Transsexualism
Transsexualism is a congenital disease, in which there is a persistent awareness of its belonging to the opposite sex, despite the correct( corresponding to the genetic sex) development of the sex glands and secondary sexual characteristics.
Women's transsexualism is distinguished( in which the genetic and biological sex is female, and the patient feels herself in the male field) and male transsexualism( in which the patient with a set of chromosomes 46, XY and the male sexual organs feels herself to be a woman).
The prevalence of transsexualism ranges from 1 to 35 cases per 100 000 population. Male transsexualism, according to foreign literature, predominates over the female in the ratio of 3: 1, but in our country( for reasons that are not clear yet) there is a directly opposite relationship.
Transsexualism is based on gross violations of the development of brain structures responsible for sexual behavior, which are the biological basis of the so-called sexual center, responsible for the formation of a sense of gender( sexual autoidentification).Previously, there was an opinion that the basis of transsexualism was the excessive formation of hormones of the opposite sex, and in this connection even attempts were made to treat transsexualism with sex hormones corresponding to the genetic sex. However, hormonal examinations have shown that transsexualism has no disturbances in the formation of sex hormones. Until now, there is a claim that transsexualism occurs when trying to educate a child in another aspect, but they also have no basis, because sexual behavior is caused by sexual differentiation of the brain, which occurs before the birth of the child.
Of all the signs of transsexualism, behavior disorders characterized by a sense of belonging to the other sex are at the forefront. Such violations can be seen already at the age of 2-3 years. Such children call themselves the names of the opposite sex, seek the right to wear sexually neutral clothing, but they set the goal of wearing the opposite sex, prefer toys of the opposite sex( girls play machine, and boys in dolls).It is interesting that before the period of puberty in children's groups they are perceived in accordance with their behavior. For example, a transsexual girl is often the "leader" among boys, and the transsexual boy is a favorite "girlfriend" among girls, who, along with other girlfriends, are trusted with all secrets.
The critical period for transsexualism is the period of puberty, when the development of secondary sexual characteristics reaches its maximum, the formation of sexual desire develops, the sensation of life in a foreign, hateful body sharply grows. Extremely acute is the development of genital organs and secondary sexual characteristics, which testify to belonging to an "alien" body. Such children begin to hate the body in which they are, hesitate to undress in the presence of strangers, carefully try to hide the genitals. So, girls bandage the mammary glands, the young men fix the penis to the perineum with bandages. Quite often there are cases when desperate people with male transsexualism decide to self-amputation of the penis or complete self-castration.
The formation of sexual desire corresponds to sexual self-awareness. Thus, in transsexual women, sexual attraction is directed towards women, and in transsexual men - to men. The latter in human society is perceived as a homosexual attraction, but in fact it is not, as, correspondingly, sexual self-awareness, is directed to the opposite sex.
When examining persons with transsexualism, a set of chromosomes corresponds to the biological sex without changing their number and structure. The content of hormones remains within the limits of the age norm of the biological sex.
Confirmation of true transsexualism occurs only after a psychiatric examination. It is necessary to distinguish transsexualism in time from diseases with similar manifestations that can be observed in schizophrenia, endogenous psychoses, organic brain damage. Sometimes for the legalization of their sexual orientation, homosexuals require treatment aimed at changing the sex. If surgery is performed in such cases, then disappointment occurs, because the operated homosexual is no longer interested in his sexual partners.
Treatment of transsexualism involves changing the passport sex, surgical correction of the genitals( plasty of the penis and removal of the mammary glands in the case of female transsexualism, vaginal plastic in case of male transsexualism) and hormone therapy. Hormonal treatment should be started at least 6 months before the surgical correction of the genital organs. With male transsexualism, hormone therapy is carried out in two stages. At the first stage( before the operation), the treatment is aimed at suppressing the male secondary sexual characteristics and developing the organism according to the female type. Combined therapy with estrogen( female sex hormones) and anti-androgenic drugs is used. The second stage is to remove the male sex glands after surgical correction of the external genitalia. Hormonal therapy at this stage, in addition to maintaining secondary sexual characteristics, is aimed at preventing the development of post-stroke syndrome and is of a substitutionary nature. Preparations of female sex hormones are selected individually. Treatment of female transsexualism includes changing the passport sex, surgical correction of the genitals( plasty of the penis), which is carried out in several stages, the removal of mammary glands and hormone therapy. Hormonal therapy is performed with drugs of male sex hormones - androgens. Before the surgical correction of external genital organs, including removal of the ovaries and amputation of the uterus, the criterion for effective hormonal therapy is the complete cessation of menstruation.