[Transsexualism--when is gender transformation operation indicated?]

The indications for transformation surgery for transsexuals cannot be defined at one single examination; they gradually become apparent over a period of long-term care lasting a minimum of 1.5 years, beginning with the first contact with the therapist and ending with surgery. Patients who have been well prepared for the sex change over this period usually become socially well integrated after the operation. Positive results do not depend on sexually corrective surgery alone, but on the overall therapeutic package. Although the operation represents the last step in the course of treatment for most transsexuals, surgical correction per se is not the solution for every patient with problems of sexual identity.