Sex changes are all done on a purely elective basis, since it is just cosmetic surgery anyway. Transsexualism is a genetic defect, and has been called a disease by more than one expert. Sex changes are NOT simple cosmetic surgery which anyone can elect to have. Surgery is not an option with transsexuals. It is a necessity required to live.
All Transsexuals are gay.
Saying that all transsexuals are gay is no different than saying all men are homosexuals, or that all women are lesbians. And the emotional impact of calling them that is no different than the emotional impact of calling anyone else gay. Transsexual means the same thing as Transvestite. A transvestite is a person who enjoys dressing as the opposite sex, but doesn't want to BE the opposite sex. Transvestites who seek minor surgery to take on more of the secondary sexual characteristics of the opposite sex, while retaining their own genetalia are called transgenderists.