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The purpose of this paper is to present the transsexual's problem as a manifestation of orality, rather than a problem of sexuality, and to show its similarities to other presentations of rationalized emotional uncomfortableness of a nonsexual nature. As an issue of increasing interest to psychiatrists, psychologists, social workers, surgeons, endocrinologists, lawyers, clergy, and the popular press, there is a need for a proper perspective in viewing transsexualism and its unconscious motivations. Rather than accepting the problem on its face value as a “puzzling” distinct entity, an attempt will be made here to reduce transsexualism to a common denominator shared by other well-known and frequently encountered problems in psychiatry.
Although the term “transsexualism” was first used as recently as 1949 by Cauldwell,1 the human desire to change identity and assume the role of the opposite gender has been recognized since antiquity. With the increasing acceptance of matters sexual by society and with the recent surge of scientific studies on sex, transsexualism has come to light as a global entity much more prevalent than previously supposed. The incidence of transsexualism has been conservatively estimated2, 3 at one case per 34,000 for males in the general population and one case per 108,000 for females. In its first two and one-half years, the Gender Identity Clinic of the Johns Hopkins University had over 1,500 individuals requesting evaluation for sexual reassignment.4 There are now fourteen gender identity clinics in North America, and many more are in the planning stage. During the past few years, there has been an increasing number of well-qualified and reputable surgeons in private practice here in the United States, who are performing sex reassignment operations apart from these clinics. The Erickson Foundation of New Orleans actively provides free information, help, and direction to anyone serious enough to consider a sex change.
There has been no determinat