THIS paper is a clinical review of a dramatic psychiatric syndrome, characterized by the male's intense desire for sexual transformation by surgical and/or hormonal means, based upon his complete identification with the feminine gender role. The transsexual represents an extreme manifestation of psychosexual inversion, wherein the individual attempts to deny and reverse his biological sex, and pass into and maintain the opposite gender role identification.91 These biological males identify with the feminine role to such an extent that they attempt to share feminine interests, attitudes, behavior, dress, sexual object choice, and desperately strive to approximate the female anatomical structure. This latter aim becomes the single theme of the transsexual's life, and requires the cooperation of the physician. The syndrome is of interest to the surgeon (urologist and gynecologist) and internist (endocrinologist), as well as the psychiatrist, for it is to the
IRA B. PAULY. Male Psychosexual Inversion: TranssexualismA Review of 100 Cases. Arch Gen Psychiatry. 1965;13(2):172–181. doi:10.1001/archpsyc.1965.01730020074009
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