of his sister and the failure of a heterosexual relationship. His personal history was marked by delayed language acquisition and virtually no social or familial interactions during his school years and after, except for a symbiotic relationship with his sister. His limited social abilities contrasted with his remarkable skills in mathematics and an early inclination for electronics. During the interview, Mr. G revealed his desire since childhood to be a woman, and he asked for a sex change operation. Gender identity disorder was diagnosed. After a few months, Mr G experienced a hypomanic episode with mood lability and began wearing eccentric women?s clothing in public and insisted on receiving female sex steroid hormones and sex change surgery.