disturbance of gender identity in which the affected person believes that he or she should belong to the opposite sex. The transsexual male, for example, is born with normal male genitalia and other secondary characteristics of the masculine sex; very early in life, however, he identifies with women and behaves in a manner appropriate to the female sex. His sexual orientation is generally one of attraction to other males. Unlike the male homosexual, however, the transsexual male desires to relate to other men and be treated by them as if he were a normal female.

With the development of successful surgical techniques and hormone therapy, several thousand transsexuals, male and female, have undergone a permanent sex change. Although both male and female transsexuals exist, the male-to-female operation is more common because the genital reconstruction is more satisfactory. The male transsexual's penis and testes are removed and an artificial vagina is created; breast implants may be inserted, although some breast development usually is promoted with the use of feminizing hormones. Female transsexuals may undergo mastectomy and hormone treatments to produce the male secondary sexual characteristics, but attempts to create an artificial penis have not been particularly satisfactory.