Transvestism

What is transvestism?

Transvestism is a sexual disorder. People who have this disorder are sexually excited by wearing clothes of the opposite sex. Usually it refers to men who dress in women's clothing. This is also known as cross-dressing or dressing in drag. Some men wear a single item of women's clothing such as underwear, while others need to wear makeup and dress entirely as a woman to become excited.

What is the cause?

The exact cause of this disorder is not known. Experts think it may be caused by differences in the brain or nervous system. It might also be related to things such as child abuse or a family history of mental illness. Transvestism usually starts in childhood or adolescence. This disorder tends to be life-long unless treated.

What are the symptoms?

Some homosexual men dress in drag for fun. Some men with a gender identity disorder dress in women's clothing because they want to be women. Neither of these groups are transvestites. Transvestites are heterosexual men who do not wish to be mistaken for women. They are not attracted to other men.

This is considered to be a psychological disorder only when the man meets the following conditions. He:

• is heterosexual
• has intense sexual fantasies, urges, or behaviors when dressing in women's clothing
• is upset by these fantasies, urges, or behaviors or they cause problems in his life

How is it diagnosed?

Your healthcare provider will ask about your symptoms, relationships, medical history, and substance abuse history. He or she may also ask if someone close to you has a history of mental illness.

You may be diagnosed with transvestism if the fantasies, urges, or behaviors cause you distress or keep you from being able to function in school, on the job, or in relationships.

How is it treated?

Insight-oriented psychotherapy, which helps you to understand the reasons for the behavior, can be helpful.

Conditioning therapy can be another way to treat this disorder. There are several kinds of conditioning therapy:

• Biofeedback therapy. You are connected to a machine that gives you feedback with light or sound. You try to keep feedback within a certain range while you are exposed to sexually exciting material.
• Covert sensitization. You first relax and picture scenes that excite you. Then you imagine something negative, such as getting your penis stuck in the zipper of your pants.
• Assisted aversive conditioning. In this form of therapy, the negative event is real rather than imagined. For example, your therapist sprays a bad smell such as ammonia in the air. The goal is for you to link your actions with something negative and avoid both.

When should I seek help?

If your symptoms are causing problems with your daily life, seek help from your healthcare provider or a mental health professional. Transvestism can be a part of a more severe sexual disorder. Treatment can make a big difference in the overall quality of your life. There are many support groups for transvestites and their wives or partners.

For more information, contact:

• National Alliance for the Mentally Ill (NAMI)
  Phone: 1-800-950-NAMI
  Web site: http://www.nami.org
• Mental Health America
  Phone: 1-800-969-6642
  Web site: http://www.mentalhealthamerica.net