THERAPY AND PROGNOSIS OF TRANSVESTISM
Therapy
Some transvestites live for years before they seek therapy or before an incident with the law requires them to do so. Others undoubtedly never seek therapy. Some associate with other transvestites, sometimes in bars where they congregate, or by joining a society formed for the purpose of sociability and self-help.
Transvestism is closely related to the hysterical, dissociative phenomenon of dual personality. It is to be expected, therefore, that the symptom of cross-dressing may in some instances undergo spontaneous remission, or that it may go into remission under the influence of some form of psychotherapy, including hypnotherapy, behavioral modification (aversive conditioning), or even religious exorcism. It has been known also to remit, at a time of formidable personal crisis, to a combined therapy of antiandrogen (medroxy-progesterone acetate) plus counseling. However, since transvestism is also a form of addiction—addiction to female clothing—it is not surprising that it has proved singularly resistant to today’s known methods of therapy.
For the most part, the treatment of transvestism is ameliorative and supportive. Often it is necessary as well as wise to include the family in the counseling program. In the case of the married transvestite, effective counseling can ameliorate a separation, if separation is inevitable, and equally well ameliorate continuance of the marital relationship.
Prognosis
The prognosis for complete and permanent remission of symptoms is poor, but not totally negative. The possibility of relapse is such that, in any instance of remission, the patient should be kept in follow-up at least four to six times a year, indefinitely.
Most patients with transvestism will not have a remission of symptoms. They can be helped in rehabilitation, however, to find a modus Vivendi as transvestites.
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