A doctor in 1996 treated a patient with various behavioral symptoms and a fixation on becoming the other sex with a low dose of the antipsychotic pimozide. This medication did not affect libido or sexual function and did not scar the patient’s body. The medication was fully reversible and gender dysphoria came back when the patient reduced the dose. The gender dysphoria went away again when the dose was increased. The main side effect was daytime sleepiness.
This doctor held space for the idea of true transsexuals, for whom medication would not remove gender dysphoria, but like a responsible physician, this conclusion was one of several possible options in a differential diagnostic tree that explained the surface behavior and belief structure. Then he empirically tested which branch of hte differential this patient happened to fall on, via psychotherapeutic probing and medication trial, and it turned out this patient had a delusion that resolved with antipsychotic medication. Surely this is a better outcome for a given patient than having his genitalia removed.
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Literature Review: Gender Dysphoria Successfully Treated by Antipsychotic Pimozide