Transsexuality, also termed 'Gender Dysphoria' is now reaching the point of being reasonably well understood, though many myths and general foolishness about the subject still abound. This document concerns the classic definition of transsexuality, as defined by Benjamin, Money, Green, and so forth. Intersexuality and transgenderism will not be addressed other than obliquely.

IN A NUTSHELL: This is about standard, classical transsexuality.
 

SUMMARY DEFINITION:

Gender Dysphoria, literally a misery with regard to gender, is the condition of being in a state of conflict between gender and physical sex.

A transsexual is a person in which the sex-related structures of the brain that define gender identity are exactly opposite the physical sex organs of the body.

Put even more simply, a transsexual is a mind that is literally, physically, trapped in a body of the opposite sex.

IN A NUTSHELL: Transsexuality means having the wrong body for the gender one really is.
 

GRAND OVERVIEW:

Gender and Sex are very separate things, though the terms are often considered interchangeable by the less aware. Sex is physical form and function while Gender is a component of identity. There can be considered to be some legitimate overlap in that the brain is structured in many sex-differentiated ways, and the brain is the seat of identity. However, with regard to the dilemma of the transsexual, the difference between sex and gender are at the very core of the issue.

A transsexual person, born to all appearance within a given physical sex, is aware of being of a gender opposite to that physical sex. This conflict, between gender identity and physical sex, is almost always manifest from earliest awareness, and is the cause of enormous suffering. It is common for transsexuals to be aware of their condition at preschool ages.

This agony can and does lead to self destruction unless treated. The incredible difficulties that surround achieving treatment are themselves often agonizing, the sum total of which can play havoc with the lives of the gender dysphoric. Indeed, it is apparent that some fifty percent of transsexuals die by age 30, usually by their own hand. This morbidity is known as the
 

Being a transsexual is not something that can be ignored or suppressed forever. Unlike the facinations of  the crossdresser or the partially altered transgenderist, the absolute compulsion of classical transsexualism is a matter of life and death. Social oppression, culturally indoctrinated shame, self loathing, and bigotry slaughter transsexuals. With treatment and support, comes survival and a successful life. The success rate for the treatment of transsexuals is among the highest in medicine.

Transsexuality occurs roughly equally in both physical males and physical females, and is caused by factors (such as a critically timed hormonal release caused by stress in the mother, or by the presence of hormone mimicking chemicals present during critical development) which interfere with fetal development. Transsexuality occurs independently of sexual orientation, and occurs in humans and in other animals, such as apes, monkeys, dogs, cats, rats, and mice, among those studied.

The standard treatment for a diagnosis of transsexuality is to reassign the transsexual to a physical sex congruent with their gender identity, a process involving the administration of appropriate hormones and surgery. The success of this treatment is exceedingly high, and many transsexuals go on to live successful lives. 

Although transsexuality is not the same thing as homosexuality, the two can sometimes occur in conjunction with each other, and there is evidence that both are created by the similar mechanisms, in utero.

Transsexuality differs greatly from the commonly - and erroneously - associated terms "Crossdressing" or "Transvestitism", as well as "Transgenderism".

Whereas transsexuality is concerned primarily with gender identity and the correction of physical form to fit that identity, transvestitism is primarily a sexual fetish that occurs after puberty, and the transvestite has no desperation to redress a physical incongruity. The transvestite gains satisfaction from appearing as the opposite sex only, and the behavior is apparently not rooted in a biological, pre-natal basis, but is learned. Transvestitism, unlike transsexuality, primarily is the activity of males.

A recent term in usage is Transgenderism essentially an empty word conjured up as a neutral label for any individual not conforming to common social rules of gender expression. The term was created to help unite very disparate individuals under a vague commonality of interest in gender, in order to provide a basis for mutual benefit and support within an often violently antagonistic society.

