TRANSEXUALIDAD Y SÍNDROME DE KLINEFELTER. ¿CARIOTIPO, IMPRESCINDIBLE EN EL PROTOCOLO DE REASIGNACIÓN DE SEXO? A PROPÓSITO DE UN CASO

Objective: To present a case of transsexuality and Klinefelter syndrome, an uncommon association. Case Report: A 32-year-old male patient, who reported discomfort with his phenotype sex and behavioral orientation towards female sexual pattern from early childhood, known and treated by Psychiatry. She came to our practice eight years ago, with manners and feminine appearance, for pharmacological management. Treatment with estrogen therapy and GnRH analogues (Triptorelin 11.25 mg every three months) was indicated. Personal history: Gynecomastia since infancy. Genetic diagnosis of Klinefelter syndrome (46XY/47XXY). Physical examination: Weight 71.5 kg, Height: 1.66 m, BMI: 26 kg/m2, disproportion of body segments with predominance of inferior, gynecomastia grade II, genitalia with scrotal hypoplasia, testicular volume 10 cc both. Patient who initiates transition from man to woman more than 10 years ago, currently integrated into society in her role of female gender, awaiting definitive reassignment of sex. Conclusions: Transsexuality is the condition according to which a person is born with a specific sex but feels and is perceived of the opposite sex. As a consequence he seeks to adapt his body and change his physical appearance, through pharmacological and surgical methods. In our case, the patient has a chromosomal anomaly leading to a primary testicular failure, which in most cases is not associated with gender identity disorders, as reviewed in the literature. Although the chromosomal analysis is not considered transcendental in the management of the sex reassignment, it is imposed as complementary exploration to rule out the association of hormonal alterations that could condition some type of behavioral disorder and other complications.