Clinical observations suggest that male-to-female (MTF) transgendered individuals often use contragender-negative reinforcement to conceal their transgender feelings from others and to support the rejection of these transgender feelings within themselves. However, this remains a theoretical construct that does not appear to have been addressed in research. As a means of controlling, concealing, or compensating for these feelings, the person may exhibit an exaggerated transgender negativity, a general disdain for sexual diversity, or may exhibit hypermasculine behaviors that serve as a facade to conceal his internal feminine feelings. He may make commitments in his male gender role that are difficult to alter at a later time in his life, when making changes toward a female gender role may appear more desirable. These early decisions become obstacles to change and become a significant factor in the timing of when the person will address his transgender identity. They also make the treatment process more complicated.