HORMONAL THERAPY OF GENDER DYSPHORIA: THE MALE-TO-FEMALE TRANSSEXUAL
Fascination with cross-gender states appears to be intri nsic to being human. The Kevidencc" for the existence of a pope who appeared to be a man but was a fertile woman was recently the subject of the presidentia! address for the Endocrine Society (New & Kctzinger, 1993). Current medical understanding says that gender dysphoria or true rran$scxlla[ism is a neuroendocrine condition of unknown cause, unknown inheritance, and has a preva lence of about 1: 18,000 in the male population (Asscheman, 1989), Trans$cxua[ism has been shown ro be poorly responsive to intense psychotherapy to change the identi ty disturbance. Therefore, treatment of a biological male with female hormones becomes the primary therapy fo llowed by anatomical reassignment after a period of livmg as a woma n.