Utilizzo del test di Rorschach nella diagnosi di disturbo dell’identità di genere e nella valutazione dell’idoneità alla riassegnazione chirurgica del sesso

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 suitability for sexual 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 suitability 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 criteria. For this purpose we analysed the Rorschach responses of 47 patients (33 GID and 14 GID NAS). Results show that DIG 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. This research shows that the Rorschach test cannot be used alone in the determination of the differential diagnosis between DIG and DIG NAS in the diagnosis and evaluation of patient suitability for sexual SRS, especially when comparing groups which do not shows significant differences in the prevalence of the main - psychotic, depressive and anxiety - psychopathological disorders