Phenomenology of ideas of gender change in patients with schizotypic disorder

Objective: a psychopathological analysis of the ideas of sex change and a description of the state of the sexual sphere in patients with schizotypal disorder. Materials and methods: we examined 38 patients who applied with a request to change their passport sex and were diagnosed with schizotypal disorder, 27 of them were women, 9 were men. Methods: clinical-psychopathological, sexological. To assess the sexual sphere and identify the motivation for changing sex and plans for the future a specially designed questionnaire was used. Results: variants of the ideas of gender reassignment were identified: obsessive, fixed, dominant, overvalued, delusional, their features specific to schizotypal disorder were described. For each variant, varying degrees of severity of violations of criticality and features of sexual behavior are described. An analysis of the characteristics of the sexual sphere of the studied groups showed the predominance of delays in psychosexual development and the associated deactualization of this sphere. In order to characterize the ability to adequately assess one's state, it is necessary to assess criticality as a variant of capacity, the issue of its methodology needs to be developed. Conclusions: the selected options differ in the degree of violation of criticality, which should be taken into account when deciding whether to change the passport gender.