目的：本文報告三例合併出現憂鬱症之變性慾患者的心性發展史，及門診中接受治療之經過。並回顧文獻，討論變性慾患者治療原則及精神科醫師如何參與協同治療。 病例報告：個案一，16歲男向女 (male to female) 變性慾患者，因憂鬱症狀，拒絕求學而前來求診。個案二：21歲男向女 (male to female) 變性慾患者，亦因重鬱症及自殺意念求診。個案三：25歲女向男 (female to male) 變性慾患者，已接受變性手術，結果良好，但四年後出現憂鬱症狀及自殺意念。三個案之憂鬱症狀及適應情況在藥物合併心理治療後，均有顯著改善。 結論：對變性慾患者的術前評估，精神科醫師除了決定接受手術的適當性，必需注意合併的精神症狀並加以治療，例如憂鬱症等等，我們同時也強調對此症患者變性手術後的追蹤。

　　　　　Objective: We report psychotherapeutic outcome for three transsexual patients with depressive disorder, and review the literature in the context of therapeutic strategies. Case Reports: A 16 year-old male-to-female transsexual patient (Case A) sought psychiatric help due to depressive mood and truancy. Case B was a 21 year-old male-to-female transsexual patient who visited our out-patient department to seek treatment for depressive mood and suicidal ideation. A 25 year-old female-to-male transsexual patient (Case C) developed suicidal ideation and dysphoric mood after four years of successful sex-reassignment surgery. All of these patients improved significantly after receiving a combination of pharmacotherapy and psychotherapy. The surgical conversion been completed for only one patient, Case C. Conclusion: Psychiatric assessment for transsexual patients should be an ongoing process which not only determines their suitability before the sex-reassignment surgery, but also detects and treats concomitant psychiatric symptoms after the operation.