Orthognathic Surgery for Patients with Gender Identity Disorder

Abstract

Gender identity disorder （GID） is defined as “a condition in which biological gender （sex） does not match gender self-consciousness or gender identity.” One of the main symptoms is “dislike or avoidance of one’s gender.” That is, GID patients will want to acquire physical characteristics that are closer to their gender identity. Facial morphology centered on the maxilla and mandible is one such characteristic. The present case was a 51-year-old man. He visited Tokyo Dental College Suidobashi Hospital with the chief complaint of “wishing to improve prognathism and facial asymmetry”. We started surgical orthodontic treatment to improve the patient’s occlusion and facial esthetics, but along the way, it turned out that the patient was being treated for GID. As orthognathic surgery, Le Fort Ⅰ osteotomy and sagittal split ramus osteotomy were performed to improve facial asymmetry and mandibular prognathism. The patient then underwent sex reassignment surgery （SRS） abroad. The patient is continuing to visit our hospital. Here, we report on considerations when planning orthognathic surgery for GID patients, which is expected to increase in the future.