Gender Dysphoria is a natural condition, abnormal due to its rarity (possibly one in 30,000 being affected by it). It is medically recognized and is also know as Transsexualism. It occurs when individuals identify as being of the opposite gender to their physical sex. They are sometimes described as being gender dysphoric individuals.

This condition occurs in both sexes in roughly equal numbers and experts are virtually certain that it starts while still in the fetal state of development, in other words, one is born with the condition and it usually makes its Presence felt any time after the age of two years. However, it may take great many years before an individual feels sufficiently confident and capable of self- describing the condition to another person. For that reason, it is sometimes misidentified as something that the patient has only recently diagnosed.

This failure to differentiate is the result of an accident in nature, which leaves the bearer with a female brain in a male body, or vice-versa. This condition knows no boundaries and can occur in all levels of the social, economic and educational scale it does not confine itself to any one race or culture and it knows no geographical boundaries. It will not disappear in the face of brutality, aversion therapy or any other form of persuasion. If handled within a family or workplace setting without understanding or support, it can cause intense anguish and emotional upset for all concerned.

Dealing with the condition is possible medically, legally and socially. It is not against the law to "change sex" or gender and many organizations, companies and trade unions recognize its existence and have given comfort and support to their affected employees or members. To help them, some retain legal and medical counselors. More people than ever before are changing successfully on the job, as often the employer already has a substantial investment in the individual and firing provides no answer to anyone's dilemma.

True transsexuals have normal XY (male) or XX (female) sex chromosomes appropriate for their physical gender. There is no laboratory test for Transsexualism. Hermaphrodites and others with ambiguous sex characteristics at birth may or may not develop gender dysphoria. The vast majority of transsexuals, however, have no identifiable physical abnormality.

No. Homosexuals are sexually attracted to members of their own sex but are content with their bodies and have no desire to change them. Gay people may occasionally think that changing their sex would help them feel more socially acceptable. With help, they can come to understand that self-acceptance does not come from a gender change.
Transvestites are men who are preoccupied with crossdressing in women's clothing largely for the purpose of sexual satisfaction. They are generally happy with themselves as men, but their desire to become women may increase temporarily under stressful life circumstances.

Although some cases may appear to have such origins many transsexual go through a period of transvestite or homosexual behavior while exploring their true nature. Transsexualism often crystallizes with increasing age, not reaching its greatest intensity until age 40 or 50.

Not really. A person's chromosomes and reproductive organs cannot be changed to those of the opposite sex. With hormonal treatment and surgery, however, most transsexuals can achieve satisfactory physical appearance and sexual function.

No. Fertility is lost in the reassignment process. Eggs or sperm may be stored by cryogenics, if desired before any hormonal treatments begin if a family may be desired in the future

A team of doctors and other professionals must first evaluate individuals who have been referred to a recognized gender dysphoria clinic. A detailed history of gender development from childhood through puberty and thereafter is key to the evaluation. Medical and personal history is also considered, as well as life circumstances and general stability. Additional psychological assessment may be arranged to clarify unanswered questions. Care must be taken to ensure that he or she is a good candidate and that, above all, no harm is done. If any alternatives to reassignment are considered possible, the clinic will actively pursue these options. It is often the case that individuals initially coming to clinics requesting reassignment discover that there are less drastic possibilities.

Generally, recognized clinics follow the guidelines of the Harry Benjamin International Gender Dysphoria Association, Inc. For a male becoming female, treatment with female hormones is required for at least a year before irreversible surgical steps are taken. This produces changes in the secondary sex characteristics, such as body hair reduction, breast development, and feminization of body shape and skin texture. The time required for acceptable results varies widely from one individual to another. Patients are also required to be living full time as a female for a minimum of one year before surgery is authorized. Many transsexuals choose to have electrolysis to remove facial hair at this time. A few also elect to have cosmetic surgery if distinctly masculine features such as a large nose or jaw is present. When a patient feels ready, she may apply for medical approval of reassignment surgery. The entire clinic team will then review her progress and adaptation to the new role. Surgery may then be approved based on the evaluation, and letters of referral written to the client's selected surgeon.

The actual procedure is considered major surgery. Under general anaesthetic, the testes and erectile tissue of the penis are removed. An artificial vagina is then created and lined with skin of the penis, the nerves and blood vessels of which remain largely intact. Scrotal tissue is then used create labia, and the urethra is shortened and positioned in the female location.

For the female to male patient, the process is similar, although the male hormone, testosterone, is taken by injection or patch (or both) rather than orally. It produces largely irreversibly effects of beard growth and masculine muscle development, as well as a deepening of the voice. For approved patients, the surgical aspects of reassignment are more complex, however. A mastectomy may be authorized as early as six months into the hormone program as it is of significant benefit in helping the patient to appear male in public. At some point after one year the ovaries and uterus are surgically removed. Additional procedures are more costly and difficult to obtain than male-to-female ones, and some patients go no further. For those able and wishing to continue phalloplasty (penis construction) and artificial testes implants are available, as are procedures to create a male urethra and relocation of the clitoris to the head of the penis.

"M-to-F" patients have an easier time and better results with genital surgery, while the "F-to-M" usually has the edge in physical appearance and "passing" in the new role.

No. Male-to-female patients must learn to learn to raise the pitch of their voice to a suitable level. Coaching on inflections and female speech characteristics is often of help.

Many transsexuals feel a tremendous societal pressure to fit in and be "normal." They will go to great lengths to prove their masculinity or femininity. They often deny their dysphoric feelings even to themselves and pursue traditional careers and family situations, outwardly appearing in function will in all respects. Gender specialists do not consider a patient's previous sexual orientation to be of major importance, as this is separate from one's gender identity. Some may continue to have the same orientation after their transition is complete, while for many, their "true" orientation may not emerge until they become a fully functional member of their chosen sex.

The response varies widely with the individual. Some transsexuals face a great deal of rejection, while many have found nothing but acceptance and support about family and friends, even to the point of retaining the same job throughout their transformation. Fortunately for most, the reactions are generally more positive than have been feared. How one presents the news to others has a great deal of bearing on how it is received, and counseling on this and other issues should be considered part of the professional treatment provided.

Patients must be referred, usually by a psychiatrist, family doctor, or social service agency, although different clinics may have varying requirements. There is usually a considerable demand for clinic's services, however, and the applicant should be aware that the waiting list might be many months long.