They are generally happy with themselves as men, but their desire to become women may increase temporarily under stressful life circumstances. Although some cases may appear to have such origins many transsexual go through a period of transvestite or homosexual behaviour while exploring their true nature. Transsexualism often crystallizes with increasing age, not reaching its greatest intensity until age 40 or 50. A person's chromosomes and reproductive organs cannot be changed to those of the opposite sex. With hormonal treatment and surgery, however, most transsexuals can achieve satisfactory physical appearance and sexual function.
Fertility is lost in the reassignment process.
How are prospective patients assessed for possible reassignment Individuals who have been referred to a recognized gender dysphoria clinic must first be evaluated by a team of doctors and other professionals. A detailed history of gender development from childhood through puberty and thereafter is key to the evaluation. Medical and personal history is also considered, as well as life circumstances and general stability. Additional psychological assessment may be arranged to clarify unanswered questions. Care must be taken to ensure that he or she is a good candidate and that, above all, no harm is done.