Transsexualism – a discrepancy between the officially registered sex and gender identity (awareness of belonging to a certain gender); the desire to live and be perceived by others as a person of the opposite sex, traditionally accompanied by a feeling of discomfort from one’s anatomical sex or a feeling of inappropriateness of one’s gender; the desire to undergo surgery or receive hormonal treatment in order to achieve, as far as possible, compliance with the preferred sex. There are male and female transsexualism. Epidemiology. The prevalence in men and women is 30:1 and 6:1, respectively. Approximately 1 in 30,000 men and 1 in 100,000 women seek to change their gender by surgery. Risk factors

    • Overly cold, formal relationship between parents
    • Frequent severe punishment in childhood
    • Excessive compliance of parents in raising a child
    • Parents taking advantage of their child
    • Education in conditions of cruelty, hostility
    • Insufficient emphasis on internal and external sexual characteristics in the process of education.


    • A strong and enduring sense of belonging to the opposite sex (not just a desire to take advantage of the culture’s benefits for the other sex).
    • Toddlers
    • A persistent and powerful desire to be or be perceived as a person of the opposite sex
    • Boys have a preference to wear women’s clothes or things resembling women’s; girls have an insistence on wearing only men’s clothes
    • A strong and persistent preference for playing the role of the opposite sex in children’s games or fantasies, representing oneself as a person of the other sex
    • Intense desire to take part in games or pastimes typical of the opposite sex
    • Significant preference for playing with children of the opposite sex.
    • In adolescents and adults, the disturbance manifests itself in a pronounced desire to be a person of the opposite sex or the use of female cosmetics by men, the desire to live and be perceived as a person of the opposite sex.

or a belief that he or she feels and reacts as a person of the opposite sex.

    • A persistent feeling of discomfort associated with one’s gender, or a feeling of inappropriateness of the sexual role associated with one’s belonging
    • In boys, a statement that their penis or testicles are disgusting or that they will disappear, or a statement that it would be better if there were no penis; aversion to typical games, toys for boys and male activities
    • In girls, refusal to urinate while seated, assertion that she has a penis or wants it to grow, or assertion that she does not want her breasts to enlarge or menstruation, and marked distaste for feminine attire .
    • In adolescents and adults, the disorder manifests itself in the desire to get rid of their primary and secondary sexual characteristics (for example, the demand for hormonal treatment, surgery, or other procedures to change their sexual characteristics in order to become like a person of the opposite sex) or the belief that their birth as male or female is false.

differential diagnosis;

    • Schizophrenia
    • Transvestism
    • Homosexuality.


    • Surgical gender reassignment. Mandatory conditions for surgical intervention: a consistently high level of adaptation in the bulk of spheres of life; stable, active and energetic personality; absence of comorbid mental disorders and other disorders of sexual behavior
    • After surgery – appropriate correction of gait, motor skills, voice
    • Appropriate hormone therapy (androgens or estrogens)
    • Psychotherapy.

ICD. F64.0 Transsexualism

Literature. Pathology and gender correction. Kirpatovsky ID, Golu-

beva IV. M.: UDYa., 1992

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