New Onset Psychosis Following Abrupt Discontinuation of Hormone Replacement Therapy in a Trans Woman

Estrogen and related hormones have a significant role to play in the etiology and the treatment of psychotic illness. Here we present the case of a 38-year-old immigrant trans woman referred for management of first onset psychotic symptoms following abrupt discontinuation of female hormonal therapy first started in adolescence. The patient's symptoms progressed to catatonia, but were eventually treated with significant success by a combination of clozapine, estradiol and medroxyprogesterone.