I have never treated a patient with a "transsexual" diagnosis (now known as Gender Identity Disorder), and I know little about it.
The case in Germany described in Clayton Cramer's piece, in which a 12 year-old boy is undergoing hormonal treatment in preparation for surgical transformation into a "female," raises the issue. The German Child Endocrinologist says this:
"They are not freaks, nor do they suffer mental illness. They are simply trapped in the wrong bodies. That is why it is best to help them as early as possible and reduce the trauma for them and their families."
Freud made it clear, and he was right, that everyone is psychologically a bit male, a bit female, and, on some level, bisexual. Psychiatrists, and especially psychoanalysts, tend to look for the inner motives for things in general, and to view desires for external change as "externalizations." Just the phrase "trapped in the wrong body" is based on a strange premise. Furthermore, who has the body they really think they want? I was a tomboy myself, refused to wear dresses, and liked guns and sports. However, sometimes things do go awry during early development - before birth - which affect the development of the brain and thus the personality.
I guess all I can say about this is that I'd like to imagine that there could be some "therapy" for a kid like this that would fall short of dreadful physical mutilation. I'd be willing to give it a try.
And, by the way, I do not believe you could do this thing they are doing in Germany in the US: I doubt any physician would be willing to do it at that age. Primum non nocere.
