TRANSSEXUALISM AND TRANSVESTISM

very much. But at the age of 3 or 4 the child rebelled and wanted to be dressed and treated "like other girls." The parents and two older sisters fought for a son and brother, but finally gave in. To keep peace they allowed the girl's dresses but for a while at least -insisted on regular boy's haircuts. These constituted the most distressing moments in the boy's life. He grew up into an ex- tremely feminine-looking transvestite and transsexualist. He was studied by two groups of psychiatrists. One group recommended the conversion-operation as the only way to preserve the patient's sanity; the other group advised against it as unlikely to solve the underlying psychological problems. In September of this year, however, the patient succeeded in realizing his life's ambition and did have a conversion-operation performed abroad.

I saw him a couple of weeks ago and can only say; so far, so good. He is happier and seems better balanced emotionally than when I saw him two years ago. However, I would make no predic- tion for the future; much will depend upon follow-up therapy.

I am fully aware that I am repetitious, but I feel that occasion- ally there is justification for it. Allow me, therefore, to summarize briefly my opinion: Our genetic and endocrine equipment consti- tutes either an unresponsive, sterile or a more or less responsive, that is to say, fertile soil on which a psychic trauma can grow and develop into such a basic conflict that subsequently a neurosis or sex deviation results.

Or, differently expressed: Our organic sexual constitution, that is to say the chromosomal sex supported and maintained by the endocrines, form the substance and the material that make up our sexuality. Psychological conditioning determines its final shape and function. The substance is largely inaccessible to treatment (except in its endocrine constituent.) The function is the domain of psychotherapy.

LEGAL ASPECTS

The legal aspects of transvestism, transsexualism and conversion- operations will be discussed by Mr. Robert Sherwin. The fear of arrest when they venture out in female dress and the utter frus- tration when they resist the temptation makes life truly miserable for these patients. A comparison to drug addiction readily comes to one's mind. One can only wonder that their neurotic symptoms are often not more pronounced.

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