We report the case of a 32-year-old male transsexual patient with unipolar mania. Since the onset of his affective psychosis, alternating states of male and female identification were observed. The patient himself behaved as a woman only in manic phases. Possible relations between transsexuality and affective psychosis are discussed, together with a short review of the literature, especially psychodynamic theories on the genesis of transsexuality.
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