Transgenderism can refer to those who crossdress, those who are intersexed, those who live in the opposite societal role of their physical sex, those who play with gender expression for any purpose whatsoever, and transsexuals as well. While there is potentially great survival benefit in this mutual association labeled as 'transgenderism', the primary function is social and political, and not clinical, despite the efforts of some to legitimize this essentially meaningless term.

The exact number of transsexuals in any given population will probably never be accurately known (the best current estimate is one per 30,000). Because transsexuality is most commonly caused by stress-related hormonal changes in the womb, the number of transsexuals in any society would logically flux, based on the current state of affairs within a generation. There is evidence that more transsexuals are born during times during or following war, for instance. Even so, the condition is fairly rare.

Several interesting physical and mental indications have been statistically shown to occur in relation to transsexuality. One factor is intelligence, the transsexual is on average two standard deviations in intellect greater than the base population, and one standard deviation higher than those defined as homosexual.  This probability of high intelligence is currently not explained, though there are suggestions that it may be the result of the unique and somewhat mixed brain 'wiring' of the transsexual, who may benefit from a combination of male and female structures or functions.

Another curious correlation is creativity, transsexuals tend to possess a high degree of artistic and general creative ability.

Transsexuals commonly show some physical indications of their condition that may cause trouble for them from parents or peers.
The male-to-female transsexual may be slow to develop male sex characteristics such as body hair, voice change, and overall physical development compared to the general population. The Female-to-Male Transsexual may display evidence of masculinization of bone structure, hair, or voice. These traits are generally very subtle, but often present.

There is tremendous social bigotry -and often outright violence- expressed towards the transsexual, and this often makes the life of the transsexual very difficult. Some transsexuals who have completely successful in transition to the appropriate sex therefore choose varying degrees of secrecy about their state and history. Other transsexuals never succeed in transforming physically to the point of being undetectable as transsexuals, and tend to suffer accordingly.

Transsexuals suffer many hurdles to achieve their required correction of the error of their birth. They must face society, the medical establishment, the common loss of all family and friends, the cost of treatment, the extreme difficulty of the required 'half-way' phase of transition which may last up to two years, and the inner turmoil of self-doubt and conditioned self loathing of their condition. It has been estimated (in 1981) that about 50% do not survive the malady, ending up dead by the age of 30, usually by their own hand. Almost all of this morbidity is attributed to the additional burden caused by the violent unacceptance of society, the rejection of family and friends, and the inability to find decent care.

The drive that motivates the transsexual is essentially a matter of life and
death.
 
IN A NUTSHELL: Transsexuals suffer because they are trapped in a body of the wrong sex. This hurts so much that they are driven to fix that problem, or die trying. Transsexuality begins in the womb and occurs in many animals besides man. Transsexuality and homosexuality seem to share a common prenatal causality, but are not the same thing. Transsexuality is sometimes associated with things it is not really related to, such as crossdressing, for social or political reasons.
 

The Natural History Of Transsexuality:

Since transsexuality is caused by hormonal alteration of the nervous system of developing fetuses, and occurs in perhaps all mammalian species, it would be reasonable to infer that it has been around for a very long time. Indeed, since birth defects in general are just part of nature, it would be unthinkable to imagine an era of Man devoid of transsexuals. We have always been, and from time to time, history has recorded that fact.

The only clues we have of paleolithic transsexuals would be by considering the societies of aboriginal peoples still living with stone age technologies. The few left remaining on the earth, in the rain forests of South America, or the remaining unspoiled lands of Africa, all have reverential positions for the transsexuals that are born to them. In such societies, Transsexuals are considered magical, kin to the gods or spirits, and possessed of shamanic powers.

Every society in history has had some name, role or way of relating to the transsexual, from ancient Canaan and Turkey to India, even to the present day.

Examples abound. For instance, in ancient Rome existed the 'Gallae', Phrygian worshipers of the Goddess Cybele. Once decided on their choice of gender and religion, physically male Gallae ran through the streets and threw their own severed genitalia into open doorways, as a ritualistic act.
The household receiving these remains considered them a great blessing. In return, the household would nurse the Gallae back to health. The Gallae then ceremoniously received female clothes, and assumed a female identity. Commonly, they would be dressed as brides, or in other splendid clothing.

