[Transsexualism--an extreme form of sexual identity disorder]

Transsexualism is the most extreme form of disturbed sexual identity. The sufferer identifies him or herself completely with the opposite sex. In many cases, the delusional and painful urge to belong to the opposite sex is so pronounced that the sufferer is at risk from autoaggressive and suicidal activity. Stimulated and supported by the possibilities offered by modern medical-technical advances, most transsexuals now seek a sex change by means of hormonal and surgical treatment. Patient satisfaction after the complicated, high-risk and irreversible procedure of sex change treatment is variously assessed. Recently, there have been reports on successful psychotherapeutic treatment of transsexuals resulting in the preservation of the biologically given sex. In the present article, attention is drawn to the sociocultural change in transsexualism throughout the course of history, to the hypotheses resulting from research into causes, and to diagnostic criteria and therapeutic approaches.