Mother and daughter became father and son: a case report

During later youth, she suffered from psychological problems such as panic attacks and social phobia. After finishing hotel management training, she worked as an educator until she was 25. She stopped working because of psychological and orthopedic problems. In her twenties, she experienced forced sexual contacts with men. However, in her own sexual fantasies she wanted to be a man with a female partner. At the age of 27, she had a relationship with a bisexual woman. Currently, he has a female partner. A diagnosis of GD was established in 2007, thus 3 years after the mother's diagnosis. During the diagnostic phase, no hormonal nor genetic abnormalities were found. She had a normal karyotype 46, XX. In 2008, cross-sex hormone therapy was started. Bilateral subcutaneous mastectomy and endoscopic hysterectomy/ovariectomy were performed in 2009. Because of a postoperative complication after the mastectomy further genital surgery was temporarily postponed. During transition, he felt supported by his family, although his father initially had a hard time accepting his decision. His parents divorced during the transition process. He was informed about his mother's transition when she already was receiving cross-sex hormonal therapy and initially experienced a feeling of loss. However, since transitioning himself, their relationship has improved. Both father and son are doing well now. It is estimated that about one-third of persons with GD has children. 2 The question rises whether children of parents with GD are more likely to show GD themselves. The exact etiology of GD remains unclear although there is a tendency in the more recent literature to focus on biological aspects. With regard to biological factors contributing to the development of GD, research focused on brain structures and genetic factors. The existence of sexually dimorphic brain nuclei has been known for a long time. Several studies revealed that some of these nuclei in transsexuals resemble the nuclei in cis-gendered males and females. Furthermore, these nuclei are considered to be part of a complex network that influences the development of sexual behavior. It should be noted that only one female-to-male transsexual was reported in the referenced work. 3 According to neuroimaging studies that used gonadotropin-releasing hormone analogs to suppress puberty in adolescents with GD, the microstructure pattern of white matter, the gray matter volume of the putamen and cerebral activation patterns in GD persons before treatment seemed to share more features with those of the experienced gender than those of …