Transvestic Disorder

While transvestic disorder involves cross-dressing, it does not necessarily indicate a desire for a different gender identity or sexual orientation. Misunderstandings about this can lead to stigma and misrepresentation. In addition, an individual with transvestic disorder must also experience significant distress or impairment in daily functioning.

Signs and symptoms of transvestic disorder may vary, but some common indicators may include:

• Intense sexual arousal from cross-dressing that often leads to feelings of shame, guilt, or anxiety when these activities conflict with personal or societal expectations
• Difficulty or inability to achieve sexual arousal with a partner unless cross-dressing

Other signs and symptoms related to sexual activity and cross-dressing may include:

• Embodying the opposite sex through cross-dressing
• Developing an erection when cross-dressing

Not all individuals who cross-dress have a psychiatric disorder. Transvestic disorder involves sexual arousal from cross-dressing (transvestism) that causes significant distress or substantially interferes with daily functioning; it differs from healthy, consensual kinks which can involve similar behaviors but without causing personal distress or disruption in daily functioning.

In some cases, those with transvestic disorder may experience the following additional features:

• Compulsive behaviors related to cross-dressing
• Hiding or denying cross-dressing activities due to social stigma or fear of rejection
• Struggles with personal identity, relationships, or social functioning

To be diagnosed with transvestic disorder, an individual must experience intense sexual arousal from cross-dressing for at least six months. In addition, the behaviors, fantasies, and actions associated with cross-dressing must cause distress or other problems in various areas of life, such as work or relationships. 

Although the symptoms and intensity of transvestic disorder can vary from person to person, those affected may seek professional help. Mental health professionals can provide support and help individuals overcome the challenges they experience, depending on how the disorder affects their lives. 

The exact causes of transvestic disorder are not clearly understood, but several factors may be involved, including genetic, psychological, and environmental factors. For example, studies suggest that individuals with a family history of paraphilic disorders, such as transvestic disorder, may have a higher risk of developing the disorder. Genetic factors may also contribute to developing related mental health conditions like gender dysphoria and substance use disorder.

Certain environmental factors may also increase the likelihood of transvestic disorder. For instance, early childhood experiences, such as receiving praise or rewards for cross-gender behaviors, could potentially lead to cross-dressing habits and, eventually, transvestic disorder. In addition, traumatic events might contribute to the development of paraphilias like transvestic disorder. Triggers³ or reminders of traumatic experiences may lead to stronger urges to cross-dress or more distress related to the urges.

Psychological factors may be considered when considering this disorder's development. People with transvestic disorder may often show certain personality traits, such as introversion⁴ or perfectionism. Societal and cultural views on gender roles could also influence the development of the disorder. Being surrounded by a community that doesn't accept or understand people who don't fit “typical gender roles” may cause guilt or shame, including some who experience gender dysphoria, which could worsen symptoms of transvestic disorder.

People with this condition may have fear about seeking treatment,⁵ possibly due to a lack of awareness or stigma about the disorder. The treatment for transvestic disorder usually involves therapy and support. These methods may help reduce the disorder's distress and adverse effects on an individual’s quality of life.

Medication

There are no specific medications approved for treating transvestic disorder. Certain medications may be prescribed to alleviate particular symptoms, such as compulsive behaviors:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), commonly used to treat anxiety and depressive disorders, can potentially reduce obsessive thoughts and compulsive behaviors related to cross-dressing.
• Antiandrogens: In some cases, medications that reduce testosterone levels, known as antiandrogens, may be recommended to decrease sexual arousal associated with cross-dressing.
• Anxiolytics: For individuals experiencing significant anxiety or stress because of their condition, anxiolytic medications may provide short-term relief.

Other treatment options

Additional treatment options may be explored, depending on a person’s needs. These options might include:

• Stress reduction techniques: Practicing relaxation techniques like deep breathing meditation to manage stress related to transvestic disorder may be beneficial. 
• Physical activity: Regularly exercising may support emotional stability and improve mental health, which could improve overall functioning.
• Establishing a support network: Connecting with friends, family, or others may help with the emotional distress of the disorder and offer practical assistance during challenging times.

Despite the available options, there is no established treatment for transvestic disorder due to limited evidence and studies. The treatment of transvestic disorder can be highly individualized and may involve a mix of therapies, support, and medication. 

Individuals seeking support for transvestic disorder may look for various resources. As therapy may be beneficial for managing the disorder, an online therapy platform like BetterHelp may be a convenient way to find mental health support.

In addition to therapy, certain mental health organizations and groups may offer support for individuals with transvestic disorder. These resources may provide a safe and non-judgmental space for people to share their experiences or learn about related problems that can affect all aspects of life. These organizations may include the World Professional Association for Transgender Health (WPATH), Trans Lifeline, Gender Spectrum, and Gender Diversity. However, it can be essential to note that transvestic disorder is different from being trans. 

These support groups may also be helpful for those with transvestic disorder. Local support groups often provide a platform where people can openly discuss their feelings and challenges, be more connected, and learn from others who have faced similar experiences. They can also offer emotional support and practical advice on coping with distress. 

Please see our Get Help Now page for more immediate resources.

Recent studies have assessed the possible causes and potential treatment options for transvestic disorder. One case study looked at a 17-year-old boy with transvestic disorder, obsessive-compulsive disorder (OCD), and bipolar disorder (BD). 

The study discussed how it may be challenging to differentiate between transvestic disorder and OCD, as the urges to cross-dress may be similar to the obsessions and compulsions seen in OCD. Researchers concluded that it can be challenging to diagnose and treat individuals with multiple disorders that could potentially overlap. 

The study notes that there isn’t a clear connection between intelligence and paraphilia and that paraphilias can be considered part of OCD spectrum disorders. The study concluded that treatment for paraphilia can be effective when other coexisting disorders are present.

Below are several statistics on transvestic disorder:

• It has been found that about 3% of men and 0.4% of women have experienced signs of transvestic disorder at least once in their lives. While transvestic disorder predominantly affects men, it can occur in individuals of any gender.
• One study found strong links between sexual orientation and transvestic fetishism, with a lifetime prevalence three times higher among non-homosexuals (69%) than homosexuals (23%).
• Around 62% of men in a cross-sectional study of almost 2,000 men reported experiencing at least one paraphilic-associated sexual arousal pattern (PASAP). PASAP was reported to cause distress in nearly 2% of the cases.
• From a total of 62 adults with primary tic disorders who participated in a survey, it was found that 12.9% reported compulsive sexual behavior and 19.4% reported paraphilic interests.