IN RECENT years an increasing interest in and concern about sex transformation procedures have been evidenced.1-18 While the number of people who have undergone such modifications in their anatomy is small, the moral, legal, and social problems they raise are highly problematic, intensely controversial, and of the broadest significance.
In our studies of normal and abnormal gender identity we have seen patients who have demanded that their primary and secondary sex characteristics be changed so as to approximate those of the opposite sex. We have noted that a male's demand, for example, for penectomy, testicular castration, construction of an artificial vagina, development of breasts, etc, involves the physician in decisions which are so highly charged in our culture as to make his dealings with such patients very difficult indeed. Having been struck by the intensity of the feelings aroused by such requests, we decided
GREEN R, STOLLER RJ, MacANDREW C. Attitudes Toward Sex Transformation Procedures. Arch Gen Psychiatry. 1966;15(2):178-182. doi:10.1001/archpsyc.1966.01730140066011