In India, ritual practices for transsexual individuals continue to the present day. Called Hijiras, this sect also worship a Goddess, and undergo a primitive sort of sex reassignment surgery. The Hijiras are treated in a rather hypocritical fashion within Indian society however, in that they are both despised and revered at the same time. Hijiras often are paid to attend a bless weddings, and to act as spiritual and social advisors, but are also shunned as less than worthy eunuchs. Yet in other circumstances, such as social situations, they are accorded the status of true females.

The Dine, or Navajos of the southwest United States, recognize three sexes instead of only two. For the Dine, there are Males, Females, and Nadles, which are considered somewhat both and neither. While those born intersexed or hermaphroditic are automatically considered Nadle, physically 'normal' individuals may define as Nadle based on their own self-definition of gender identity. The Nadle once possessed far greater respect before the Navaho were conquered  and their culture all but obliterated by the forced assumption of Catholicism.

Among the Sioux, the Winkte served much the same function, and individuals could assume the complete role of their preferred gender. Physical females lived as male warriors, and had wives, while physical males lived their lives completely as women. In Sioux society no special magic was associated with this, it was just considered a way of correcting a mistake of nature. Winkte would also perform primitive reassignment operations of a sort, and history records the process used by physical males: riding for days on a special hard saddle to crush the testicles and thus effectively castrate the individual.

Being transsexual in ancient cultures took a special form of courage too, even if society may have been embracing of the Transsexed!

Whether it is the Sererr of the Pokots of Kenya, the Xaniths of Islamic Oman, the Mahu of Tahiti, or even the Sekrata of Madagascar, the story is essentially the same: transsexuality was a fact of life, and a place in society was made for the gender dysphoric to be themselves.

The modern classification of transsexuality and the medical intervention of sex reassignment  was first attempted in Germany in 1930. Einar Wegener sought treatment and was operated upon. Afterwards, she lived as Lily Elbe, but alas not for long...the surgery had tragic complications. The first well known, surviving post operative transsexual was American ex-G.I. George Jorgensen, who became Christine Jorgensen in 1953. Christine became the center of a whirlwind of publicity despite an effort to avoid it, and had little choice but to capitalize on the misfortune. Christine became the first 'Media Transsexual' - or as some transsexuals put it 'Transie Martyr' , and suffered both the benefit and curse of fame. Christine starred in several hollywood movies as a result, and became celebrity enough to bring transsexualism out of the closet and into view of post-industrial society.

For decades only the rare individual physician dared treat the transsexual, while the mainstream medical community considered transsexuality to be a mere mental disorder without a biological basis. The first professional to truly try to help transsexuals with compassion and scientific study was Dr. Harry Benjamin. Dr. Benjamin carefully treated and studied the cases of transsexuals, essentially devoting most of his career to the project. The results of his carefully documented studies were published in 1966 in his book "The Transsexual Phenomenon". This work led directly to the benefits that we modern transsexuals enjoy, for it opened the door to serious study of the condition. Currently, the worldwide Harry Benjamin International Gender Dysphoria Association continues his work, and helps to set standards of care for the treatment of transsexuals by the medical establishment.
 
Recent study of brain functioning has shed important light on the causes of transsexuality, and surgical techniques as well as overall treatment continue to improve. Society is slowly becoming accepting once again of the inevitable transsexual in it's midst, and it may well be that the future will hold even greater help for the transsexuals born into future ages.

IN A NUTSHELL: Transsexuals have always existed. In the ancient world, transsexuality was both accepted and respected. Throughout the ages, transsexuals have attempted to correct the error of their bodies, with varying results. The modern, technological world at last provides a real chance for the transsexual to finally, truly correct the errors of Nature.