Aim The aim of the paper was to present the basic data about delusions of sex change and body dysmorphic disorder and describe two cases of patients with these symptoms and paranoid schizophrenia Method Analysis of the course of illness and medical documentation, Results Coexisting of transsexualism and schizophrenia cause a lot,of doubt Moreover, delusions of sex change are probably more frequent than It is thought It causes that in some cases the differential diagnosis of psychosis and gender identity disorders may be very difficult Treatment of transsexuals is on one hand connected with expected effects but on the other hand with many serious, often irreversible health consequences That is why the differential diagnosis of transsexualism and schizophrenia should be made carefully and thoughtfully Body dysmorphic disorder can appear as nonpsychotic or psychotic disorder The delusional variant can cause diagnostic and therapeutical problems as well as diagnostic Mistakes Sometimes people suffering from this disorder can be diagnosed as having schizophrenia It usually takes place when psychotic symptoms, obsessions and compulsive activities connected with hiding of the imaginary look problem significantly distort everyday functioning Conclusions Rare, atypical psychopathological symptoms can coexist with schizophrenia In this situation it is necessary to act carefully and precisely to make a proper diagnosis