Traditionally, gender identity disorder (GID) is associated with high level of psychiatric comorbidity, particularly psychotic and affective disorders. The aim of this study is to evaluate clinical aspect of GID in a sample of patients in charge of the Operative Unit for Diagnosis and Therapy of GID, Psychiatric Clinic and the Department of Endocrinology, University of Cagliari.

Assessment was made by SCID-I, for Axis I comorbidity, GAF, for global functioning, BUT for body discomfort (BUT-A measures different aspects of body image, BUT-B looks at worries about particular body parts).

The sample comprised 14 MtF (56%) and 11 FtM (44%), of age between 17–49 years; a diagnosed psychiatric disorder was reported in 32%: 16% mood disorders, 12% anxiety disorders, 4% psychotic disorders. Among subject with GAF < 85, 58.3% were identify to have a Axis I disorder compare to 7,7% patients with GAF ≥ 85 (P = .011), especially for mood disorders (P = .039). Main score of Global Severity Index (GSI) for BUT-A was 2.45 ± 883; all subjects had a score GSI > 1.2 (clinically relevant discomfort index).

Regarding BUT-B, MtF have higher scores in PSDI global scale (3.37 ± .577; P = 0.019) and subscale VI (4.38 ± 1.496 vs. .81 ± 1.864; P = 0.006): there are not significant gender differences in the others subscales, although discomfort regards different aspects of both sexes.

According to literature, we observed a slightly higher prevalence of Axis I psychiatric disorders compare to general population, with functioning level statistically significant.

Generally, GID was not associated with higher level of psychopathology, appearing as specific diagnostic aspect, where the main origin of discomfort is dissatisfaction toward self-body imagine.