What is transsexualism ?

 The first level of expression of transsexualism is cross-dressing (transvestitism).  The second is hormone therapy.  The third is the sex-change operation.  Some authors call this condition "gender dysphoria".   Basically a transsexual man feels like a woman and wishes he could look like one and live like one.  The inverse, female-to-male transsexualism, also occurs,   less frequently.  I feel a bit uncomfortable with the term "gender dysphoria",  and yet recognize its utility as well.   The term literally means dissatisfaction with the sexual appearance of one's body.  So in fact, the term highlights the plight of transsexuals,  since the only full liberation available to them is major surgery and lifelong hormone treatment  -not to mention the necessity of rebuilding one's interpersonal life.   On the other hand,   some transsexuals have expressed extreme satisfaction after having "changed" their sex,  so that I find the term "gender dysphoria" a bit superficial since it does not necessarily apply.   Research on transsexuals (Doorn, Poortinga et Verschoor, 1994) has found that the condition manifests itself far earlier than does sexual orientation (homosexuality or heterosexuality).  Prevalence of transsexualism is estimated, based conservatively on surgical sex changes, at one case in 22,100 births (Bakker, Van-Kesteren, Gooren et Bezemer, 1993).   The same study determined that males are more often transsexual than females by a factor of 2.5. Most transsexuals identify themselves as such,  and can usually be so identified by others,  during the preschool years.  The relation between sexual identity and sexual orientation is not as simple as one would think.   One would expect that if a man feels like a woman inside,  then he will be attracted to men in a manner similar to the way women are  -especially if he undergoes the sex-change operation.   We would expect the inverse for transsexual women of course.   However,  one study (Devor, 1993) found that only about forty percent of operated transsexuals had more sexual relations with people of the opposite genotype and body phenotype!  However, as if this weren't complicated enough,  a sizable proportion of the sexual partners of transsexuals are homosexually oriented (see Dickey et Stephens, 1995).  Finally, it is not unusual for transsexuals to be sexual partners autres (Blanchard et Collins, 1993).   What I make of this is that with the uprooted life and ambiguous anatomy of transsexuals,  they often end up with sexual partners who have high tolerance for sexual ambiguity or atypicality and cultural disparity.   However it has clearly been documented that some transsexuals actually have a sexual identity of the opposite sex (by definition) and a homosexual orientation within this sexual identity.   One study documented, very explicitly, two cases of genotypic men, who felt and lived like women,  and were sexually attracted, very preferentially, to women.  The proportion of such cases is increasing with each survey,  such that the latest most credible surveys indicate that 50% of genotypically male tanssexuals are sexually attracted primarily to women.  This proves that there is a substantial difference between, and dissociability of,  sexual orientation and sexual identity. According to Ray Blanchard,  evidence indicates that bisexual, asexual, and heterosexual male gender dysphorics are similar to each other (the autogynephilia type), and dissimilar to homosexual male gender dysphorics (the androphilia type), with regard to a history of transvestic fetishism, degree of recalled childhood femininity, age at clinical presentation, extent of interpersonal heterosexual experience, and a history of erotic arousal in association with the thought of being a woman (for details, see Blanchard, 1985, 1988, 1989a, 1989b). 

I am saddened to have to say that very  little is known about the biological basis of transsexualism.  Surely the major difficulty preventing rapid advance of our neurobiological knowledge of transsexualism is the fact that it would be extremely difficult,  if not silly or just crude,  to try to develop an animal model of sexual identity.  There are of course a large array of sex-specific behaviors,  often very different from one species to the other,  but these are usually related to reproduction (territorial, parental, sexual behaviors).   At any rate,  the most interesting aspect of human transsexualism,  the subjective gender dysphoria,  cannot be estimated,  nor does it probably exist, in lower animals.

  The first level of expression of transsexualism is cross-dressing (transvestitism).  The second is hormone therapy.  The third is the sex-change operation.  Some authors call this condition "gender dysphoria".   Basically a transsexual man feels like a woman and wishes he could look like one and live like one.  The inverse, female-to-male transsexualism, also occurs,   less frequently.  I feel a bit uncomfortable with the term "gender dysphoria",  and yet recognize its utility as well.   The term literally means dissatisfaction with the sexual appearance of one's body.  So in fact, the term highlights the plight of transsexuals,  since the only full liberation available to them is major surgery and lifelong hormone treatment  -not to mention the necessity of rebuilding one's interpersonal life.   On the other hand,   some transsexuals have expressed extreme satisfaction after having "changed" their sex,  so that I find the term "gender dysphoria" a bit superficial since it does not necessarily apply.   Research on transsexuals (Doorn, Poortinga et Verschoor, 1994) has found that the condition manifests itself far earlier than does sexual orientation (homosexuality or heterosexuality).  Prevalence of transsexualism is estimated, based conservatively on surgical sex changes, at one case in 22,100 births (Bakker, Van-Kesteren, Gooren et Bezemer, 1993).   The same study determined that males are more often transsexual than females by a factor of 2.5. Most transsexuals identify themselves as such,  and can usually be so identified by others,  during the preschool years.  The relation between sexual identity and sexual orientation is not as simple as one would think.   One would expect that if a man feels like a woman inside,  then he will be attracted to men in a manner similar to the way women are  -especially if he undergoes the sex-change operation.   We would expect the inverse for transsexual women of course.   However,  one study (Devor, 1993) found that only about forty percent of operated transsexuals had more sexual relations with people of the opposite genotype and body phenotype!  However, as if this weren't complicated enough,  a sizable proportion of the sexual partners of transsexuals are homosexually oriented (see Dickey et Stephens, 1995).  Finally, it is not unusual for transsexuals to be sexual partners autres (Blanchard et Collins, 1993).   What I make of this is that with the uprooted life and ambiguous anatomy of transsexuals,  they often end up with sexual partners who have high tolerance for sexual ambiguity or atypicality and cultural disparity.   However it has clearly been documented that some transsexuals actually have a sexual identity of the opposite sex (by definition) and a homosexual orientation within this sexual identity.   One study documented, very explicitly, two cases of genotypic men, who felt and lived like women,  and were sexually attracted, very preferentially, to women.  The proportion of such cases is increasing with each survey,  such that the latest most credible surveys indicate that 50% of genotypically male tanssexuals are sexually attracted primarily to women.  This proves that there is a substantial difference between, and dissociability of,  sexual orientation and sexual identity. According to Ray Blanchard,  evidence indicates that bisexual, asexual, and heterosexual male gender dysphorics are similar to each other (the autogynephilia type), and dissimilar to homosexual male gender dysphorics (the androphilia type), with regard to a history of transvestic fetishism, degree of recalled childhood femininity, age at clinical presentation, extent of interpersonal heterosexual experience, and a history of erotic arousal in association with the thought of being a woman (for details, see Blanchard, 1985, 1988, 1989a, 1989b). 

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I am saddened to have to say that very  little is known about the biological basis of transsexualism.  Surely the major difficulty preventing rapid advance of our neurobiological knowledge of transsexualism is the fact that it would be extremely difficult,  if not silly or just crude,  to try to develop an animal model of sexual identity.  There are of course a large array of sex-specific behaviors,  often very different from one species to the other,  but these are usually related to reproduction (territorial, parental, sexual behaviors).   At any rate,  the most interesting aspect of human transsexualism,  the subjective gender dysphoria,  cannot be estimated,  nor does it probably exist, in lower animals.