AUTHOR=Morabito Giuliana , Cosentini Dora , Tornese Gianluca , Gortani Giulia , Pastore Serena , Genovese Maria Rita Lucia , Cozzi Giorgio 

TITLE=Case Report: Somatic Symptoms Veiling Gender Dysphoria in an Adolescent

JOURNAL=Frontiers in Pediatrics

VOLUME=9

YEAR=2021

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2021.679004

DOI=10.3389/fped.2021.679004

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> Somatic symptom disorder is common in children and adolescents; usually, it is an expression of a mental health problem or other conditions that lead to psychosocial impairment and suffering. Among these, in pubertal age, gender dysphoria should be considered.</p><p><bold>Case Presentation:</bold> We present the case of a 15-year-old girl admitted to the hospital because of a 2-month history of scattered arthralgia and myalgia, headache, and fatigue, with repeated visits to the emergency room. The physical exam was unremarkable, except for step walking and pain. Repeated diagnostic tests were normal, and consecutive psychological interviews disclosed intense suffering due to a gender incongruence. Referral to the hospital gender service was offered and refused by the parents.</p><p><bold>Conclusions:</bold> In pubertal age, gender dysphoria may be expressed through somatoform symptoms. Diagnosis is challenging to accept for the parents even in the presence of adequate multi-disciplinary hospital services.</p>