Psychotropic-associated delusional pseudo-gender dysphoria: a case report
Bibliographic record
Abstract
BACKGROUND: Gender dysphoric delusions are reported in about 20-25% of patients with schizophrenia. There have been no previous cases of psychotropics contributing to the occurrence of gender dysphoric delusions or cases where two different types of gender dysphoric delusions occur in the same patient at different times. CASE PRESENTATION: We report on a 30-year-old female with bipolar disorder who after being maintained on sodium valproate and once-monthly paliperidone, experienced side effects in the form of hirsutism (facial hair) and amenorrhea. After discontinuing them, she started reporting that her lower half was female and her upper half was male, then began to identify as "a man trapped in a woman's body" and expressed a desire to undergo gender affirming surgery. Treatment with a clozapine resulted in her identifying once again as 100% female. CONCLUSIONS: This is the first case to report on the contribution of psychotropics in the development of gender dysphoric delusions and is also the first to report on two different types of gender dysphoric delusions occurring in the same patient at different times, with initial delusions of simultaneously belonging to both genders and then delusions of belonging to the opposite gender only.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".