性同一性障害による自己去勢

A case of self-castration with gender identify disorder

　症例は52歳の男性。妻および子供2人と同居。40歳頃より，女性になりたいとの願望が生じる。日々自己性器への嫌悪が強まり，自宅で陰囊をカミソリで切開後，両側精巣を摘除し投棄した。その後，陰囊部の疼痛と腫脹が増強し，当科を受診した。同日緊急に血腫除去，精索断端の結紮およびドレナージを行った。術後に精神神経科で性同一性障害と診断され，現在外来で経過観察中である。本邦における自己去勢報告例は，本症例を含めて4例のみである。

　A 52-year-old man,with a family consisting of his wife and two children,has desired to be a female for the past twelve years. He cut off his own testes from his scrotum with a razor by himself,because of gradually developed repudiation of his male genitals. He was admitted to our hospital with scrotal swelling and severe pain 3 days after the self-mutilation. Removal of hematoma after a debridement,ligatures of cutting edges of the bilateral spermatic cords was perfarmed at the emergency operation. After the operation,he was diagnosed as gender identity disorder by a psychiatrist.