Delusional misidentification syndromes are rare psychotic disorders, in which the patient believes that the identity of a person, object, or place has been changed or replaced by another. These disorders include Capgras syndrome, Fregoli syndrome, and inter-metamorphosis. Reverse types of misidentification syndromes were introduced to distinguish alteration of the self rather than of others.

Reverse Capgras syndrome refers to the psychological change of the self as opposed to others, while reverse Fregoli syndrome is the delusional belief in which the patient has undergone fundamental changes in physical makeup without any psychological changes, and reverse intermetamorphosis is a variant in which patients believe that they have undergone physical and psychological transformation.

Here we present an interesting case of a transgender woman presenting with delusional misidentification of the self in the context of Schizophrenia. A review of literature, with emphasis on etiological factors, forensic implications and association with violence is presented.

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