A 38-year-old married, exclusively heterosexual man dresses in women's clothing several times a week. Cross-dressing produces sexual arousal, followed later by guilt and marital conflict because his wife disapproves strongly. He has no wish to live permanently as a woman and no discomfort with his male anatomy. What is the most likely diagnosis?

• A Gender dysphoria in adults
• B Fetishistic disorder
• C Dual-role transvestism
• D Transvestic disorder ✓

Explanation

Transvestic disorder is defined by recurrent sexual arousal from cross-dressing over at least six months, causing distress or impairment, typically in heterosexual men. The absence of any desire for permanent transition or rejection of his assigned sex rules out gender dysphoria, the strongest distractor. Fetishistic disorder requires arousal from non-living objects other than garments worn for cross-dressing, and dual-role transvestism is an ICD category involving wearing clothes of both sexes without sexual arousal.

Reference: Kaplan and Sadock's Synopsis of Psychiatry, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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