OBJECTIVE: The case is reported of a gender dysphoric patient who responded successfully to pharmacotherapy with pimozide.
CLINICAL PICTURE: An adult male patient with a borderline learning disability presented with cross-dressing and a strong wish to undergo a sex change.
TREATMENT: Supportive psychotherapy and pharmacotherapy with pimozide was tried.
OUTCOME: There was an excellent response to pimozide 2 mg daily, with a cessation of both cross-dressing and the wish for sex reassignment. When, after 1 year, the dose was reduced to 1 mg daily, there was a rapid return of the cross-dressing and the wish for sex reassignment. An increase in the dose again led to a remission which has been maintained since then.
CONCLUSION: Pharmacotherapy with pimozide should be considered in cases of doubtful gender dysphoria.