Paul Kirk reports ransvestites are almost always men and very often hetero-sexual. They enjoy dressing as women either some of the time or permanently. They may dress up in full female regalia in public or in private. They might also be quite satisfied by wearing a single item of female underwear beneath normal male clothing. They may or may not dress as the opposite sex but are unhappy with their sex organs and may often mutilate themselves.
Transexuals frequently suffer from severe anxiety and depression.
A trawl through the Internet reveals a number of hospitals that offer gender reassignment surgery. The operation is not called a sex-change in medical parlance as it cannot completely alter the sex of the patient. Gender reassignment surgery usually requires the approval of at least three psychiatrists. Potential patients are also usually expected to have been under counselling for at least two years. A number of institutions also expect patients to have lived as a woman for a period of time.