Management of Gender Dysphoria: A Multidisciplinary Approach

Not often does it happen that once one decides to edit a book, the DSM changes the name of the matter of interest. The initial title of this book was Management of Gender Disease that was then changed to Management of Gender Dysphoria according to the new DSM V defi nition. In this brief introduction, I will try to explain how I have arrived to this moment. My initial knowledge of the ‘problem’ started in 1990 when I encountered my fi rst patient, who at that time we called ‘transsexual’. In that period at the Department of Urology of the University of Sassari , we had experience in operating children affected by ‘male pseudohermaphroditism ’. Surgery often consisted in creating a neo-vagina in little patients who presented external female aspect but in the complete absence of a vagina. As one can easily understand, it is very difficult to operate in such little space as there is the rectalprostatic area especially in such small patients. So I was very happy when 1 day, my teacher and chief, Emanuele Belgrano , told me we had to operate on a … 22-year-old patient. The surgical treatment was very similar, but in this case, he/ she was a healthy biological male who wished to become a female. The surgery was easier, the result was satisfactory, but that day my life changed a lot.