as a man or a woman). Although there are connections between these concepts and facts, neither one "causes" or "determines" the other.

Because "transsexualism" involves, is indeed virtually sy- nonymous with, extensive surgical alterations of the "normal" human body, we might ask what would happen, say, to a man who went to an orthopedic surgeon, told him that he felt like a right- handed person trapped in an ambidextrous body and asked the doctor to cut off his perfectly healthy left arm? What would hap- pen to a man who went to a urologist, told him that he felt like a Christian trapped in a Jewish body, and asked him to re-cover the glans of his penis with foreskin? (Such an operation may be alluded to in I Corinthians, 7:17-18.)

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"But," the medically informed reader might object, “isn't transsexualism a disease? Isn't it in the grandly deceptive phrase of the American psychiatric establishment used to characterize all 'mental diseases' 'just like any other illness.?" No, it is not. The transsexual male is indistinguishable from other males, save by his desire to be a woman. ("He is a woman trapped in a man's body" is the standard rhetorical form of this claim.) If such a de- sire qualifies as a disease, transforming the desiring agent into a "transsexual," then the old person who wants to be young is a "transchronological," the poor person who wants to be rich is a "transeconomical," and so on.

Such hypothetical claims and the requests for "therapy" based on them (together with our cognitive and medical responses to them) frame, in my opinion, the proper background against which our contemporary beliefs and practices concerning "trans- sexualism" and transsexual "therapy" ought to be viewed.

Clearly, not all desires are authenticated in our society as diseases. Why the desire for a change in sex roles is so authenti- cated is analyzed with great sensitivity and skill by Janice Ray- mond in The Transsexual Empire. Arguing that "medicine and

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