50.

a symbolic expiation of guilt (like an attempted suicide), thus relieving the aggressive and hostile feelings towards his own genitalia. The rationale in the second group may be the gaining of a stronger "barganining position" with authorities, presumably with the following line of reason- ing. "Look here, I am physically no more a male; now it is easier for you to recognize and sanction it."

In the severe or malignant form the individual would be satisfied with nothing else but a complete conversion operation and an official recognition of his "new" civil status. When frustrated in his obsessive demand for the surgical "correction" of his "wrong" sexual organs, a transsexualist may attempt to mutilate himself.

The intermediate type of transsexuallism probably consists of cases of very slowly developing transsexual- ism, presenting for years a typical picture of a "mere" transvestism, and turning eventually into transsexualism often under the impact of publicity on cases of the "change of sex".

(((Ed. Note: The author overlooks those individuals who have been TVs for a long time and frustrated in their desires to be able to go about publicly dressed in female attire, who finally, tired of the fight, decide that the only way they can live their own lives without fear of prosecution is to cease being "males". The author has known several such cases. If society had given them the freedom that such persons enjoy in France for example, he would have been content to retain his male organs and simply live wholly or par- tially as a woman. This brings to mind the thought that of all of the cases of "sex change" that I have read or heard about, which is quite a few, I dont re- call ever hearing of a French case. Interesting, if true, dont you think?)))

The extreme rarity of such cases justifies a brief survey. Only 3 such cases are known (though they were not recognized as such by authors who reported them.)