A SURVEY OF VARIOUS ASPECTS OF TRANSVESTISM IN THE LIGHT OF OUR PRESENT KNOWLEDGE

N LUKIANOWICZ M.D.

(Continued)

49.

TRANSEXUALISM

Everything said about transvestism is applicable to transsexualism, with the following reservations. 1. It is likely that all transsexualists are homosexual. 2. Transsexualism is a typically male sexual deviation, and there is only one case which might be regarded as female transsexualism...3. The morbid desire "to be a woman" is much deeper in transsexualism, and turns soon into an obsessional urge for a conversion operation.

(((Ed. Note: Again indicating that a lot of psych- iatric conclusions may be based either on inferior or inadequate case histories--I personall know of 4 females who want desparately a conversion operation. 3 of these I have met personally, 1 of them has had both breasts removed and lives and works and is known as a man and a husband. (The wife incidentally is a former male who has been "converted".) These two have lived their reversed roles for over 10 years and appear to be as happy as ordinary couples.)))

Clinically transsexualism may be divided into mild, severe and intermedieate types. In the mild or benign form the patient may be satisfied with a partial "oper- ation" (or self-mutilation), without demanding an official change in his civil status (e.g. the soldier described by Wyrsch; the patient of Grotjahn) or a partial "oper- ation (or self-mutiliation) and an obsessive demand for an official recognition as a member of the opposite sex, but without the desire for any further surgical inter- vention. There seem to be two possible explanations of the mechanism involved. Either the "operation" may re- present an emotional shock, bringing the patient back to reality; or it may act as a strong emotional cathexis, a