Prediction of outcome in transsexualism by means of the defense mechanism test and multivariate modeling: A pilot study

To elaborate the predictive value of the projective method using the Defens e Mechanism Test in a 5-yr. follow-up study of 16 transsexuals, all subject s were approved for sex reassignment surgery and had completed the baseline assessments and the 5-yr. follow-up evaluation. Furthermore, we intended t o create an out come model based on the test data for prior patients wherei n new consecutive applicants for sex change could be tested to predict the outcome in individual cases, Outcomes after five years showed that 62% of t he transsexuals a ere judged as improved in a variety of areas of psychosoc ial functioning, 19% were unchanged, and 19% were worsened. Firstly, the an alysis of the test data confirmed differences between the improved transsex uals and those who were nor. Secondly, sex differences were found, with fem ale-to-male transsexuals having a Letter outcome and being more homogeneous than their male counterparts. Thirdly, there was good correspondence in pr e diction of outcome between the model based on the Defense Mechanism Test and a clinical judgment made by a psychiatrist for two new applicants for s ex reassignment surgery. It appears the Defense Mechanism Test has a predic tive ability for patients with gender-identity disorder.