[Transsexualism. Current status of research and clinical practice]

In the past decades the cultural and social status of transsexuals has changed considerably. They have established their own organizations, obtained legal rights and access to health insurance services. The professional point of view has changed as well considerably. Very different personality structures, developmental courses and sexual preferences are described. As differential diagnoses homosexual and transvestitic developments, psychoses, early-onset personality disorders, adolescence crises, culturally induced gender dysphorias, and intersexual disorders have primarily to be considered. In therapy, the old confrontation psychotherapy vs. surgery has widely been relinquished. Patient's age is nowadays much lower. Sex ratio in Germany is approaching for the first time 1:1. So far worldwide a preponderance of biologically male transsexuals is reported. The total number of adult transsexuals in Germany is estimated 2000-4000.