Gender Dysphoria: Development, Research, Management

In the decade-and-a-half since I coedited Transsexualism and Sex Reassignment (Green & Money, 1969), remarkable changes have occurred with Harry Ben- jamin's "transsexual phenomenon" (1966).

Formerly, when writing about this condition in scientific journals, it was necessary to define the term transsex- ualism.

Now the lay public recognizes it. Even the American Psychiatric Asso- ciation acknowledges it as a "disorder," with its inclusion in the Third Edition of its Diagnostic and Statistical Manual (1980).

Although this "elevation" to the status of mental illness may seem a Pyrrhic victory, it is a recognition of the legitimacy of transsexual ism as a source of human suffering.

The controversy that surrounded the decisions in the early patient cases to perform sex-change surgery has largely dissipated.

The cries of "collusion with delusion," principally from psychoanalysts, have quieted.

The dire predictions of psychosis and/or suicide following surgery as the "last psychic defenses are cut away" have almost never been realized.

By contrast, many postoperative patients consider the surgery to have been life-saving.

Medical centers worldwide have incorporated programs for evaluating and treating persons requesting sex reas- signment.

Elaborate guidelines for patient management have been developed by an international organization of health care professionals (Harry Benjamin Inter- national Gender Dysphoria Association, 1981).

Harry Benjamin's child has come of age.