Transsexualism is a gender identity disorder (GID) in which there is a strong and enduring desire to live and be accepted as a member of the opposite sex. Transsexuals feel a persistent discomfort with their anatomical sex and a sense of unease in the gender role of that sex. They wish to have hormonal treatment and gender reassignment surgery - a sex change - to acquire the physical characteristics of their psychological sex.
What treatment is there for transsexuals?
The currently accepted and effective model of treatment involves hormonal therapy and surgical reconstruction, and may include counselling and other forms of psychotherapy. The course of treatment depends on the individual's needs, and is usually negotiated between the patient's GP and the psychiatrist and surgeon providing specialist care.
What does hormonal therapy involve?
Male-to-female patients treated with oestrogens can expect to experience: breast growth, some redistribution of body fat in line with a more feminine appearance; decreased upper body strength; softening of the skin; a decrease in body hair; slowing or stopping of loss of scalp hair; decreased fertility and testicular size; and less frequent, less firm erections. Female-to-male patients treated with testosterone can expect the following permanent changes: a deepening of the voice; clitoral enlargement; reduction in breast size; more facial and body hair; and male pattern baldness. Reversible changes include: increased upper body strength; weight gain; increased sex drive; and decreased hip fat.
Are there any rules governing this treatment?
Although there are no legally binding rules, standards of care have been drawn up by the Harry Benjamin International Gender Dysphoria Association (HBIGDA). The association has established standards of care for the treatment of GIDs, which are generally accepted by psychiatrists across the world. These standards are revised to take into account new scientific information, and were last updated in 2001. They provide "flexible directions" for the treatment of transsexuals, which may be modified in line with a patient's particular needs and circumstances. They include minimum eligibility requirements for some procedures, such as the prescription of hormones and sex change operations.
