Date of Award

Fall 1995

Document Type


Degree Name

Doctor of Psychology (PsyD)



Committee Director

Robert P. Archer

Committee Member

Robin J. Lewis

Committee Member

Donald Epstein

Committee Member

Barbara Cubic

Committee Member

Barbara Winstead


Both clinical experience and empirical data from psychological tests present a picture of extreme clinical variation among those individuals who request gender reassignment surgery. Results of past empirical studies utilizing the MMPI and the Rorschach Test have tended to be equivocal regarding the level and nature of psychopathology associated with samples of gender dysphorics. These past studies are considered limited particularly in terms of methodological problems related to statistical power. This present study examined the nature and degree of psychopathology in a sample of candidates approved for gender reassignment surgery as reflected on their MMPI-2 clinical scale values and scores on selected Rorschach variables (Exner Comprehensive System). This study compared the MMPI-2 basic scale T-scores from the gender dysphoric sample (56 male-to-female transsexuals and 56 female-to-male transsexuals) to T-scores obtained from a general psychiatric adult inpatient sample (n = 112) and T-scores obtained from a normal adult sample (n = 112). The comparison groups were matched for gender and age. The Rorschach data (n = 67) obtained from the same gender dysphoric sample was compared to frequency data of the Nonpatient Adult Sample, the Character Disorder Sample, and the Inpatient Schizophrenic Sample from the published work of John E. Exner. It was hypothesized that MMPI data for the gender dysphoric group would show a lower level of psychopathology when compared to the inpatient psychiatric group, and a higher level of psychopathology when compared to the normal adult group. For the Rorschach data, it was hypothesized that a greater percentage of the gender dysphoric group would exhibit psychopathology when compared to a nonpatient adult group, and a lower percentage of the gender dysphoric group would exhibit psychopathology when compared to a character disorder group. In terms of the initial hypotheses, the transsexuals appeared less deviant than expected on the MMPI and more deviant than expected on the Rorschach. On the MMPI-2, the SRS candidates produced a relatively normal mean profile apart from a clinical elevation on scale 5. The Rorschach findings suggested that SRS candidates are different from the normal population and that transsexualism may be associated with various psychological problems which are characteristic of individuals with a personality disorder. The SRS candidates were less likely to manifest psychotic thinking when compared to the Inpatient Schizophrenic sample. The findings from this study were discussed in terms of power coefficients, opposing theoretical formulations of transsexualism, sample selection, self-presentation, the relationship between the MMPI and the Rorschach, clinical case management, and recommendations for future research.


A Dissertation Submitted to the Faculties of The College of William and Mary, Eastern Virginia Medical School, Norfolk State University, and Old Dominion University in Partial Fulfillment of the Requirements for the Degree of Doctor of Psychology in Clinical Psychology through the Virginia Consortium Program in Clinical Psychology.


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