This chapter examines the harmful effects of the practice of transgenderism on the health and functioning of transgenders themselves. It describes the treatment options for both male and female-bodied trans-genders and details the consequences and side effects. The chapter understands the 'ef cacy' of treatment to relate to the degree of improvement in mental health without injury to physical health. The study on forms of hormone treatment concluded that the 'adverse effects of sex steroid therapy are real and apparent' and it states that 'gender reassignmen should not be considered a cure. Surgeons have become active participants in the contemporary epidemic of self-mutilation. In the last decade the transgender surgery industry has diversified considerably and now of ers a wide variety of facial feminisation surgeries (FFS). The inability of many, if not most, of those in the medical profession to accept that physical treatments of transgenderism should be considered professional misconduct is likely to reflect several realities.